Croup - Treatments

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What is the treatment for croup?

Croup can be frightening for both children and parents. Therefore, comforting and reassuring the child is the first step. Breathing difficulties can develop and worsen rapidly. Close monitoring of the child is important during the early phases of the illness.

To help the child breathe more comfortably, a cool or warm mist vaporizer can be placed near the child. The humidified air promotes reduction of vocal cord swelling and thus lessens symptoms. To avoid accidental burns, hot water vaporizers should be out of the reach of infants and toddlers. Also effective is having the child breathe in a bathroom steamed up with hot water from the tub or shower. When cough or stridor worsens at night, 10 or 15 minutes sitting or driving in the cool night air can also help the child breathe.

In infants and children, blockage in the nasal passages from mucus can further impair breathing. Careful instillation of saltwater nose drops (¼ teaspoon of table salt in 1 cup of water) into the nasal openings every few hours, followed by gentle suction using a bulb syringe, can be helpful in opening nasal passages.

The American Academy of Pediatrics recommends avoiding most combination cough and cold medicines. Several studies show that these medicines are ineffective in children. They can potentially cause side effects that could lead to more serious symptoms. Acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) are helpful for pain relief and fever. Acetylsalicylic acid (Aspirin, Ecotrin) is avoided in the treatment of croup and other viral illnesses since aspirin is suspected as being related to Reye's syndrome in children. Reye's syndrome is a serious illness causing kidney, liver, and brain damage, which can lead to the rapid onset of coma. Occasionally, cortisone medications are prescribed for more severe cases of croup. Because a virus usually causes croup, antibiotics are reserved for those rare occasions when bacterial infections cause croup or become superimposed on the viral infection.

Even though plenty of fluids are encouraged to avoid dehydration, forcing fluids is generally unnecessary. Popsicles are a popular means of providing fluid. Activity should be restricted to quiet play during the first days of the illness.

Children with croup are most contagious during the first days of fever and illness. Infection spreads easily in a household. Other children in the family will often develop a sore throat or a cough, without necessarily developing the croupy cough and stridor seen in croup. Infants and children may return to school or day care when their temperature is normal and they feel better. A lingering cough can last another two weeks but should not be the reason to keep them at home.

Return to Croup

See what others are saying

Comment from: Akstat, 35-44 Female (Caregiver) Published: November 08

My son is 5 and he's has had croup and stridor since he is 15 months old. It is very scary for me. He gets it 2 to 3 times a year between October and February. He starts out symptomless except for slight runny nose. He doesn't seem sick, but at night he will awake suddenly with acute croup and high pitch stridor sound on inspiration. We have a routine we have car keys ready, shoes and coats by the door because he get it so bad we need to get to the ER for racemic epinephrine. This drug can only be given at the hospital so we do not wait for ambulance as time is essential to get help. We also use cool mist and steam vaporizers during winter. The croup barking cough is one thing but if your child has stridor, high pitched inspiration get to the ER and stay calm and tell your child he or she will be just fine and that you need to take him for medicine. Drive with the windows down the whole way to the ER. The cold air shocks the lungs and opens the airways temporarily.

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Comment from: mammy, 3-6 Female (Caregiver) Published: November 25

My son has had this since he was 1. Steamy bathroom air and a calming chest massage showing the child how to breathe slowly, help. It's important to calm the child in this situation because any panic will be felt immediately by the child and worsens the disposition. Keep a calm head, it will pass. I only had to give him cortisone once during a severe case otherwise once I hear the cough emerging I'll do a foot bath before the fever breaks as he is usually cold, massage his chest and back with a suitable aetheric oil cream to open the pathways. Following this I will give him a diclofenac preparation to relieve swelling. It is usually gone within 2 to 3 days.

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