What should you know about a barky croup cough?

Swelling narrows the upper airway and changes the sound of air moving through it. Symptoms can become more obvious at night, with crying, or when the child is unsettled. A common cold may occur at the same time. Other causes of a barky cough include Acute Bronchitis, Asthma, Allergic Rhinitis, Acid Reflux, and Bronchiolitis; a clinician may distinguish them by age, examination, and the pattern between coughs.

Keep the child sitting upright on a caregiver’s lap and speak calmly. Offer fluids in small amounts if swallowing is comfortable. Check them regularly, including during sleep, for noisy breathing or increased effort. Keep away from smoke and avoid steam treatments that can cause burns. Use only medicines advised for that child; antibiotics do not treat viral croup unless another infection is found.

Call emergency services for struggling to breathe, ribs pulling in, blue or grey lips, pauses in breathing, extreme sleepiness, drooling with difficulty swallowing, or a harsh breathing sound that remains while the child is calm. Seek prompt assessment if the child cannot drink, is unusually quiet, or symptoms are getting worse. Mild symptoms that do not improve should still be discussed with a clinician.

Is this pattern consistent with croup or another airway problem? What should we listen for while the child is resting? Which medicine, if any, is suitable? How often should we check breathing and fluids tonight?