Difficulty breathing with continuous stridor* or chest retractions despite 10 - 20 minutes of steam treatment
Constant noisy breathing
Dehydration
Excess drooling, spitting or difficulty swallowing
Lips turn bluish with coughing episodes
Unable to bend the neck forward
Unable to lie down comfortably
Appears listless, lethargic or difficult to arouse or just look sick
Call During Normal Hours **
Coughing spasms are worsening or becoming more frequent
Refusing fluids or vomiting and is appearing well-hydrated or only mildly dehydrated
Fever more than 38C
Secondary infection - ear infection, pneumonia
** - If these are present during normal hours
The main concern is if the child is having difficulty breathing. The difficulty breathing may be minimal or severe. A child who is having mild or moderate distress in the day may be a lot worse in the night.
A distinctive cough in children that sounds like a barking seal. It is usually caused by a virus that affects the voice box. There may be a hoarse voice and sometimes by a breathing pattern called stridor. *Stridor is a harsh raspy breathing sound heard mostly when breathing in.
The doctor should be at least contacted if they are having breathing difficulty in the day.
Children at most risk for getting into trouble with their breathing are usually under 3 years of age.
A child may switch from having mild to severe croup several times within the course of the disease.
Croup is often cause by a virus which also causes cold symptoms such as congestion, sore throat and sometimes fever.
It affects children between 6 months and about 4 or 5 years old.
Symptoms are typically worse at night, or the child may awaken with the first signs of croup in the middle of the night.
It peaks in severity over 3 to 5 days and then begins to resolve.
The term spasmodic croup refers to a type of croup that develops quickly and may happen in a child with a mild cold. The barking cough usually begins at night and is not accompanied by fever. Spasmodic croup has a tendency to come back again (recur). Treatment is the same.
Croup may also be caused by a bacteria and is then called bacterial tracheitis. This is less common and more serious. These children have severe difficulty breathing, appear quite ill and are often hospitalized for oxygen and antibiotics.
Children may get croup more than once in their life and some children seem to get it more often than others.
