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WHAT IS CROUP?

 

Croup is one of the most common causes of respiratory illness in young children, affecting up to 6 per cent of children under six years old every year.

 

• Otherwise known as acute laryngo-tracheobronchitis, croup is an infection of the airways. There is progressive obstruction of the airway caused by inflammation and swelling of the tissues lining the larynx (voice box), trachea (windpipe) and bronchi (large airways in the lungs). 
• Croup is caused by a virus, so antibiotics are ineffective and the illness has to run its course, with treatment aimed at alleviating the symptoms. 
• The majority of cases of croup do not need medical treatment, but of those seen by doctors, up to 30 per cent are admitted to hospital. 

One of the main symptoms of croup is a harsh 'barking' cough. Other symptoms include a sore throat and, in extreme cases, difficulty breathing.

 

How croup is contracted

 

The viruses responsible are normally present in the environment.

 

• It is usually caused by the parainfluenza virus. 
• Children are more susceptible than adults as they have an immature immune system.  The  virus may be caught by droplet infection from person to person. 
• It can occur in babies as young as two months, and is common up to the age of six years, occurring more frequently in boys than in girls. 
• It tends to occur during late autumn and early winter, when the viruses are more prevalent

Symptoms

 

The symptoms of croup are varied, but the main ones to look out for are respiratory problems and a harsh cough.

 

The symptoms usually begin with a cold that lasts for one to four days. The child will have a runny nose and sometimes a slight fever with a temperature above 37.2°C(99°F).

 

The child gradually develops a hoarse voice and a characteristic cough, which sounds like the barking of a seal.

 

A  baby may be miserable and reluctant to feed.

 

On breathing in there is a harsh, rasping noise, known as stridor.

 

An older child may also complain of a sore throat, and find it difficult to swallow.

 

As is often the case with respiratory illnesses, the symptoms tend to be worse in the evening and at night, and often become worse for several nights before getting better.

In a more severe case, the child will be breathing hard, and flaring the nostrils with each breath.

 

When to call the Doctors

 

You should call a doctor immediately if your baby has any of the symptoms of croup listed above, or if a toddler or older child has any of the symptoms below.

 

Looks very pale and has dusky (blue tinged) lips and nails. 

Is breathing very hard and sucking in the muscles between the ribs and under the rib cage, or there is stridor. 

If the symptoms don't improve after at least 20 minutes of breathing steamy air or your child is fighting for breath. 

If your child is becoming increasingly agitated or increasingly lethargic

While you are waiting for help, take your child into the bathroom, close the door and turn on the hot taps as steam can alleviate the symptoms.

 

Home nursing

 

Most cases of croup are mild, and can be treated at home. However, severe cases can be life-threatening, so if you are in any doubt at all you must seek medical help ­whatever the time of day or night.

 

*  Encourage your child to sit up to help him to breathe, comfortably propped up with pillows.

The head of a baby's cot can be raised by placing a folded towel under the mattress.

 

*  A warm, steamy atmosphere will alleviate the symptoms and is most easily achieved by taking your child into the bathroom, closing the door, and turning on the hot water in the sink, bath and shower.

 

*  Stay with your child until the symptoms subside, and afterwards ensure he sleeps in a room where you can hear him during the night if he happens to wake up.

 

*  Make sure your child is sitting comfortably and keep him calm, for example by reading a story or talking to him.

 

*  Offer him regular sips of clear fluids to drink, such as water or diluted squash ­not milky drinks as these thicken the mucus in the throat, making breathing more difficult.

 

*  Try to appear calm, even though you may not be feeling it. If your child senses you are anxious, this may heighten his anxiety and make his breathing difficulties worse.

 

*  Give regular infant paracetamol to ease the sore throat and any fever.

 

MEDICAL TREATMENT FOR CROUP

 

A nebuliser administers steroid medication, which the child inhales via a face mask or mouthpiece.

 

After this treatment, the doctor will assess its effectiveness and decide whether it is necessary to admit the child to hospital for observation and further treatment. If not, you should continue to treat your child at home, but don't hesitate to call the doctor if the attacks get worse and more frequent.

 

The symptoms of a croup attack will gradually subside over a few days. However, although seemingly cured, in some cases children may go on to develop an ear infection or a chest infection. These can be treated by your  doctor  with antibiotics.

 

If your child suffers from croup, your doctor may show you how to use a nebuliser to administer medication that can soothe the symptoms. She will monitor its effectiveness.

 

Recurrent croup

 

Some children do suffer recurrent attacks of croup for a few years. Medication used to prevent asthma are in effective for croup and at the moment there is no known way of preventing it. However, there are ways in which you can help.

 

Some success has been claimed in treating croup with natural, homeopathic remedies.

 

Breast-feed babies are thought to be less prone to developing respiratory illness, such as asthma, croup and pneumonia, than bottle-fed babies.

 

Don't allow smoking in the household or anywhere near your child as this can irritate your child's respiratory system.

 

Do not smoke anywhere near to your child if she suffers from croup. This is because the smoke from tobacco can exacerbate the condition and any other respiratory illnesses.

 

For  More  Information:  Please  consult  your  physician  on  your  next  visit.