The funny thing about croup is that it’s like the vampire of toddler illnesses. During the day it may not have a visible impact beyond your toddler eating little (and lets face it sometimes they do want to live on air and crayons) and sounding hoarse. Daytime clues to croup might be largely losing one’s voice, eating little, a sensation like a slight obstruction in the throat, difficulty swallowing, and a mild temperature.
Toddlers have softer windpipes than older children so it’s often when they lie down to sleep that the narrowed airways will become more apparent. Their breathing may start to wheeze and become progressively more of a struggle; it can also cause a strange cough (stridor). What does a croup cough sound like in a two year old? It sounds a bit like a lion purring or a seal bark; personally I think stridor sounds most like a lion coughing up a fur ball. The animal metaphors might sound cute but the cough can be so loud that it’s enough to travel between rooms and wake you up at night; it can also be frightening if it’s the first time you’ve heard it and you have no idea what it means!
For many children, croup will be a mild illness (which can recur) and which can be treated at home. For others, they need to see a doctor or require urgent medical care. In New Zealand there is a registered nurse available 24/7 to provide free health advice on Healthline (0800 611 116); they can help assess your child and advise whether to ring for an ambulance or wait to see a doctor the next morning.
Personally, I think that croup is worse for children that have allergies. In fact, as well as viral croup, there is also a form of spasmodic croup which may be caused by Gastric Reflux Disease (GERDs) or by allergies. I’ve also read blog posts from other allergy families where croup has become a recurrent problem for their toddllers.
For us, it involved night time difficulties with breathing and a croup cough. On ringing Healthline, I was advised to ring emergency services. A triage nurse did an assessment over the phone and dispatched an ambulance. We spent the night in the Emergency Ward as she required oral steroids, monitoring for fever, and to remain semi-upright to provide relief for airways. Recovery at home took time, monitoring of airways, and a largely liquid / soft foods diet for a few days.
I continue to feel that croup can be a much more serious illness for families with medically fragile children – including food allergies, airborne/environmental allergies, asthma, and reflux. Doctors will most commonly look for croup in babies and very young toddlers but plenty of allergy families have shared that their children have continued to have viral croup up to age 10!
NOTE – Thank you to all the readers that have shared their stories with me!
If you’re familiar with what a croup cough sounds like then do advocate on behalf of your child for medical care if it’s needed – you’re the one awake in the wee hours of the night hearing it (and they may not have the cough during the day)! Don’t hesitate to ring for an ambulance at night if your child is struggling to breathe!
It’s worth investigating what charges there are for your local ambulance service and if they have a subscription service. If you live in New Zealand, it’s around NZD$90 for each medical emergency (non-ACC) call-out of a St John’s ambulance but you can get an annual ambulance subscription for the whole household for NZD$65 per year.