Croup is a very common childhood illness that has a very characteristic cough described as a "barking seal."  Most commonly caused by viruses, croup is an inflammatory condition affecting the upper airway.  The larynx (voice box) and trachea (windpipe) become swollen and this narrowing can disrupt breathing or cause noisy breathing.

Croup occurs most commonly between ages 6 months to 5 years; beyond that age the trachea is large enough that it is less likely to be affected by such inflammation.  While corup is most common between October and March, it can occur at any time of year.  The characteristic cough often lasts 3 nights; symptoms are typically worse at night or if your child is upset (crying).

Stridor is a coarse noise, almost like a harmonica, that occurs when a child breathes in through a narrowed airway.  This noise is common in croup, but can range in severity.  With mild croup, stridor occurs occurs with activity or agitation (e.g. if crying or upset).  Stridor when a child is sitting/lying at rest can be a sign of severe croup; if this occurs with your child, contact the doctor immediately.  Other emergency signs include difficulty swallowing, bluish coloring around the mouth, and not speaking due to difficulty catching one's breath.  Any time your child's breathing is a struggle, call 911.

Moisture is an important part of treating croup.  Sitting quietly for 15 - 20 minutes in the warm, moist air of a steamy bathroom or cool outside night air may allow children to breathe more comfortably.  Occasionally, oral steroid medications are used to reduce the swelling/inflammation in the throat.  Since viruses cause croup, antibiotics are not helpful in the treatment.  Cough syrups are not helpful either as they have no effect on the larynx or trachea.
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Silver Spring Pediatrics
Drs. DeConcini, Schooler, Zang, Wang, Yee & Marcus