Breathing with croup: what parents should know

Croup is an upper-airway illness that can cause swelling around the voice box and windpipe. A harsh, barking cough and a high-pitched sound when breathing in, called stridor, may appear. Symptoms often become more noticeable when a child cries because distress makes breathing harder. A hoarse voice, runny nose or fever can occur too. Croup commonly follows a viral cold, but noisy breathing should be judged by how hard the child is working to breathe, not by the cough alone.

Sit your child upright, hold them comfortably and use a calm voice. Offer small, frequent drinks if swallowing is comfortable. Avoid forcing food, examining the throat, or using steam, which can cause burns. Follow any medicine plan already given by the child’s clinician; do not give a cough medicine unless advised. Note whether the noisy sound occurs only during crying or also while your child is settled. A child health consultation can assess breathing, and nebuliser treatment may be considered by clinicians when symptoms are significant.

Seek emergency help immediately if your child is struggling for each breath, the skin between the ribs or at the neck is pulling in, the lips look blue or grey, or they are unusually sleepy, floppy or difficult to wake. Urgent assessment is also needed for stridor while resting, drooling, or trouble swallowing. Keep the child upright while help is arranged. If breathing is noisy only during crying but settles when calm, contact a clinician promptly for advice, especially if symptoms are worsening or fever persists.

Ask whether the breathing noise is stridor and what changes should trigger emergency help. Ask how to use any prescribed medicine, whether follow-up is needed, and how to support fluids and sleep safely tonight.