Croup symptoms in a 2-month-old baby

Contact an urgent medical service now for advice even if the baby currently seems settled. Call emergency services if breathing is laboured, noisy while resting, interrupted by pauses, or accompanied by blue or grey lips, severe drowsiness, drooling, or inability to feed.

Croup is swelling around the voice box and upper windpipe, usually during a viral infection. It commonly presents with a harsh barking cough, a hoarse cry, and a high-pitched sound when breathing in called stridor. Symptoms may become more noticeable when a baby cries or becomes upset.

Other airway and breathing problems can sound similar in a small infant, so a clinician should confirm the cause. Stridor heard while the baby is calm is more concerning than noise that appears only with crying.

Keep the baby calm and upright in your arms while awake, because crying can make upper-airway noise worse. Offer small amounts of the usual breast or formula feed only if breathing is comfortable. Note when symptoms started, whether stridor occurs at rest, and whether feeds and wet nappies have changed.

Do not use steam, hot showers, cough syrup, decongestants, essential oils, or someone else's nebuliser medicine. A clinician may use medicine to reduce airway swelling after examining the baby; treatment depends on severity and the diagnosis.

Call emergency services for blue or grey colour around the mouth, pauses or irregular breathing, pronounced pulling in between or below the ribs, grunting, a weak cry, limpness, extreme sleepiness, or severe agitation with breathing difficulty.

Emergency assessment is also needed if the baby drools and cannot swallow, cannot feed, or has stridor continuously while calm. Any measured fever in a baby this young requires urgent medical advice, as do fewer wet nappies or repeated vomiting.

Ask whether the sound is stridor and whether it occurs at rest, what treatment is appropriate for the baby's age, and how long close observation is needed. Confirm which breathing changes mean you should call emergency services rather than travel independently.