What should you know about croup and wheezing?

Croup most often affects young children after a viral infection. Swelling around the voice box and windpipe can make the cough sound like a seal bark. A rough, high-pitched noise when breathing in is called stridor; it is different from wheezing, which is more often heard when breathing out.

Wheezing happens when air moves through narrowed or inflamed small airways. It may occur with asthma, bronchiolitis, a chest infection, or an allergic reaction. A child can have croup and a separate lower-airway problem at the same time, so the sound alone cannot identify the cause. A clinician may listen to the chest, look at the work of breathing, and ask when the sound began.

Keep the person calm and upright, because crying and lying flat can make noisy breathing feel worse. Offer small, frequent sips of fluid if swallowing is comfortable. Avoid smoke and other airway irritants. Do not use someone else’s inhaler, antibiotics, cough medicine, or steroid medicine unless a clinician has prescribed it for that person.

If a clinician has given an asthma or allergy action plan, follow its instructions. Treatment depends on the cause: a healthcare professional may recommend a steroid for croup, an inhaler for some wheezing episodes, or nebuliser treatment when medicine needs to be delivered as a mist. Monitor the breathing rather than judging severity by the cough alone.

Get emergency help immediately if breathing is severely difficult, the lips or face look blue or grey, the person cannot speak or cry normally because of breathlessness, becomes unusually drowsy, or has sudden swelling of the lips, tongue, or throat. Sudden wheezing after eating, taking a medicine, or an insect sting may signal anaphylaxis.

Seek urgent medical assessment for noisy breathing while resting, ribs or skin pulling in with each breath, drooling or trouble swallowing, pauses in breathing, or symptoms that are worsening. Babies, children with previous breathing problems, and people with significant heart or lung disease may need earlier review.

Ask whether the sound is stridor, wheezing, or congestion; which part of the airway seems affected; and what changes should trigger same-day or emergency care. Tell the clinician when the sound began, whether it is present at rest or only with activity, and whether fever, choking, rash, vomiting, or exposure to a new food or medicine occurred.