Causes and Treatments for a Barking Cough

What is a barking cough?

The medical term for a barking cough is croup, which is a viral condition that causes swelling of the upper airways of children, especially those who are younger than 5 years old. It is also described as the inflammation of the larynx and the trachea in children.

There are a variety of causes or inflammatory conditions, which can lead to the occurrence of a barking cough. These conditions are often characterized by their varying degrees of inspiratory stridor, hoarseness, and a barking cough due to the obstruction in the area of the larynx.

Below are the following structures of the upper respiratory tract:

• Larynx - also known as the voice box, which has the vocal cords.

• Pharynx - located at the top of the throat that connects the mouth and nose to the esophagus.

• Epiglottis - a flap of throat tissue that prevents or obstructs food and liquids from entering the windpipe.

• Trachea - also known as the windpipe, which connects the pharynx and larynx to the lungs.

• Bronchi - the main passageways that lead to the lungs.

When it comes to croup, the swelling and inflammation around the windpipe and vocal cords produce a characteristic barking cough. Most of the time, children who have croup tend to recover within a few days. However, in severe cases, hospitalization may be needed.

Causes

Croup is a common respiratory condition in children and is known to be caused by certain allergic reactions or viral infections. A child who suffers from croup has a cough that would sound like a barking seal along with a wheeze-like noise or stridor when breathing.

Around 3 percent of children are affected by this medical condition every year. Moreover, it is mostly observed as a common occurrence during winter or autumn season. Children who are 3-6 years old are more prone to getting croup, but older children can also get affected.

1. Viral Infections

Let us have a look at the causes of a barking cough due to viral infections. The human parainfluenza viruses types 1, 2, and 3 tend to account for almost 70-80 percent of croup cases.

• Human parainfluenza virus type 1 (HPIV-1) - the most common cause of croup.
• Human parainfluenza virus types 1 and 2 - account for 55-66 percent of croup cases.

The human parainfluenza virus type 4 has two subtypes: 4A and 4B. These subtypes are known to be associated with the milder form of the illness, but are still not completely understood.

There are research studies that suggest that the following viruses or organisms cause other cases of croup:

• Respiratory syncytial virus (RSV)
• Influenza A and B
• Coronavirus
• Adenovirus
• Metapneumovirus
• Mycoplasma

The viral infection that tends to escalate this medical condition would also typically take the following course:

• The virus would start to infect the throat and nose.
• The virus spreads along the respiratory tract, which is at the back of the throat to the trachea and the larynx.
• As the infection progresses, there would be swelling on the top portion of the trachea.
• The space available for the air to freely enter into the lungs would start to get narrow. 
• Due to the narrowing of the space, the child tends to breathe rather quickly and deeply, which then lead to the symptoms of croup.
• Most children with the condition would feel restless or easily get agitated since they would find it difficult to breathe. Due to agitation, there would also be a constriction or narrowing of the throat, which may increase breathing difficulties. If it is not properly taken care of, then it can exacerbate the condition. Children would become exhausted in this process and would find it difficult to breathe on their own, especially in severe cases.  

2. Bacterial Infections

Apart from viruses, croup cases can also be due to secondary bacterial infections. It has been seen that most croup cases due to a secondary form of bacterial infection is caused by Staphylococcus aureus and other types of bacteria, which include:

• Streptococcus pneumoniae
• Moraxella catarrhalis
• Streptococcus pyogenes
• Haemophilus influenzae

Treatment

• Antibiotics - When it comes to the treatment of a barking cough, antibiotics are not really beneficial since most croup cases are due to a virus instead of a bacterium.

• Over-the-counter Medications - The conventional mode of treatment would involve over-the-counter medications for colds and coughs.

• Steroids - In certain cases, doctors can prescribe steroids such as prednisone, dexamethasone, and prednisolone. These medications are often suggested to the patient to reduce swelling of the airway and improve breathing.

• Epinephrine - If the barking cough becomes severe, then the child is immediately given a medicine called epinephrine to quickly reduce airway swelling.

Although over-the-counter medications, epinephrine, and steroids are known to quickly ease the symptoms, they can also cause certain side effects that can be harmful to patients. 

Hospitalization

In severe cases, hospitalization may be necessary since breathing difficulties can lead to complications. If the child finds it quite difficult to breathe, then immediate medical help is a must. However, croup cases are usually mild and can be managed using home remedies.

On an average, there is about 5-6 percent of croup cases, wherein hospitalization is needed. It was found out in randomized controlled trials (RCTs) that in comparison with a placebo, just one dose of oral dexamethasone given to children with mild croup had an improved outcome.

Steroids medications can help reduce the severity of breathing problems in children with croup. In certain cases, prednisolone can also be used as an alternative instead of dexamethasone.

Natural Remedies 

Almost 90 percent of croup cases can be successfully treated at home without the need of medications. Most of the time, a barking cough would go away on its own. Below are some natural remedies for croup:

1. Steaming

It would be helpful for anyone who has an upper respiratory problem or breathing issues to breathe in moist air. To get immediate relief, you can go to the bathroom, shut the door, and turn on the shower to its highest heat setting. Sit outside the hot shower while it runs. Try to breathe in the warm steam for around 10 minutes.

You can also use a cool mist humidifier in the bedroom during nighttime to put a continuous stream of warm mist into the air at bedtime. It can reduce coughing, thereby making it easier for the child to breath. A spasmodic barking cough is known to significantly improve with the help of a cool mist vaporizer.

2. Increased Fluid Intake

One of the recommended treatments for croup is drinking lots of fluid. It is mostly recommended by holistic health practitioners and doctors who take the conventional method. Similar to the common cold, it is quite important to keep oneself well hydrated.

Water has always been the number one option when it comes to increasing one's fluid intake. When it comes to infants, breast milk is enough. Older children can take soups, coconut water, homemade fruit juices, or broths. Fluid loss can be effectively replaced by drinking plenty of fluids.

Other warm liquids that can be taken are herbal teas, soups, or broths, which are excellent when it comes to helping the vocal chords relax as well as loosen sticky mucus. At the same time, it is quite important to avoid any food items that can lead to an increase in the production of mucus. Such foods include dairy products, processed food items, and sugary foods.

3. Create a Soothing Environment

As a parent, it becomes quite important to remain calm when your child has a barking cough to be able to provide care and comfort. It is also important that your child’s breathing is calm. Try to keep your child calm and avoid any kind of stress that can further worsen your child's breathing. Keep your child busy with fun books or games for a faster recovery and healing.

4. Rest

For those who have a barking cough, it is essential to take an ample amount of rest. If your child finds it difficult to breathe when resting in a flat position, you can slightly elevate your child by using more pillows.