Croup dry cough: what parents should know

Croup is an upper-airway illness in children. Swelling around the voice box and windpipe changes the sound of the cough, so it can resemble a seal's bark. It may sound worse at night or when a child is upset, because crying and agitation can make breathing harder.

A dry cough does not describe the whole illness. A child may also have a hoarse cry, a runny nose, mild fever, or a high-pitched sound when breathing in called stridor. Some children have only a barking cough, while others develop visible effort with breathing.

Croup often follows a viral cold. A cough that persists without the typical barking quality can have other explanations, including asthma, allergic rhinitis, acid reflux, or acute bronchitis. Repeated or long-lasting cough deserves a clinician's assessment rather than a diagnosis based on sound alone.

Keep your child calm and close to you; crying can intensify the noisy breathing. Sit them upright, offer frequent sips of fluid, and check on them regularly, including during the night. Use the medicine recommended by a clinician for fever or discomfort, following the label or the prescribed instructions.

Do not use steam from hot water, and do not give cough medicines unless a healthcare professional has advised one for your child. Arrange medical advice if the cough is worsening, keeps returning at night, or is accompanied by stridor while your child is resting.

Seek emergency help immediately if your child is struggling to breathe, the skin between or below the ribs is pulling in, the lips look blue or grey, or they cannot speak, cry, drink, or swallow normally. Drooling with difficulty breathing is also an emergency.

Contact a clinician promptly for stridor at rest, unusual sleepiness, poor drinking, fewer wet nappies, or symptoms that are getting worse. A clinician can listen to the breathing and decide whether treatment is needed. Children with breathing symptoms should not be left alone while you seek help.

Ask: Does the sound fit croup, and is there stridor when my child is calm? What signs should make us return urgently? Which fever or pain medicine is suitable for my child's age and weight? Could another condition, such as bronchiolitis or asthma, explain the breathing pattern?