What is croup? The ultimate guide to the barky cough

If your little one starts coughing in the middle of the night - and it sounds somewhat similar to a barking seal - it can be an incredibly scary moment for parents and caregivers. There is a chance your child is experiencing croup. Although it is hard to quantify the number of children who experience croup each year, it is an illness we are seeing frequently in the Emergency Department, and more frequently now that winter has arrived in Victoria.
Time to take a deep dive - what is croup, how to spot it, and when it is time to get a medical assessment.

What is croup?

Croup is caused by a viral infection, and causes swelling and narrowing to the upper airway, making it harder for a child to breath. Croup is most likely to occur between six months and six years of age, and some children may need treatment with a steroid medication to reduce the swelling and make breathing easier.

Croup notoriously occurs during the night, which is believed to be due to the body’s natural sleep cycle, narrowing airway and hormone level changing within the body.

Your child may have been sick for a day or several and then wake up during the night with symptoms of croup. It is most common for a child to develop croup on the second or third night of an illness. It is important to note that croup symptoms can worsen quickly, and therefore it is important to monitor your child closely and know what to be looking for.

Signs and symptoms of croup -

• A squeaky and high-pitched sound when a child is breathing in
• A deep barking cough that sounds like a seal
• A hoarse voice or cry
• Skin sucking in around the chest and throat

Where to get help -

Call an 🚑 ambulance if:
🚨 Your child is struggling to breath, or if they have noisy breathing (a stridor)
🚨 Your child looks drowsy, pale or overall unwell
🚨Your child's lips are blue
🚨 Your child starts drooling or cannot swallow


Go to a 🏥 hospital if:
🚨 Your child has noisy breathing (stridor) when resting and calm

What you can do to help your child with croup - 

✔️ It is key to try and keep your child calm, as often their breathing will become harder if they are upset. This is not the time to fight your child on things, as we need to keep them as calm as we can.
✔️ Encourage rest and relaxation, to promote overcoming the virus that they are fighting
✔️ Encourage fluids frequently (the fluid your child will drink, is the best type of fluid!)
✔️ Your child has skin sucking in while breathing around their chest or throat, when resting

See a general practitioner or trusted health professional if:

✔️ Your child has noisy breathing (stridor) when they are upset
✔️ You are worried your child’s symptoms are getting worse
✔️ You have concerns that your child is dehydrated
✔️ You have any other concern for your child

Look after your child at home if:

✔️ It is easy for your child to breathe while resting
✔️ Your child is drinking adequate fluids (at least 50% of their normal fluid intake)
✔️ They are alert and can interact normally with you

This blog is written by Shayna, a NICU/Emergency Nurse and Mum to her young daughter.
References:
^https://www.rch.org.au/kidsinfo/fact_sheets/croup/
^ https://www.health.vic.gov.au/infectious-diseases/croup-or-bronchiolitis

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