Croup in Children: A Pediatrician’s Guide for Newton and Boston Families
Parents in Newton, Boston, and surrounding Massachusetts communities know how stressful it can be when a child wakes up coughing through the night. At Essential Pediatrics, we frequently see families worried about that sudden, barky “seal-like” cough, a common sign of croup. This local guide explains what croup is, how it spreads, and when Boston-area parents should call their pediatrician for care or reassurance.
What Is Croup?
Croup is a viral infection that causes swelling in the upper airway, around the voice box and windpipe. That swelling leads to the distinctive “barky” cough, hoarse voice, and sometimes noisy breathing.
It’s most common in children between 6 months and 3 years, though older kids can get it too. Croup tends to appear in the fall and winter, when many respiratory viruses are circulating; however, it can occur any time of the year.
The parainfluenza virus is the most frequent cause of croup, but other cold viruses can cause it as well, such as COVID-19, RSV, Influenza, rhinovirus, and adenovirus.
How do you get Croup?
Croup spreads just like the common cold: through respiratory droplets and contaminated surfaces. That means a child can catch it from:
- Breathing in droplets from a cough or sneeze.
- Touching a toy, doorknob, or surface that has the virus on it, then touching their nose, mouth, or eyes.
Prevention tips for families:
- Wash hands often (especially after wiping noses or coughing).
- Teach kids to cover coughs and sneezes with their elbow.
- Keep children home when they have a fever or an active cough.
- Wipe down shared surfaces and toys regularly.
Recognizing the Symptoms
Croup often begins like an ordinary cold, with a runny nose, mild cough, and low fever. Then over the course of 1-2 days, as the airway becomes swollen, the classic barking cough appears, often worsening at night.
Parents might notice:
- Barky, seal-like cough
- Hoarse voice
- Noisy breathing (a high-pitched sound called stridor, especially when inhaling)
- Symptoms are worse at night or when crying
- Fever, usually low-grade
Most children remain alert and playful during the day, though nights can be rough.
Typically, croup resolves within 24 to 72 hours. However, the cough may persist for up to a week.
How Doctors Diagnose Croup
Croup is usually diagnosed clinically in the office by listening to and observing your child. Typically, no special tests are needed. A pediatrician can often identify croup just by hearing the cough and reviewing your description of the illness.
Treatment: Helping Your Child Feel Better
Most cases of croup can be safely managed at home. Here’s what we recommend to parents:
- Stay calm and keep your child comfortable. Crying can worsen airway swelling, so comfort and reassurance go a long way.
- Reduce Fevers. If your child has a fever (100.4°F or 38°C), treat it with acetaminophen or ibuprofen (for children older than 6 months). If your child is younger than 2 months, please consult with your pediatrician.
- Try cool or moist air. While studies have not proven that inhaling cool, moist air reduces symptoms, some parents find that these measures can be useful.
- Sit with your child in a steamy bathroom for 10–15 minutes.
- Or step outside into cool night air for a few minutes — it often helps quickly.
- Keep your child well hydrated. Frequently offer water, warm soup, or Pedialyte popsicles.
- Monitor breathing. If your child’s breathing becomes labored when resting, it’s time to call your pediatrician.
For children with stridor, your pediatrician may prescribe a single dose of steroid medicine (like dexamethasone) to reduce airway swelling. This medication is safe, effective, and can make a large difference within hours. In rare, more serious cases, children may need nebulized epinephrine in the ER to help open the airway quickly.
When to Call the Doctor or Go to the ER
Seek medical attention if your child:
- Has stridor (noisy breathing) even when calm
- Struggles to breathe (chest pulling in with each breath, flaring nostrils, fast breathing)
- Drools or can’t swallow
- Looks very tired, pale, or blue around the lips
- Is younger than 6 months
- Has other health conditions that affect breathing
The Good News
The worst symptoms of croup usually last just one or two nights, and most children recover fully within 3–5 days. With rest, fluids, and a little patience, your child will soon be back to their normal, noisy self, minus the bark.
Remember, you don’t have to face those long nights alone. If your child develops a barking cough, hoarse voice, or noisy breathing, don’t wait and wonder. Families in Newton, Boston, and nearby areas can schedule a consultation with Essential Pediatrics for expert evaluation and peace of mind.
Our experienced pediatricians are here to help your little one breathe easier.
