Like a horror film, croup seems scarier in the middle of the night

Scary films are usually set at night, which makes sense when you think about it.

It wouldn’t be a particularly frightening horror film if Michael Myers exclusively struck around lunchtime.

There’s something primal about our dislike of the dark.

Two parents came to see me last week and they weren’t very much looking forward to that evening, on account of their sick child.

He had croup and, as is often the case, his symptoms were worse at night.

Croup is caused by a virus and usually affects children between six months and three years old, but sometimes a bit older.

Just like a normal cold, it makes the child feel poorly, with a sore throat, runny nose, temperature and so on.

What differentiates croup is that it affects a small child’s developing larynx and trachea – the voicebox and the airways, which get bigger and stronger as a child grows and therefore less susceptible to croup.

Croup typically causes a sharp, barking cough which is due to the inflammation of the larynx.

It also causes something called stridor.

This is simply noisy breathing caused by mucus in the inflamed airways, often when the child breathes in rather than out.

The symptoms usually peak over a three-day period and most of the time – in nine out of 10 cases, it’s estimated – croup clears up without the child needing to be admitted to hospital.

As I mentioned, the symptoms can be taxing for the child – as well as mum and dad – at night.

If the child starts finding it difficult to breath then I advise parents to contact an NHS out-of-hours service.

They should look out for laboured breathing – for instance chest or neck muscles being pulled in with each breath.

A real struggle to breathe, or if the child is turning blue, then it’s time to call 999.

Not to worry though – most children will be fine. Parents should stay calm if their child is distressed, try to keep them from getting too hot and give them lots of cool drinks if they can take them.

As with all viruses, antibiotics won’t help, but I gave my patient a single dose of steroid medicine to ease his symptoms and give his parents a better night.