Croup and runny nose: what to know

Croup is an upper-airway illness that can cause a hoarse voice, a barking cough and a harsh, high-pitched sound when breathing in. A runny nose may appear before or alongside these symptoms because the same viral illness can affect the nose and voice box. Nasal discharge can be clear or thicker as the illness changes; its appearance alone does not show whether antibiotics are needed.

Croup symptoms are often more noticeable at night or when a child is upset and crying. Keeping the child calm matters because distress can make noisy breathing seem worse. A runny nose can also occur with a common cold, influenza or COVID-19, while allergies usually cause repeated nasal symptoms without the typical barking cough. Explore information about the [Common Cold](/conditions/common-cold/) or [Runny Nose](/symptoms/runny-nose/) if nasal symptoms continue after the cough settles.

Keep your child upright and comfort them in a quiet setting. Offer frequent small drinks if swallowing is comfortable, and check that they are passing urine as usual. Saline nose drops or spray may loosen nasal mucus; gentle nose wiping can make breathing and feeding easier. Use medicines only as directed for the child’s age and weight, and do not give cough or cold products unless a clinician or pharmacist has advised them.

Avoid steam-filled rooms and do not force food or drinks when breathing is difficult. Watch the breathing pattern when your child is calm, including whether the skin pulls in between the ribs or at the neck. A clinician may recommend treatment for croup after assessing the airway; do not use leftover antibiotics, because croup is commonly linked to a virus.

Seek emergency help immediately if your child is struggling to breathe, has noisy breathing while resting, cannot speak or cry normally because of breathlessness, has blue or grey lips, becomes unusually sleepy, or cannot swallow saliva. Keep them upright and calm while help is arranged.

Arrange urgent medical advice if breathing sounds harsh with activity, symptoms are worsening, your child is drinking much less, or there are signs of dehydration such as very little urine, a dry mouth or no tears. A runny nose without breathing difficulty is usually less urgent, but persistent symptoms, fever in a very young baby, or a child who looks seriously unwell should still be assessed. Consider [Influenza](/conditions/influenza/) or [COVID-19](/conditions/covid-19/) guidance when other viral symptoms are present.

Ask: Does the breathing sound fit croup, and is treatment needed? What signs should make us return urgently? How much fluid should my child take, and which fever or pain medicine is suitable? Could another illness, such as [Sinusitis](/conditions/sinusitis/), an allergy, or a viral infection, explain the ongoing nasal discharge? Tell the clinician when the cough began, whether noisy breathing occurs at rest, how much your child is drinking, and any medicines already given.