New study shows cold air helps with croup.

New study shows cold air helps with croup.

Cold Air Found to Ease Children’s Croup Symptoms, Study Suggests

By Amy Norton, HealthDay Reporter

Croup, a common childhood illness, has long puzzled parents and pediatricians alike. It begins as a regular cold but quickly escalates when the infection causes swelling around the voice box and windpipe. This leads to distinctive croup symptoms, including a cough that resembles a seal’s bark and a high-pitched “creaky” or whistling noise when the child breathes in, known as stridor.

Fortunately, most cases of croup are mild, and pediatricians have traditionally recommended some old-fashioned tricks to alleviate symptoms. These include running a hot shower and standing with the child in a steamy bathroom, standing in front of an open refrigerator freezer, or bundling up the child and spending some time outside in the chilly air.

According to Dr. Mike Patrick, an emergency medicine physician at Nationwide Children’s Hospital in Columbus, Ohio, the common denominator in these methods is the introduction of moist air. He explained that indoor air, especially during winter, tends to be dry, which exacerbates the symptoms of croup. Interestingly, this advice has been given by pediatricians for almost 30 years, demonstrating its efficacy.

In most cases, by the time parents rush their child to the emergency room due to worsening nighttime symptoms, the symptoms have already improved, as observed by Dr. Matthew Harris, an emergency physician at Cohen Children’s Medical Center in New York. This suggests that spending a short time in cool air can actually be beneficial.

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To investigate the effects of cold air exposure on croup symptoms, a recent study led by Dr. Johan Siebert and colleagues at Geneva Children’s Hospital in Switzerland was conducted. Families who brought their baby or young child to the emergency room due to croup symptoms were recruited for the study. If the symptoms were mild to moderate, the families were randomly divided into two groups: one group where the children were given the oral anti-inflammatory drug dexamethasone and then spent 30 minutes outside in the chilly air, and another group where the children received dexamethasone but stayed inside the ER.

It is worth noting that none of the children in the study had severe symptoms that require immediate intervention. In such cases, inhaled epinephrine is typically administered to quickly open up the airways.

The findings of the study revealed the potential benefits of cold air exposure for relief of croup symptoms. Out of the 59 children exposed to outdoor air, 49% experienced a significant improvement in symptoms within the 30-minute timeframe. This percentage dropped to about 24% in the group of 59 children who remained indoors.

However, the authors caution that this does not mean ERs should start sending families outside to manage a child’s croup symptoms. The ER in this study served as a controlled setting to observe the effects of cold air exposure. Instead, the findings should be viewed as evidence that supports the practice of using moist air to alleviate croup symptoms.

Dr. Joanne Nazif, of Children’s Hospital at Montefiore in New York City, also acknowledged the study’s evidence for the benefits of cold air. However, she pointed out that in the study, cold air was combined with dexamethasone and did not consistently bring relief for every child.

Therefore, if parents have any concerns about their child’s breathing, they should seek medical care. However, Nazif suggests that they may want to crack a window in the car on the way to the ER, acknowledging the potential benefits of cool air.

This study contributes valuable evidence to support the use of moist air in managing croup symptoms in children. By understanding the underlying science and conducting rigorous research, medical professionals can provide evidence-based recommendations for parents dealing with this common childhood illness.

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Source: Pediatrics, September 2023

More information The American Academy of Pediatrics has more on croup.