Parenting a small child means, of course, doubling the number of people whose well being is your responsibility. This can be difficult, for a Wearer Of A Garbage Bag Because You Forgot To Buy Laundry Soap For The 27th Consecutive Week—for someone who has arrived, mostly by accident, deep in the swamp of real-deal adulthood, without ever learning how to identify the day-to-day challenges of grown-up life, much less how to wrangle them. (We are talking about you, here, so you should dislodge your hand from the inside of your nose and pay attention.) Even if it was just taking care of two people, instead of one, that would be asking a lot of the inadequate schlub.
The trick with parenting a small child is, a small child has many of the same day-to-day needs and challenges you do—you both need food, you both need shelter, you both need someone to help you bathe yourself—plus many strange, small-child-specific ones. Your own life has prepared you for dealing with hunger, or a scraped knee, or the desire to watch SpongeBob SquarePants all afternoon; it has not prepared you for teaching someone how to read, or for consoling a heartbroken 6-year-old when her friends excluded her on the playground for no reason and all you want to do is suplex their parents through the fucking windshields of their goddamn Range Rovers. It has not prepared you for being awakened at three in the morning by a terrified, blue-faced child who cannot speak and makes a high, screeching sound like a train whistle when he tries to inhale some air.
That terrifying sound is called stridor, and is a symptom of a severe case of something called croup; it is the sound of a child trying to draw breath through a raw, inflamed airway the size of a goddamn coffee stirrer. Croup is a thing that can happen to kids when they get infections in their respiratory systems: they’re fine all day, a little sniffly in the evening, and then suddenly, in the wee small hours of night, they’re something out of a fucking J-horror movie. Stridor is just one of the frightening sounds of croup; another fun one is the distinctive cough pediatricians call a “seal bark,” because it sounds exactly like a seal barking:
No, really. It sounds exactly like that. Another common symptom of croup is a frantic parent’s sudden realization that all the talk of parenting doubling the number of people whose well being is your responsibility is a load of shit, because actually, your entire sense of well being resides in this small barking person who suddenly seems to be in danger of taking everything worth living for with her into the afterlife.
It’s scary! And not in the way that everything is scary when you are a woefully unprepared parent. Severe croup is fucking scary, even when it’s not particularly severe. It’s also fairly common in small kids, and extremely uncommon in everybody else; even if you yourself once had it, you likely don’t remember it, so your experience is useless when your kid gets it. Here’s a primer on croup for parents—what it is, and what to do about it—so that you won’t turn into a useless lump of shit if you encounter it in your kid.
What in the damn hell is croup? Oh god what is happening to my little Lögynn.
Croup, basically, is inflamed upper airways. Once upon a time, diphtheria was a common cause of croup, but diphtheria’s been pretty well vaccinated to hell in the post-industrial world; nowadays, when kids in the U.S. and Canada get croup, it’s mostly caused by viruses. It starts out like your basic cold—runny nose, normal cough, shitty ’tude—and commonly turns into full-blown croup at night, while the kid’s asleep. In its most common, mildest forms, it amounts to slightly-more-difficult-than-usual breathing, a weird cough every once in a while, and a hoarse and grumpy kid. In these cases, you can do stuff at home that will alleviate the symptoms until it goes away, in the manner of colds and other random viruses.
In more severe cases, croup involves stridor—that awful screeching sound during inhalation—blue lips, chest-wall indrawing (your kid’s chest will look noticeably tighter and more concave than usual), and a trip to the hospital, where doctors will treat it with steroids and an oxygen mask.
What do I do? What do I do? SOMEONE TELL ME WHAT TO DO.
The obvious first and most important thing to do if your child develops croup is to keep your wits about you.
Step 1: Keep your wits about you
Easier said than done, right? Of course. It’s Jaecquyllynne we’re talking about, here! In whom resides literally all of your reasons for ever feeling good or hopeful about anything! And she’s having trouble breathing! If ever there were a time when the casting away of wits would be an understandable move, this is it.
But still: Don’t panic. If you panic, your kid will panic; panicking will make her breathe more violently, which will exacerbate things. You need need to remain calm so that you be a source of calm; calmness won’t fix croup, but it can help prevent it becoming worse. Plus, if you panic, too, then everyone is panicking, and nobody is fixing the croup. You need to remain calm. That’ll be easier if you know what to do.
Step 2: Try to calm your kid as much as you can
Possibly little Aethyn is taking big, freaked-out drags of air, and exhaling by way of crying a lot. Do what you can to calm him down. Communicate with your voice and face and body language that oh, you poor thing, this sucks, but the situation is under control, and encourage him to relax and try to take nice deep breaths.
The oh, you poor thing, this sucks part is important: If you act too blasé about the whole thing, that will freak him out worse because he’ll worry that you don’t understand what’s going on, and he’ll do the little-kid thing of crying even harder to try to communicate how fucked up this situation is. That will make things worse. Your kid needs to know that you know that this is fucked up and awful, but that you’re not panicking because you know it’s going to be okay.
(Probably don’t say “this is fucked up and awful.” Probably his teacher will disapprove when he repeats that bon mot in the autumn.)
This will be hard to express! Because you are shitting your pants in terror. You can do this for the li’l guy or gal. Oh my gosh, Kraeydynn, you poor little pumpkin! Let’s take some nice deep breaths together. Like Daddy, okay? And then demonstrate some nice deep relaxed breaths.
Even if all this does is keep you from fainting, that’s not nothing.
