24 August 2019

'Help! My baby's cough sounds like a dog's bark'

You've heard what different coughs sound like, but this one is too distinctive to treat it like it's any other cough.

Croup is a viral illness which triggers the swelling of your baby's voice box and windpipe.

The high-pitched or barking cough develops when air is forced against a constricted airway during a breath in or a cough.

The smaller your child is, the more distinctive and noticeable the sound.

Some children with severe croup get a harsh, tight sound while breathing in. This is called stridor.

When does it happen?

The virus associated with the development of croup can be passed on by breathing in respiratory droplets from a cough, or from playing with toys that have the virus on them.

Croup normally affects infants and children between the ages of 6 months and 3 years.

As children grow, so do their airways. Therefore, children above the age of 6 rarely get diagnosed with croup.

What are the symptoms?

You may notice the typical symptoms of a cold, like a runny nose and fever. Usually, the barky cough begins at night, and gets worse when your child gets upset and cries.

Croup typically lasts 3-5 days.

How is croup diagnosed?

The doctor will usually listen for a cough and stridor.

They may also ask if your child has had any recent illnesses that caused a fever and congestion and whether the child has a history of croup or upper airway problems.

He may also perform an X-ray if the croup is severe and doesn’t get better after treatment.

An X-ray in this case will help show the top of the airway narrowing to a point, which doctors call a "steeple sign”, which is a tapering or narrowing of the airway below the vocal cords.

Home treatment for croup 

If your child wakes up in the middle of the night with croup, try to keep him calm as this will help him breathe better.

Crying can make croup worse.

For a fever, medicine like paracetamol, also known as acetaminophen or, only for kids older than 6 months, ibuprofen; can help make your child more comfortable.

Ask your doctor for guidance in giving your child the medicine. 

Help your child breathe in moist air. This can make him feel better.

  • Use a cool-mist humidifier or run a hot shower to create a steam-filled bathroom where you can sit with your child for 10 minutes. Breathing in the mist will sometimes stop the severe coughing.
  • In cooler weather, take your child outside to help ease symptoms so they can breathe fresh air. 
  • Make sure your child is well hydrated. If needed, give small amounts of liquid more often using a spoon or medicine dropper. Children with croup should also get lots of rest.

When to call the doctor

If you are concerned that your child's croup is not improving, contact your child's doctor, especially if  these symptoms persist:

  • A sound that gets louder with each breath
  • If your child speaks or makes verbal sounds for lack of breath
  • Seems to be struggling to catch his breath
  • Has bluish lips or fingernails
  • Has stridor when resting
  • Drools or has extreme difficulty swallowing saliva

References: WebMD, KidMed, HealthyChildren, KidsHealth, Remedy

Image credit: iStock


Ask the Expert

Cough Expert

Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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