What should you know about croup and cough?

The cough may sound harsh or seal-like because the upper airway has become narrower. A child may also have a runny nose, fever, or a raspy voice. Noisy breathing called stridor can happen when the child breathes in; it may become more noticeable when they cry or become upset. Croup often begins after cold-like symptoms and can feel worse at night.

Croup is different from a simple cough because swelling near the upper airway can affect the sound of breathing. Other conditions can also cause cough, including the common cold, acute bronchitis, asthma, or bronchiolitis. A cough that continues for a long time may need assessment for chronic cough, while mucus draining from the nose or acid reflux can also irritate the throat.

Keep the child calm and hold them upright or let them sit in a comfortable position. Crying can make upper-airway noise worse. Offer frequent sips of fluid if they can swallow comfortably, and check them regularly, including during sleep. Use medicines only as directed for the child’s age and by a clinician or pharmacist; do not give cough or cold products intended for adults.

A clinician may assess the child’s breathing and give treatment to reduce airway swelling when needed. Do not rely on steam or a hot shower for relief, because hot water can cause burns and the benefit is uncertain.

Seek emergency help immediately if the child is struggling to breathe, has persistent noisy breathing while resting, is unable to speak or cry normally, has blue or grey lips, becomes unusually sleepy, or cannot swallow and is drooling. Do not force food or drink if breathing is difficult.

Arrange prompt medical advice if the cough is worsening, breathing remains noisy, the child is drinking much less, passes very little urine, or you are worried about their breathing. A healthcare professional can decide whether this is croup or another cause of cough and whether treatment or observation is appropriate.

Ask what signs show that the child’s breathing is becoming harder, whether the child needs an examination today, and which medicines are suitable for their age. Tell the clinician when the barking cough began, whether noisy breathing occurs at rest or only during crying, and how much the child is drinking.