Many childhood illnesses resemble asthma, making it difficult for a definitive diagnosis of asthma in babies and young children. We’ll take a look at what causes croup and some of the differences between asthma and croup.

What is Croup?
Croup is a contagious infection of the larynx, trachea and the upper bronchial tubes. It’s usually caused by a viral infection, but is sometimes caused by a bacterial infection.

The croupy cough is characterized as sounding like a “barking seal” and there may be gurgling sounds during inhalation. Croup causes narrowing of the upper airways, making breathing difficult. Croup is most often seen in children between the ages of 6 months and 3 years of age. The illness is typically seen in late fall and early winter.

Croup can be passed through the air when an infected child sneezes or coughs, or can be spread by contact with infected mucous on hard surfaces. The incubation period for croup is about 2-3 days--this is when it is most contagious. The illness typically lasts from 4 to 7 days, though the cough may linger for some time after the illness. Croup can range from mild to life-threatening (which is rare), depending on the degree of narrowing in the airways.

Mild to Moderate Croup Symptoms
• Fever (100 F-103 F)
• Hoarseness
• Sore throat
• Barking “seal cough”
• Gurgling or raspy sounds during inhalation
• Nasal stuffiness
• Labored breathing
• Rapid pulse

Severe Croup Symptoms
Severe forms of croup may include the following symptoms:
• Fever
• Stridor (high-pitched, musical breathing caused by narrowing of the upper airways)
• Drooling
• Painful swallowing
• Restlessness
• Rapid heart rate
• Semi consciousness
• Cyanosis (bluish coloring, especially around the mouth and lips)
• Inability to bend the neck forward

These symptoms are considered life-threatening. You should contact your doctor and/or an ambulance immediately to get medical assistance for your child.

Croup Treatment
Treatment of croup may include cool moist air to humidify the air, saline nose drops to ease nasal stuffiness and congestion, OTC pain and fever medications (such as acetaminophen or ibuprofen. Aspirin should be avoided, as it can cause Reyes Syndrome and should be avoided). Children with bacterial croup will also receive a round of antibiotics. In severe cases of croup, children are hospitalized. Hospital treatment may include oxygen, mist therapy, nebulizer treatment with saline solution or racemic epinephrine, antibiotics (if the injection is bacterial)and possibly corticosteroids.

Asthma vs. Croup
Sometimes it may be hard for you and your doctor to tell whether your child has asthma or croup. Croup affects the upper airways, while asthma inflammation typically takes place in the lower airways. Another distinction between asthma and croup is that an asthma cough is typically deeper than a croup cough. Other signs your child may have asthma rather than croup are shortness of breath while exercising or nursing. In addition, asthma wheezing is made by the lungs when air is expelled, while raspy breathing sounds are made while inhaling when a child has croup.

The doctor’s diagnosis is based on your child’s medical history, family history of asthma and allergies, symptoms and an exam of the throat. A throat culture may be done to determine if your child has a bacterial form of croup.

A course of asthma medications may be prescribed, as a test, to see if your child responds to the medication. A long-term, recurrent croupy cough is more likely to be asthma and will be treated the same as other types of asthma: bronchodilators (inhaler or nebulized) and oral or inhaled corticosteroids, along with avoidance of asthma triggers.

Can Croup Cause Later Asthma Development?
Croup does not seem to cause asthma development in later childhood years. However, children who have a recurrent form of croup may be more disposed to asthma, especially if they have a family history of allergies and asthma.

Telling the difference between asthma and croup can be confusing and scary. Both croup and asthma can be life-threatening. Children who have frequent or recurring croup do have a higher tendency to develop asthma if they have a family history of allergies and asthma. When your kids have breathing difficulties of any kind, be sure to monitor them closely and call the doctor or head to the emergency room at the first sign of serious breathing distress.

Please check out my new book Asthma's Nothing to Wheeze At!


Now also available on Amazon Asthma's Nothing to Wheeze At!