What should you know about croup breath sounds?

The sound is called stridor. It comes from air moving through a narrowed upper airway near the voice box. It may happen only when a child cries, coughs, or becomes active, but stridor while resting is more concerning. Croup can also cause hoarseness and a barking cough. Wheezing is usually a musical sound heard mainly when breathing out and comes from lower airways, so the distinction helps a clinician consider other causes. The volume alone does not measure severity; the child’s effort, posture, colour, and ability to drink are more useful clues.

Keep the child sitting upright and minimise crying, since distress can intensify the sound. Offer small sips if swallowing is easy. Stay nearby and observe whether the noise continues when the child is settled. Do not use steam or force an examination of the throat. Record a brief audio or video only if this does not delay care. A child health consultation can help assess the sound and determine whether prescribed treatment is needed.

Seek emergency care if stridor is present at rest, breathing is fast or laboured, the ribs or neck pull inward, the child cannot drink or speak normally, drooling prevents swallowing, pauses occur, or the lips look blue, grey, or unusually pale. Get prompt advice if the sound is getting louder, the child is tiring, or symptoms began after choking. Do not wait for a fever; serious breathing difficulty can occur without one.

Ask whether the noise is stridor or wheeze, whether it occurs at rest, and which changes mean immediate review. Tell the clinician the child’s age, when the sound started, whether there was a choking event, and how well the child is drinking.