Why does croup worse at night

The danger of croup with stridor is that sometimes the airway may swell so much that your child may barely be able to breathe. In the most severe cases, your child will not be getting enough oxygen into her blood. If this happens, she needs to go to the hospital. Luckily, these most severe cases of croup do not occur very often. If your child wakes up in the middle of the night with croup, try to keep him calm. Keeping him calm may help him breathe better.

In the past, parents may have been advised to try steam treatment in the bathroom. Though some parents may find that this helps improve breathing, there are no studies to prove that inhaling steam in a bathroom is effective. There are also no studies to prove that breathing in moist, cool night airs helps improve breathing. If you are concerned that your child's croup is not improving, contact your child's doctor, local emergency department, or emergency medical services even if it is the middle of the night.

Consider calling if your child:. If your child has viral croup, your child's doctor or the emergency department doctor may give your child a breathing treatment with epinephrine adrenaline to decrease the swelling. After epinephrine is given, your child should be observed for 3 to 4 hours to confirm that croup symptoms do not return.

A steroid medicine may also be prescribed to reduce the swelling. Steroids can be inhaled, taken by mouth, or given by injection. Treatment with a few doses of steroids should do no harm. Steroids may decrease the intensity of symptoms, the need for other medications, and time spent in the hospital and emergency department. For spasmodic croup, your child's doctor may recommend allergy or reflux medicines to help your child's breathing. Antibiotics , which treat bacteria, are not helpful for treating croup because they are almost always caused by a virus or by allergy or reflux.

Cough syrups are not useful and may do harm. Another cause of stridor and serious breathing problems is acute supraglottitis also called epiglottitis. This is a dangerous infection, usually caused by bacteria, with symptoms that can resemble croup. Luckily, this infection is much less common now because of the Haemophilus influenzae type b Hib vaccine. Rarely, supraglottitis is caused by other bacteria.

Acute supraglottitis usually affects children 2 to 5 years of age and comes on suddenly with a high fever. Your child may seem very sick.

He may have a muffled voice and prefer to sit upright with his neck extended and face tilted upward in a "sniffing" position to make his breathing easier. He also may drool because he cannot swallow the saliva in his mouth.

If not treated, this disease could rapidly lead to complete blockage of your child's airway. Your child must go to the hospital right away. If he has supraglottitis, he will need antibiotics, and he may also need a tube in his windpipe to help him breathe. Call your child's doctor right away if you think your child may have supraglottitis. Your child should get the first dose of the Hib vaccine when he is 2 months of age.

This vaccine will also protect against meningitis a swelling in the covering of the brain. Since the Hib vaccine has been available, the number of cases of acute supraglottitis and meningitis has dramatically decreased. When croup persists or recurs frequently, it may be a sign that your child has some narrowing of the airway that is not related to an infection.

This may be a problem that was present when your child was born or one that developed later. What is it, and what can you do to help your child? Announcer: Keep your kids healthy and happy.

You are now entering the "Healthy Kids Zone" with Dr. Cindy Gellner on The Scope. Gellner: That barking cough you hear is called croup, a sound that can cause a lot of concern and rightfully so.

So what is croup? Croup is actually a viral infection of the vocal cords and the trachea, which is the windpipe. It causes a tight, low pitched, barking cough. It actually sounds like your child is a seal with how they're barking. They can also have a hoarse voice leading up to it. Sometimes they have a vibrating, raspy sound when they breathe in called stridor. Stridor is a scary sound, because they're sitting there and they're coughing, and then all of a sudden when they take a big breath, you hear [makes sounds] and that's cause for alarm.

With severe croup, breathing actually becomes difficult. Croup is usually part of a cold, and there's a bunch of viruses going around right now, all of which can cause the croupy cough. When your child has croup, the hoarseness and the bark are actually caused by the opening of the vocal cords becoming more narrow.

It's like the space between the vocal cords went from being that of the diameter of a straw to that of being the diameter of a coffee stirrer. It's really hard to push air through something that narrow, and that's when you hear the bark when they're trying to take a deep breath in and cough that air out very forcefully. Croup usually lasts for a couple of days, and it generally gets worse at night. We do hear it during the daytime, but it's almost always at night, and for some reason it likes the times between pm and am.

It can go back and forth from being mild to severe, but the worst symptoms are seen in kids under the age of 3, and usually we don't see it after the age of 8 when your child's airway is bigger and can allow for more swelling before the airway gets too constricted. Breast-Feeding Questions. Drinking Fluids - Decreased. Fluid Intake Decreased. Medicine - Refusal to Take. Solid Foods Baby Foods.

Is Your Child Sick? Illnesses and Symptoms Medicine Dosages Medical Conditions Medical Library Browse our library of information about various medical conditions. TM Illnesses and Symptoms Croup Print version of this article Is this your child's symptom? Barky cough and hoarse voice caused by a virus Croup is a viral infection of the voicebox larynx The croupy cough is tight, low-pitched, and barky like a barking seal The voice or cry is hoarse called laryngitis Some children with severe croup get a harsh, tight sound while breathing in.

This is called stridor. When to Call for Croup Call Now Severe trouble breathing struggling for each breath, constant severe stridor Passed out or stopped breathing Lips or face are bluish when not coughing Croup started suddenly after bee sting, taking a new medicine or allergic food Drooling, spitting or having great trouble swallowing.

Exception: drooling due to teething. You think your child has a life-threatening emergency Call Doctor or Seek Care Now Stridor harsh sound with breathing in is heard now Trouble breathing, but not severe Lips or face have turned bluish during coughing Breathing is much faster than normal Can't bend the neck forward Severe chest pain Had croup before that needed Decadron Weak immune system.

Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids. Caution: do NOT give your baby any fever medicine before being seen.

Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Contact Doctor Within 24 Hours Stridor harsh sound with breathing in occurred but not present now Nonstop coughing Age less than 1 year old with a croupy cough Earache or ear drainage Fever lasts more than 3 days Fever returns after being gone more than 24 hours You think your child needs to be seen, but the problem is not urgent Contact Doctor During Office Hours Coughing causes vomiting 3 or more times Croup is a frequent problem 3 or more times Barky cough lasts more than 14 days You have other questions or concerns Self Care at Home Mild croup barky cough with no stridor.

Call Now Severe trouble breathing struggling for each breath, constant severe stridor Passed out or stopped breathing Lips or face are bluish when not coughing Croup started suddenly after bee sting, taking a new medicine or allergic food Drooling, spitting or having great trouble swallowing.

First Aid - Croup with Stridor Stridor is a harsh, tight sound with breathing in. Stridor means the croup is severe. Breathe warm mist in a closed bathroom with the hot shower running. Do this for 20 minutes. Other Option: Use a wet washcloth held near the face. You can also use a humidifier containing warm water. Caution: do not use very hot water or steam. These can cause burns.

Hot steam can also cause high body temperatures.