Children's Health

Understanding Croup -- Treatment

What Are the Treatments for Croup?

Croup can usually be managed with cool mist or steam therapy, which dissolves sticky or dried mucus in the child's breathing passages and lubricates the throat and windpipe. Because the condition commonly worsens at night, many doctors recommend that you sleep in the same room with your child or use a baby monitor to listen for any change in the child's condition. Be ready to get medical help if your child doesn't improve.

Doctors recommend home care for all but the most serious cases of croup. Antibiotics are not helpful for treating viral croup. If the symptoms are severe enough, the child will be given inhaled medications such as racemic epinephrine in the emergency room. If the child is still not better, an X-ray may be taken and the child may be kept in the hospital overnight.

Oral corticosteroids (prednisolone, dexamethasone, and others) are sometimes used to reduce inflammation and swelling. This treatment is prescribed for those with the worst symptoms and as a precaution for those children with stridor -- or noisy breathing -- during the day, knowing that stridor will often increase at night. The treatment starts to work in one to two hours and has maximum effect by eight to 12 hours after it is taken.

At-Home Remedies for Croup

• A cool-mist humidifier may help your child breathe if he has croup. Direct the mist away from the face and don't put medications in the water; they can irritate your child's throat.
• The best approach to treating croup with steam is to run hot water full out and steam up the entire bathroom. Because the windpipe area is inflamed, cool steam is a bit better than hot, so crack open the window just slightly. Hold your child in your arms in the steamy bathroom for 20-30 minutes. If the child is not better, head for the nearest emergency room. If the child improves, give plenty of fluids and place a vaporizer -- or preferably a cool mist (ultrasonic) nebulizer -- at your child’s bedside as above.
• Do not be surprised if the child gets worse again. The second and third nights of the disease are always the worst, and you may have to repeat the steam treatment.
• Cold air sometimes improves croup. If the night is cool, take your child for a ride in the car with the windows down.
• Acetaminophen (Tylenol and multiple generic brands) or Ibuprofen (Motrin and many generic brands) will bring down a fever and that may lower your child's respiratory rate. (But remember, never give children aspirin to reduce fever!)
• Offer plenty of liquids to restore fluids and to loosen phlegm.
• As always, keep your child away from cigarette smoke.

Once you have made it through the third night of the croup, you can pretty much relax -- it will get better from that point.