Croup is a common respiratory illness that affects young children, usually between the ages of 6 months and 3 years. It is caused by a viral infection and is characterized by inflammation of the larynx (voice box) and trachea (windpipe), which can cause difficulty breathing and a distinctive barking cough.

The symptoms of croup can come on suddenly and include a hoarse or barking cough, a high-pitched whistling sound when breathing in (called stridor), and difficulty breathing. In severe cases, the child may have trouble getting enough air and may turn blue, which is a medical emergency.

Croup is usually a mild illness that can be managed at home with rest, hydration, and over-the-counter medications to relieve fever and pain. In some cases, a healthcare provider may prescribe medication to reduce inflammation and improve breathing.

Most children with croup recover within a week, but in some cases, the illness can be more severe and require hospitalization. Parents and caregivers should seek medical attention if the child's breathing becomes more difficult, the child develops a high fever, or they are concerned about the child's condition.

Prevention of croup is difficult, as it is caused by a viral infection that is spread through respiratory droplets. However, good hygiene practices, such as frequent hand washing, can help reduce the risk of infection.

Croup is usually caused by a viral infection, most often a parainfluenza virus.

Your child may contract a virus by breathing infected respiratory droplets coughed or sneezed into the air. Virus particles in these droplets may also survive on toys and other surfaces. If your child touches a contaminated surface and then touches his or her eyes, nose or mouth, an infection may follow.

To prevent croup, take the same steps you use to prevent colds and flu.

• Frequent hand-washing is the most important.
• Keep your child away from anyone who's sick.
• Encourage your child to cough or sneeze into his or her elbow.

To stave off more-serious infections, keep your child's vaccinations current. The diphtheria and Haemophilus influenza type b (Hib) vaccines offer protection from some of the rarest — but most dangerous — upper airway infections. There isn't a vaccine yet that protects against parainfluenza viruses.

The majority of children with croup can be treated at home. Still croup can be scary, especially if it lands your child in the doctor's office, emergency room or hospital. Treatment is typically based on the severity of symptoms.

Comfort measures

Comforting your child and keeping him or her calm are important, because crying and agitation worsen airway obstruction. Hold your child, sing lullabies or read quiet stories. Offer a favorite blanket or toy. Speak in a soothing voice.

Medication

If your child's symptoms persist beyond three to five days or worsen, your child's doctor may prescribe these medications:

• A type of steroid (glucocorticoid) may be given to reduce inflammation in the airway. Benefits will typically be felt within a few hours. A single dose of dexamethasone is usually recommended because of its long-lasting effects.
• Epinephrine also is effective in reducing airway inflammation and may be given in an inhaled form using a nebulizer for more-severe symptoms. It's fast acting, but its effects wear off quickly. Your child likely will need to be observed in the emergency room for several hours before going home to determine if a second dose is needed.