What are the differences between croup and bronchiolitis

By: Osler Health International
Posted on: 27 Apr 2023

As the weather changes in Singapore, it is common for babies and children to experience coughing and other respiratory symptoms. While these symptoms may seem innocuous at first, they could be indicative of more worrying conditions such as croup and bronchiolitis, which may cause respiratory distress and complications that can result in hospitalisation. 

Croup is caused by a viral infection and affects the upper respiratory tract, specifically the vocal cords, windpipe and voice box, leading to constriction of the upper airways that causes coughing. Bronchiolitis, on the other hand, is a viral infection that affects the small airways in the lungs, resulting in an inflammation of the airways and an accumulation of mucus that causes breathing difficulties. As a parent who wants the best for your child, you may immediately wonder: when do I worry if my child has croup or bronchiolitis instead of a common cough?

Does my child have a common cough, croup or bronchiolitis?

A common cough is usually caused by irritants in the airways, such as dust or smoke. Unlike a common cough, babies and children with croup or bronchiolitis typically experience laboured breathing. While both croup and bronchiolitis can cause respiratory distress, there are several key differences between these two conditions.

Understanding these distinctions is critical to ensure you can accurately describe your children’s condition to the doctor during the consultation so they can receive the optimal treatment that helps them get back to feeling their best quickly.

1. Croup

Croup commonly affects babies and children aged three months to five years. It is caused by the same viruses responsible for the common cold and transmitted through direct exposure to infected individuals or their bodily fluids. Croup initially manifests as a typical respiratory infection with indications such as fever, congestion, and a runny nose. Its unique characteristics include the following:

  • A harsh, barking cough.
  • Hoarseness caused by the swelling of the vocal cords.
  • A high-pitched or squeaking sound during inhalation. When the condition worsens, this sound may be audible even when your baby is relaxed or sleeping.

These symptoms typically worsen at night or when the baby is agitated or crying. They may also be more severe in children younger than three years old whose airways are narrower such that even a slight inflammation can cause significant breathing difficulties. If croup is severe, a child may:

  • Exhibit a pale or bluish colour around the mouth.
  • Drool and have trouble swallowing his or her saliva.
  • Struggle to breathe or speak.
  • Be excessively sluggish and difficult to wake.

The symptoms of croup typically worsen within the first three days. Notably, for children with asthma, lung diseases, or premature birth, croup can be a source of worry as complications may arise when left untreated. This can include pneumonia or even bacterial tracheitis, a severe and potentially lethal infection.

2. Bronchiolitis

Bronchiolitis often affects babies between three to six months old. Children born prematurely or with chronic heart disease, lung disease, or a weakened immune system due to a recent illness are at greater risk of bronchiolitis. A child may contract this illness after inhaling contaminated air droplets or coming into contact with surfaces contaminated with droplets from an infected person. Bronchiolitis typically commences with a cold followed by an onset of coughing and the symptoms below:

  • Breathlessness, rapid or irregular breathing.
  • Lethargy.
  • Easy irritability that is hard to pacify.
  • Poor feeding or fluid intake.
  • Dry lips and may not urinate in the last six to eight hours.

In the advanced stages of the condition, a child may show the following signs and symptoms:

  • Blueish or greyish skin, lips and mouth.
  • Short, shallow breaths.
  • Struggle to breathe or speak.

Safeguard your child’s health with Osler Health

If you suspect your little one is suffering from either croup or bronchiolitis, please seek support from your paediatric doctor or family physician.  Our experienced children’s doctor – Dr Nicole Plesko- Altermatt has years of experience in paediatric health. 

Recognising that every child has unique needs, we approach each case with a tailored plan of action, and we strive to create an environment where your little one feels comfortable and can establish a rapport with our doctors. From croup to bronchiolitis and everything in between, you can rest easy knowing your children’s health is in good hands. Reach out to one of  our clinics in Singapore or book an appointment online today.

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