There are two things which make croup seem much worse than the actual illness usually is:
1. The cough which characterises croup is a loud, violent barking cough which can sound horrendous to parents when it is emanating from their small baby or toddler.
2. Croup attacks often come at night, when problems seem much worse because you are half asleep and feel more helpless because help is not instantly at hand.
In reality, croup is rarely a serious illness and can usually be treated quite easily at home.
What is croup?
Croup is caused by an imflammation of the vocal chords, a lining of mucus in the windpipe, and consequently, restricted breathing which makes the patient seem short of breath. It is usually caused by a viral infection passed on by coughing, sneezing and/or touch.
It tends to affect babies and children, most commonly aged six months to four years, and usually strikes in the winter months (October onwards).
Sometimes the child's lips and skin will pale, and as they breathe, there might be a wheezy, whistling noise. This difficulty in breathing can make a baby or child upset because the pulling will be painful and frustrating for them.
A couple of days before the cough arrives, the child might go through what seems like the beginnings of any normal cold: a runny nose, a bit of a temperature and feeling generally low. The peak of the illness usually only lasts about three days, though it can trail off over a further week or so.
Croup usually comes on worse at night (partly because a child is lying down and partly because a warm, dry bedroom will make for stuffy conditions).
Treatment for croup
Try to create a humid atmosphere at home: take your baby into the kitchen, sit your child on your knee and try to keep him upright but comfortable, whilst creating a steamy atmosphere with a boiling kettle (lid off so the whistle isn't upsetting), or by using a pan of boiling water. This helps to create steamy air for your child to breathe in. Alternatively, take your baby into the bathroom and run a steamy bath or shower.
When your child seems more comfortable again, settle him back to bed, making sure the room is warm but also humid - use a humidifier if you have one, or boil an electric kettle in the bedroom before putting your baby back down. Alternatively, if the radiators are on, you could leave a bowl of water or a damp towel on the radiator so that the water evaporates into the room.
Older children can be given warm, clear liquids to help them rehydrate, and babies can be offered a breastfeed or cool, boiled water.
If your child has a temperature, you can use a children's paracetamol, but you are not advised to use ones which cause drowsiness. Children who are under three months old should NOT be given such medicines unless they are expressly permitted by their GP.
When to call the doctor
If your child has a bluish appearance around the mouth, his ribs retract severely when he breathes in, he has a temperature over 39°C which does not come down once you have calmed him from a bad bout of coughing and crying, or his cough continues and does not seem to ease off once you have him sitting with you in a humid room for more than 20 minutes, call your doctor or NHS Direct on 0845 4647.
It is very rare, but your child's condition may be an illness called Epiglottis, which can cause dangerous breathing difficulties.