What should you know about bronchiolitis and croup at the same time?

Bronchiolitis irritates the small airways and may bring cough, wheezing, fast breathing, and trouble feeding. Croup swells the upper airway and may cause a barking cough, hoarse voice, or stridor, a harsh noise when breathing in. These patterns can occur during the same illness, although other problems can sound similar. A child’s breathing can worsen when upset, so observe the sound and effort while calm as well as during coughing.

Fever and a blocked or runny nose may occur. The more useful warning signs are persistent noisy breathing, ribs or neck pulling in, pauses, poor drinking, fewer wet nappies, or unusual sleepiness.

Keep the child upright and calm, offer small frequent drinks or feeds, and avoid smoke or strong fragrances. Do not force food or use steam, cough remedies, or someone else’s inhaler. Note when the noisy breathing occurs, how much the child drinks, and whether urine output changes. A clinician may decide whether observation, treatment, or respiratory support is appropriate.

Use a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) for an assessment when symptoms overlap or are progressing. You can review [Bronchiolitis](/conditions/bronchiolitis/) and [Cough](/symptoms/cough/) for related information.

Call emergency services if the child has blue or grey lips, pauses in breathing, severe struggle, cannot speak or cry normally because of breathlessness, or is difficult to wake. Seek urgent assessment for stridor while resting, chest indrawing, rapidly worsening effort, inability to drink, or dehydration. Do not wait for a cough to become severe if the breathing pattern is changing.

Ask whether the upper and small airways both seem involved, how to monitor breathing at home, whether any prescribed treatment is needed, and where to go if symptoms return overnight.