Croup in infants

Croup in infants: What is a "barking" cough?

Croup, or acute obstructive laryngitis (laryngotracheitis), is a viral illness that causes inflammation and swelling of the larynx and trachea, in the area of the vocal cords. Because infants have very narrow airways, this swelling significantly impedes airflow, leading to very characteristic and frightening symptoms.

Classic triad of croup symptoms

Croup usually starts as a common cold with runny nose and a low-grade fever. However, most often at night the child's condition suddenly worsens and three classic signs appear:

1. Coarse, "barking" cough. This is the most characteristic symptom. The cough resembles the bark of a seal or a dog.
2. Hoarse voice. Swelling of the vocal cords makes the child's voice raspy.
3. Stridor. This is a noisy, whistling sound on inhalation that occurs as air passes through the narrowed larynx.

These symptoms usually intensify markedly during crying or when the child is awakened. It is important to stay calm, because your panic is transmitted to the child, increasing its crying, which in turn worsens swelling and shortness of breath, creating a vicious cycle.

Why does it happen at night?

The horizontal body position during sleep promotes blood flow to the inflamed laryngeal tissues, increasing swelling. In addition, endogenous corticosteroid production physiologically decreases at night – hormones that suppress inflammation.

What should parents do?

The first and most important aid for croup is cool, moist air. It helps reduce laryngeal swelling. You can take the child out onto a balcony, open a window, or sit in a bathroom filled with steam from a hot shower (but do not place the child in hot water!).

If the child develops stridor at rest or signs of respiratory distress, you must call emergency services immediately. Treatment may include inhalations with hormonal medications to reduce swelling.