Q: My son has a cough that sounds like a seal barking. It’s worst at night. Could it be croup?
A: Croup is a condition that causes swelling and irritation of the larynx and vocal cords, and is most commonly caused by parainfluenza virus (which, contrary to its name, is not the same as the flu). While symptoms of croup include those associated with the common cold, such as nasal congestion and fever, the common cold does not actually cause croup. Croup is most common in children between 6 months and 3 years old, but some older children also can experience it.
As the larynx and vocal cords become inflamed and swollen, parents may hear the harsh, barking cough for which croup is known. As long as the barky cough is mild, these cases of croup usually can be treated at home with plenty of rest, fluids and fever reducers.
If swelling increases, a child may begin to exhibit stridor, which is a high-pitched sound that occurs with each inhale. Stridor is different than wheezing, which is usually fainter and more likely to be heard when exhaling.
Stridor is more common in younger children because their airway diameter is smaller to begin with. Moist air may help to alleviate mild stridor. In moderate to severe cases of croup when stridor is worse, parents should call their child’s pediatrician or go to an urgent care or emergency department for treatment. Call 911 if a child is having difficulty breathing.
—Mike Patrick, MD, is an emergency medicine physician at Nationwide Children’s Hospital and host of PediaCast, a pediatric podcast for parents.