So, your little one went to bed with a bit of a cold – and woke up in the middle of the night making the most terrifying noise you've ever heard? They might well have croup – but don't worry, although it sounds frightening, in most cases its bark is worse than its bite.
What is it?
Croup is caused by a viral infection that affects the wind wipe, larynx and bronchi (the airways leading to the lungs) and causes inflammation, making breathing more difficult.
It's not particularly common, but it occurs most frequently in young children, between the ages of six months and three years. It can occur more than once, but that's actually quite rare.
Croup is normally preceded by the normal cold-like symptoms of a runny nose, sore throat and fever (38°C or higher). If your child has croup, rather than a standard cough and cold, you'll know about it because they'll quite suddenly (and often in the middle of the night, although it is not really understood why) develop a very distinctive cough which sounds rather like a seal barking. They might also be making a bizarre, high-pitched rasping sound when they breathe, which is referred to as stridor.
According to the NHS, in around 60% of cases croup clears within 48 hours – but sometimes it can last for up to two weeks.
The majority of cases are mild or moderate and can be treated at home with the help of your GP. Very occasionally, croup can be more serious and require urgent medical attention.
What can I do?
Although it can be a bit scary when your child gets croup (for them and for you), it's really important for them that you stay calm and help them settle down, because crying and fussing will only heighten the symptoms – the more they panic, the worse it will be.
So initially, just hold your little on upright and talk soothingly to offer reassurance. If they have a fever, you can help to reduce it and make them more comfortable with the correct dose of liquid paracetamol or ibuprofen. Hopefully, once they are calm, the stridor will lessen, at which point, look closely at their symptoms to make a call on what to do next.
In most cases, you should be able to control the symptoms until the morning, with lots of cuddles and sips of water or milk to keep them hydrated.
It's not advisable to try steam inhalation from a bowl because of the risk of scalding. Instead, it might help to sit in the bathroom with a hot shower running for 10 minutes. There isn't actually any evidence that steam helps (despite what your gran told you) but sitting in a home-made sauna for a little while might be fascinating enough to calm them down if nothing else!
As soon as you can, go to see your doctor. Although croup can not be treated with antibiotics, they might give your child a steroid to help reduce inflammation of the airways, and they can advise you on how to get through the next couple of days until it passes.
Rarely, the symptoms of croup are severe and need more urgent attention. If your child appears to be having a lot of trouble breathing (or if they are too breathless to speak, or drink), if they become very lethargic or floppy, if their lips have a blue tinge, or if the skin on their neck and rib cage seems to be tight and drawn in, take no chances – call an ambulance or go to A&E, where they can be treated swiftly with oxygen and steroids.
What else could it be?
If your child has cold symptoms, a fever and a persistent, harsh sounding cough (but it does not sound like barking), the might have bronchiolitis.
If your child is wheezing, coughing and short of breath, but there is no fever and the cough does not sound like barking, they might have asthma.
You can find more health advice on Parentdish here.