What parents should know about croup

Symptoms often follow a runny nose or fever and may become more noticeable at night. Many children can be cared for at home, but noisy breathing while resting, chest pulling or a change in colour needs urgent assessment.

Swelling around the voice box and windpipe narrows the passage for air. The cough can sound seal-like, the voice may be raspy, and breathing in may produce a harsh high-pitched sound called stridor. Croup commonly presents with this barking cough, while stridor at rest points to more significant narrowing.

A common cold can precede croup, and a fever may occur. Cough and fever alone do not identify croup because many respiratory infections share them. Drooling, difficulty swallowing or a child sitting forward and appearing very unwell are not features to manage as ordinary mild croup and need emergency assessment.

Keep the child calm and upright in a comfortable position, as crying can make noisy breathing worse. Offer frequent drinks and check them regularly overnight. Give an age-appropriate fever medicine only according to the label or a clinician's advice.

Do not use steam, which can cause burns and has no reliable role in relieving airway swelling. Avoid cough medicines in young children. A clinician may give a corticosteroid to reduce swelling. Nebuliser treatment may be used in urgent care for more significant airway symptoms, with observation afterward because its benefit can wear off.

Call emergency services if the child has blue or grey lips, severe difficulty breathing, marked chest pulling, drooling with inability to swallow, pauses in breathing, or is unusually sleepy and hard to wake. Seek urgent clinical advice for stridor while resting, worsening breathing, poor fluid intake or symptoms that are not settling. Do not examine the throat of a child who is struggling to breathe.

Ask whether the breathing sound is stridor, whether a corticosteroid is advised, what changes should trigger reassessment, and how to keep fluids going. Describe whether noise occurs only during crying or also at rest, and mention any drooling, swallowing difficulty or previous episodes.