Croup usually hits in the middle of the night, as the infected child (in our case, my three year old daughter) wakes up unable to breathe. At about three in the morning, I heard her emit short, barking coughs that told me her airway was very tight. She started to panic and cry. Unfortunately, crying makes breathing tougher -- quickly.
My husband and I were up in a flash, taking steps we know help to ease a croup attack. They worked well, and we let our daughter sleep the rest of the night in our bed just to make sure she was breathing alright. The initial "attack" phase of the infection lasted two nights for her. On the third night, we let her sleep in her own bed again but woke up periodically to check on her. She slept soundly, and even though she wouldn't heal completely for several days, we knew the worst was over.
Croup usually hits children under age 5 during the cold months of the year. The first phase of the virus is the respiratory attack phase I just described. In the daytime, a croupy child may cough and have a medium to high fever. For my children, the highest the fever has reached has been 103, although that has been quite rare.
Here is what we do when one of our kids comes down with croup:
- Don't panic. Stay Calm -- I first encountered croup when my oldest was eighteen months old. We had just moved to the Midwest, and he awoke wheezing and frightened. Honestly, I was just as afraid as he was, but there was something instinctive that told me to rock him and soothe him the best that I could. When my three-year-old woke up with croup last week, I was able to talk her through it as we treated her. I told her that crying would make it harder for her to breathe. After a minute or two of repeating that and telling her that I would take care of her, she started to understand. As she calmed, her airway seemed less restricted. Being calm (both parent and child) and acting quickly are key to effective treatment.
- Use the Cold Weather -- When my oldest had his first attack of croup, I moved to soothe him, went into the bathroom and turned on the shower as hot as it would go. We sat in the steamy bathroom rocking for about 10 minutes, but he still couldn't breathe. Even though it was about 3 degrees outside, I bundled him up for a trip to the emergency room. By the time we got there, his attack was almost over. I remember talking to the emergency room personnel and being afraid that they wouldn't believe me. "But I swear, he couldn't breathe 10 minutes ago!" I said, defensively. They looked at each other knowingly and said, "Croup." What the nurse and doctor explained is that the cool winter air is one of the best treatments for croup. As the child breathes it in, it calms their bronchial passages and helps to end the attack. Now, when one of our children comes down with it, one parent immediately puts a winter hat and mittens on the child and wraps her in our warmest blankets while the other parent gets hurriedly dressed, takes the child, and goes outside. I rocked our daughter on the porch swing in the moonlight, talked to her and sung to her (as my teeth chattered). Cold air and TLC worked like a charm. If after 15 minutes, though, the cold air doesn't work, or if your child loses consciousness, get him or her emergency medical attention immediately.
- Follow up with a humidifier -- The combination of cold to open the lungs and moist warmth to soothe them has worked well for our children when they have croup. We use a steam humidifier (not a vaporizer) to keep the bedroom air the right temperature and moisture level for a croupy child to breathe easy. Even after the 'attack phase' is done, we keep the humidifier in the child's bedroom to help keep nasal passages clear and ease coughing. We are sure to empty the humidifier in the morning and set it open to dry and to fill it with clean water again at bedtime to keep bacteria from breeding. DO NOT use a mentholated rub on your child to treat croup.
- Encourage rest -- During the day, when the feeling of achiness and fever makes a child slow down, it can be useful to find sit-down activities that encourage the sick child to rest and heal. Movies, books, coloring, or play-doh are great, gentle activities for kids with little energy. In our house, we make a "sickie bed" by putting a crib-size mattress pad and sheets on our loveseat so there is a ready place for an ill child to lay down at a moment's notice. Mine have been known to spend most of the day resting in the sickie bed when they have that run-down feeling. Naps are a must in our house, too, when we're treating croup. (Naptime is a great time for me to get some shuteye, too. Treating a croup attack in the middle of the night is no picnic.)
- Treat the Fever -- I am a firm believer that it is good to allow a child's body to fight a fever naturally whenever possible. That means pushing fluids to keep your sick child hydrated and monitoring the strength of the fever. When fevers spike at night-time or when I want to ease my child's aches and pains so that they can nap, I do give an age-appropriate dose of Ibuprophen.
- Adjust the Child's Diet -- We avoid dairy products for at least a week when we're treating croup. They tend to thicken mucus secretions in the respiratory tract. Clear juices, water, and citrus fruits, along with warm foods like broth, soup, or chamomile tea with honey are comforting to a croupy child.
- Involve your Doctor -- Croup is a virus, so your doctor will not treat it with antibiotics. Still, it is a good idea to keep your healthcare provider informed about what is going on with your child. Write down and review your child's symptoms with your doctor's office to be sure it is croup. Your healthcare providers may be able to give you additional strategies and tell you what warning signs to look for that indicate a doctor's visit is in order. Your doctor may prescribe liquid albuterol or a nebulizer treatment to help ease your child's breathing. Be sure to ask questions about side effects and dosage for any treatment your doctor recommends.
For parents with sick children, I have often thought that knowledge is power. I hope this article will help you to find the best way to heal your child.
Some great websites with information on treating croup are: