What is Croup and Bronchiolitis?
Viral croup and bronchiolitis are common respiratory infections in young children. Unlike the usual coughs and colds, the inflammation in the airway associated with both croup and bronchiolitis can often be significant, causing noisy and difficulty breathing.
What is croup?
Croup is a viral respiratory infection of the upper airway, which causes swelling of the voice box (larynx) and windpipe (trachea).
What are the symptoms of croup?
Croup starts of just like any other respiratory infections with mild symptoms of runny nose, congestion, and fever. Then as the evening approaches, the croupy cough develops. The hallmark of croup is a hoarse and distinct cough that is harsh, high-pitched like that of a seal barking. Symptoms tend to wax and wane, improving somewhat by the morning, and again worsening towards the evening. The symptoms are noticeably worse at night, also when a child is upset or crying.
Typically, croup is a mild illness, and most children with croup are better in a few days. However, croup can get worse quickly, especially in the younger child as their airways are smaller. The swelling can sometimes cause significant narrowing of the airway leading to stridor, a raspy squeaky sound when breathing in and difficulty breathing.
What age do children typically get croup?
Croup tends to occur in children between 3 months to five years old, but it can occur at any age. In some children, croup tends to reoccur.
What is the difference between croup and bronchiolitis?
In contrast to croup, bronchiolitis is cause by inflammation of the lower airway/bronchioles. This produces wheezing, a high-pitched whistling sound when breathing out and laboured breathing.
Bronchiolitis affects young children under the age of two, most commonly in babies three to six months old. Some babies are at risk for severe bronchiolitis including those who were born prematurely, have a chronic heart or lung disease.
How long does croup or bronchiolitis last?
Croup typically lasts four to five days, but may last up to a week. Bronchiolitis usually lasts about two weeks, though it can last for several weeks in severe cases.
How do children get croup or bronchiolitis?
Like other respiratory infections, both croup and bronchiolitis are contagious, spreading through direct contact from respiratory secretions. Thus, basic hygiene is important in helping limit the spread of these illnesses.
What is the treatment for both?
Both croup and bronchiolitis are often mild illnesses and can be manage at home.
- Encourage hydration with plenty of fluids
- Nasal saline rinse and bulb suction is helpful, especially before feedings in infants
- Breathing in moist air, either from a humidifier or 10-15 minutes from the steam of a hot shower can help ease coughs (for croup, can also try breathing cool air by standing near an open refrigerator or being outside in cooler climate for a few minutes)
- Antipyretics for comfort relief of fever
- Cold and cough medications, antihistamines are generally not helpful
For croup, some children may benefit from steroid to promptly relieve mild symptoms, while additional aerosolized treatment is necessary for the more moderate and severe illness.
Sometimes a child with either croup or bronchiolitis may need a short hospital stay for observation, oxygen or hydration support.
When to call your doctor or get immediate medical care
Due to airway inflammation, both croup and bronchiolitis can make children feel miserable and quite ill. Therefore, it is important to keep a close eye and seek help urgently if your child develops noisy or laboured/difficulty breathing appears tire and lethargy or is not drinking well and appears dehydrated.
Dr Judy Schmidt is based at IMC Paediatric. Call 6887 4440 to make an appointment.