It can be downright scary when your child wakes up with a barking cough.

Croup is a common illness in young children, especially in fall and winter months. The American Academy of Pediatrics (AAP) defines croup as an infection that causes a swelling of the voice box and windpipe, making breathing noisy and difficult.

While most episodes of croup are mild, the illness is responsible for up to 15 percent of emergency department visits due to respiratory disease in children in this country.

Children are most likely to get croup between 6 months and 5 years of age. The AAP describes two different types of croup:

• Viral croup – The most common type, caused by a viral infection. It often starts like a cold that slowly turns into a barking cough. Your child’s voice may become hoarse and her breathing noisier. She may have a low fever, although some children have temperatures up to 104°F.
• Spasmodic croup – This type is caused by an allergy or reflux in the stomach. It often comes on suddenly in the middle of the night. Your child may be hoarse and have a cough that sounds like a seal barking. She likely won’t have a fever.

With either type of croup, your child may make a high-pitched or squeaking sound when breathing in. This is called stridor. While it’s most common with mild croup, the danger with stridor is that the airway will keep swelling, making breathing difficult. If your child has stridor at rest, it can be a sign of severe croup.

The same viruses that cause the common cold also cause croup. In fact, symptoms of croup usually start out like a cold, with a stuffy or runny nose and low-grade fever, then your child may become hoarse and develop a barking cough. It’s often worse at night.

Most children get better in a few days, and most cases of croup are mild and can be treated at home:

• Use a cool mist humidifier or vaporizer in your child’s room.
• Keep your child well hydrated.
• If your child wakes up in the middle of the night, try to keep her calm, as being upset or crying can make croup worse.
• Take your child into the bathroom, close the door, and turn the shower to the hottest setting to let the bathroom steam up. Sit in the steamy bathroom with your child for 15-20 minutes.
• If the steam doesn’t help, take your child outdoors for a few minutes, or for a short ride in the car with the windows cracked, as breathing in moist, cool night air may help.

If home remedies don’t work, your pediatrician may prescribe a steroid medication or a breathing treatment to reduce swelling in the airway. For spasmodic croup, your child may need an allergy or reflux medicine to help with breathing. Stay away from cough syrups, which may be harmful.

Although most cases are mild, croup can become serious and prevent your child from breathing normally. If you’re concerned that your child's croup is not improving, contact your pediatrician.

Call 911 or get immediate medical care if your child:

• Makes a whistling sound that gets louder with each breath
• Cannot speak or make verbal sounds for lack of breath
• Seems to be struggling to catch her breath
• Has bluish lips or fingernails
• Has stridor when resting
• Drools or has trouble swallowing
• Is very tired, sleepy or hard to awaken
• Has a sudden high fever
• Is dehydrated (look for few or no tears when crying, peeing less, sunken eyes, etc.)

If you have any concerns about croup and your child, contact your pediatrician.

One way to protect against illnesses like croup is hand washing. Encourage your kids to wash their hands regularly and properly.

Learn more about children’s services at Edward-Elmhurst Health.

Learn about our pediatric emergency care.