It was a cold November night and suddenly I was woken by what sounded like a Sealion barking! I was half asleep and slightly dazed and confused as I looked over to my clock to see it was 2am. Then I heard it again and it dawned on me that the noise was coming from my daughter’s room and she had croup!
I had put my daughter to bed as usual noting that she seemed to be developing a cold as I wiped her snotty nose. There had been no other clues that it would develop into anything else, which is often the way with croup.
I went straight in to check on her and found her struggling to breathe, making a loud noise every time she breathed in, and I knew it was time for a trip to A&E!
A few hours later after a dose of steroids and a period of observation we were home in time for breakfast and by the following day her barking cough was almost gone and she was back to her normal (very active!) self.
Croup is a common winter illness and usually affects children between the ages of 6 months and 6 years. It is caused by a virus and usually starts with a cough and runny nose. The virus causes swelling of the upper airways producing the distinctive cough and noisy breathing. Most children first develop the classic cough in the middle of the night!
Symptoms of Croup:
· Cough and runny nose
· Harsh loud ‘Barking’ cough
· Hoarse voice or cry
· Croaky noise on taking a breath in (known as stridor)
· Difficulty breathing
· Sore throat
Seek medical review (GP/A&E) if:
· Difficulty breathing
· Noisy breathing even when not crying
· They are unable to drink or swallow
· They are drooling excessively
· You are concerned they are very unwell
· They may have inhaled an object or they have had a recent episode of choking (can produce similar symptoms)
Treatment of Croup:
· Offer sips of drinks frequently
· Calpol or ibuprofen for fever and/or pain
· Sit them up and try and keep them calm
· Steroid medication to decrease swelling of upper airways
· Oxygen and nebulisers
· Support with breathing
As a paediatrician it is one of the only times you can walk through an A&E waiting room and make a spot diagnosis. The cough in croup is very distinctive and really does sound just like a sealion barking! The good news is that most children can be looked after safely at home and recover very quickly, but a small percentage do need a hospital stay and even intensive care. If your child has recurrent episodes especially without colds than see your GP to ensure there is no underlying problems.
Here’s hoping none of your children start barking in the middle of the night….