Step 3: Do some quick triage to determine if you need an ambulance
Here you’re gauging the severity of the croup. This is where that terrible high-pitched stridor sound, in its nightmarish way, can be of some use to you. It can act as a siren. And what do sirens indicate? That’s right: emergency vehicles.
Does your kid make horrifying sounds like a goddamn car horn when she inhales? Does she do it on every inhalation (as opposed to just when she’s taking an extra-deep breath before coughing an awful seal-bark cough)? Is she visibly laboring to get air? Is she too busy sucking at the air to talk? You need an ambulance.
My older son, Henry, first contracted croup a couple of years ago, when he was four. He’d been fine all morning, and then he took a nap after lunch, and then he woke up a half-hour later with full-blown severe croup. His lips were blue. He was honking like a goddamn goose when he inhaled, and barking like a seal when he exhaled. The muscles in his abdomen and visibly concave chest were straining with the effort to force air in and back out of his lungs. He couldn’t speak, because he was too busy fighting for oxygen; when he took a breath and tried to talk, he could not force more than a squeak through his windpipe. And, most terrifyingly of all for me, his deeply inadequate father, he was exhausted. The work of breathing was wearing him out; he was running out of energy for it. I could see it on his face.
My friends, I say to you today that if Fear were a nation, my home was its capital at that moment. I had never even heard of croup before. I thought my son was dying in front of me. Maybe he was! I called for an ambulance. Probably a recording of my tearful pleas still exists somewhere out there in the world. Anyway I think calling for an ambulance was a pretty good choice.
Most cases of croup are not nearly as severe as this (indeed, Henry’s had croup twice more since that first bout, including one just two weeks later, and his little brother had it once, too, and none of these were remotely as bad as that first one), and most of them do not require any medical intervention beyond what you can do at home. If your kid can still speak reasonably well, doesn’t seem to be laboring unsustainably to get air in and out of her lungs, isn’t making that awful stridor breath-sound, and isn’t blue in the lips or face—if she seems like herself, more or less, just droopy and sick and with the occasional weird cough—you don’t need an ambulance. You can do some stuff at home to alleviate the symptoms, in those cases, but keep an eye out! If shit seems to be spiraling—if the symptoms get worse despite your interventions—get some help.
Remember: Nobody will be mad at you if you call an ambulance because you’re freaked out by your kid’s croup. The EMTs will understand. Plus, your kid is cute, and (whether they will admit it to themselves or not) they got into this line of work to be heroes to cute little kids. All in all they’d probably prefer giving some oxygen to a cute kid over helping some crotchety old fart get back into his recliner.
If your kid’s croup isn’t severe enough for an ambulance, or if you’re waiting for the ambulance to arrive, you can take some measures at home to help with the symptoms.
Step 4: Get some warm and/or cold and/or moist air into your kid
Yeah, this bit’s weird. I’ve been told, by actual medical doctors, that both cold air and warm, moist air can give relief from croup symptoms. That’s both confusing and kinda nice, because it means you can try a few different things if the first one doesn’t work so well.
If you have a humidifier, get it going on full-blast in a small room (like the bathroom), and sit in there with your kid as the air gets warm and damp. Ten minutes of calmly breathing in that warm, damp air might loosen things up a bit so your kid can breathe more easily. When he’s ready to go back to bed, set up the humidifier to do its thing in his room overnight, so that the croup doesn’t worsen again.
If you don’t have a humidifier—or if you tried the humidifier trick and it didn’t seem to work—turn on the shower as hot as it will go, draw the shower curtain so the steam lingers in there, get in there with your kid, and breathe that muggy, steamy air together for a while. (You can point the shower head at the floor so that you don’t get soaked.) In my experience, this works much more quickly than the humidifier; also, the shower might distract your kid a bit, what with all the droning noise, so that she won’t even notice how violently you are sobbing.
If that doesn’t work, or if your home is already hot on the inside and the idea of filling it with hot steam seems more like punishment than medicine, take your kid into the kitchen and hold him up so he can stick his head in the freezer and breathe in the cold, misty air for a few minutes. Get him way up in there, so he’s sucking down whole lungfuls of that frosty shit right from the source. This will seem ludicrous and—if you have a regular fridge with the freezer on top—will exhaust your arms. You are not torturing your child, I promise! It can help.
But probably just do the shower thing. It works pretty well. Eventually, he’ll begin breathing more easily; since it’s the middle of the goddamn night, he’ll probably relax and get sleepy. And you will hug him, and kiss the top of his fuzzy noggin, and try to play it off like the steam is responsible for the wetness on your face.
Step 5: Go ahead and let the kid sleep next to you for the rest of the night
Mostly for your own benefit. You won’t sleep a wink, of course, because kids are like giant fidgety space-heaters, but you weren’t going to sleep anyway. At least this way you won’t be straining all night to hear if your kid is down the hall slowly suffocating to death.
Step 6: Talk to your pediatrician as soon as you can
If your kid didn’t go to the hospital overnight, but still has the seal bark the next day, call the doctor’s office, tell them your kid has croup, and ask if they’d like to see your kid. Probably they will, or maybe they’ll just give you some advice or write a prescription for a sweet-ass electric jet nebulizer and some albuterol (or whatever) that you can sock in a closet in case the croup ever comes back. In any case, the doctor ought to know that your kid has croup.
Step 7: Be a paranoid, shaky mess for the next three weeks
Don’t worry, this one takes care of itself.
Photo via Shutterstock
Contact the author at [email protected] or on Twitter @albertburneko.