What should you know about croup and bronchiolitis together?

Croup causes swelling around the voice box and windpipe. A harsh, barking cough and a rough sound when breathing in are typical clues. Bronchiolitis affects the smaller airways deeper in the lungs; it may cause fast breathing, noisy breathing, cough, and difficulty feeding. A child with bronchiolitis may also have wheezing. A viral illness can precede either problem, so symptoms can overlap. See [Bronchiolitis](/conditions/bronchiolitis/) for more detail.

Keep the child calm and upright, because crying can make noisy breathing worse. Offer small, frequent drinks or feeds and watch for fewer wet nappies, a dry mouth, or unusual tiredness. Avoid cigarette smoke and do not use steam near a child. Note whether the cough, breathing noise, or wheeze changes while resting. A clinician can decide whether observation, oxygen, fluids, or another treatment is needed; a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) can help assess both conditions.

Seek emergency help if the child is struggling to breathe, has pauses in breathing, pulls in under the ribs, becomes blue or grey around the lips, is too breathless to drink, or is difficult to wake. Seek prompt medical advice for noisy breathing while resting, worsening wheeze, or signs of dehydration. Do not force food, drink, or medicine when breathing is severely distressed.

Ask which airway signs suggest croup, bronchiolitis, or both; whether the child needs monitoring for oxygen or hydration; what changes should trigger emergency care; and whether a [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) has a role.