My experience with Croup

A little over a week ago Robbie, my 4 year old son, started coughing and had a runny nose. He didn’t have any other symptoms, but since his cough was persistent, we decided to take a COVID-19 test. It was negative, so he went back to school one he was feeling better. A few days passed, and my baby boy Antonio, who is 12 months old, started having a runny nose as the only symptom (this was 4 days after my firstborn started coughing). Antonio had a bit of a cough the next day, and I don’t recall noticing any coughing on Day 3. On Day 3 at night he went to sleep, and at midnight his situation was completely different. He had croup.

According to the Mayo Clinic, croup causes swelling of the larynx, trachea, and bronchial tubes, creating breathing difficulties, and a barking cough. Likewise, taking a breath often produces a high-pitched whistling sound (stridor). Symptoms usually worsen at night, exactly what happened to Antonio. Croup cough is medically known as laryngotracheobronchitis.

Fourth day with symptoms
At midnight, Antonio woke up crying, and each time he breathed he would have stridor, which is a wheezing sound when baby breaths in. We got him from his crib, used saline spray in his nose, he nursed, and then he fell asleep. We also placed the cold vapor humidifier on our bedside table. I placed Antonio on our bed, using my arm as his pillow so that he was a bit elevated, and so that he could breath well. At 2am he woke up crying, but this time was more alarming. He was visibly having trouble breathing, so we did some home remedies that are recommended in this case:

  1. Stay calm
  2. Use a nasal spray with saline solution and suck the boogers if you notice baby’s got a stuffy nose
  3. Take baby to the bathroom and run the shower or bath with hot water so that the steam clears their airways
  4. If it’s cold outside, bundle baby and take them outside
  5. If baby has a fever, use the proper dose of acetaminophen or ibuprofen and keep monitoring temperature

We followed the first 3 steps. Outside wasn’t cold, and we noticed that the remedies weren’t really working, so we decided to take him to the ER. We arrived at 3am, and after my baby was admitted, Robbie and papá waited in the car. Robbie had croup once when he was around Antonio’s age. We’d taken him to the clinic, and his pediatrician gave him steroids in his throat to avoid it from swelling more. Robbie, unlike Antonio, had a fever, so we had to control it at home, and we just had to wait for his body to fight the virus. We thought this would be Antonio’s case.

Emergency Room
After having waited for a while for a room for my baby, we were given one, and they started evaluating his state quickly. He neededd a dose of epinephrine and oxygen. This treatment was given to him using a nebulizer attached to the oxygen mask. It’s really hard when a baby goes through this. They don’t understand what’s going on, and they want to take off the oxygen mask. We had to hold him down and wrap him like a burrito with the help of three medical assistants and myself. Also, Antonio got a steroid shot to help his throat from swelling. The advantage of having had all this situation happen in the middle of the night is that Antonio would fall asleep at times, and I was there on the floor by his bedside comforting him any time he’d wake up.

After 3h of having gotten the treatment, the pediatrician in charge said Antonio needed one more dose of epinephrine, and that he’ll be monitored expecting improvement, but if he didn’t, they mentioned he’d have to be transferred to a children’s hospital for observation. After this dose he didn’t need more oxygen, so I had to nurse him and let him rest. This time I was able to lay down with him on the stretcher. Thanks heavens that after 3h more he was so much better. The pediatrician in charge then decided to discharge him with commitment to take him back to the ER if he worsened, and we also had to take him to the pediatrician for a follow up on Monday, since this happened on Saturday.

At home
We were lucky my brother in-law gave us a hand taking care of Robbie because my husband had to go to work, so he picked us up from the hospital. My mother in-law was on her way from Michigan to be with us in case there was an emergency. That night Antonio was really well, and he slept soundly. During the day we had given Antonio 3 steam baths, and I motivated him to drink more water, and nurse more. He also ate super well. The next day, on Day 6, my mother in-law took my sons out so that I’d shower. Antonio started having symptoms again. We think it was because of the heat. She brought them back, and I immediately took him to the bath and started running hot water. He had stridor when he was breathing, but he seemed well, and he was playing. After that he had some popsicles, nursed a lot, and he drank lots of water. It is really important to offer babies more breastmilk or formula, and to increase water intake (or breast milk) in older children.

The early hours of Day 6 we had another session of coughing with wheezing sounds and stridor. My husband spent a good chunk of time with Antonio sleeping on his shoulder on the bathroom floor. We monitored him all night and kept him vertical. In the morning we took him to the clinic to his follow up. Antonio seemed to have left that night behind, and he was looking well. His pediatrician talked to her medical team, and they said they couldn’t prescribe him more steroids. Instructions were the same, to keep giving him steam baths if needed, to offer him popsicles, and to make sure his liquid intake was good.

Antonio kept getting better, even though sometimes he has a barking cough, so typical of croup. Children between 6 months to 3 years old are more at risk when getting croup since their throats are so small. In rare cases children need to go to the ER, and it is really important to follow your instinct. Doctors told me we had done the right thing by taking him in.

If your little one starts making a weird sound when they breath (stridor) or when coughing it sounds like a barking cough, call their pediatrician. The sound of their cough and/or stridor are a sign that their larynx and trachea are swollen. If you followed the home remedies for 20-30min and you don’t see and improvement, take them to the ER, specially if your baby seems lethargic. Stridor while at rest is not normal.

 Michelle | con limón, please

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Here you’ll find some links to read more about it, and you can also hear the characteristic sound of the barking cough and stridor.

Croup (for parents) – Kid’s Health

Croup: Causes, Symptoms, Management, and Prevention – Cleveland Clinic

What is Croup? What Causes It? – WebMD LLC

Sounds of Croup – YouTube Medzcool

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