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Croup: My four-year-old woke during the night with a very strange cough, almost like a dog bark

Croup: My four-year-old woke during the night with a very strange cough, almost like a dog bark. She had a mild cold for a few days before this happened.

What do you think caused this?

This sounds very like a condition called croup, a viral infection of the upper airways around the voice box and windpipe.

A relatively common infection during the winter months, it primarily affects children between six months and six years. However, it can affect younger babies as well.

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Croup usually begins like a normal cold, followed by a sore throat, fever, hoarse voice and a characteristic cough.

But why was she coughing like this?

Children have narrow air passages and when they swell due to the infection, the air passing through them as the child breaths makes a hollow or barking sound you describe. Attacks of croup tend to occur at night, wakening the child. Usually worse on the first and second day, the symptoms usually subside over three to four days.

What should I do if this happens again?

Check her temperature before she goes to bed and if she has a fever give her some children's paracetamol. Prop her up with pillows and tell her to call you if she is woken by the cough.

Steam is very effective in relieving a croupy cough. Bring her to the bathroom and run the hot taps until the room is full of moist warm air.

The steam will loosen the thick secretions blocking her airways, making it easier for her to breath. Do not put her into the bath or shower and ensure you keep her well away from the hot water to avoid burns. Keep her in the steamy atmosphere until she settles.

However, if she develops a high-pitched wheeze or makes a grunting noise when breathing, then you must immediately seek medical attention. Called a stridor, this is a serious sign that the airway is obstructed and will need a breathing tube inserted by a doctor as quickly as possible. Other signs to look out for are difficulty breathing; a blue or pale pallor; or a child who is floppy, listless or restless. If your sixth sense tells you that your child is unwell, contact your doctor for advice even if none of these signs is present. It is always better to be safe than sorry.