Croup early symptoms: what parents should know

Croup is swelling around the voice box and upper airway. A child may first have a runny nose, mild cough, or fever, followed by a harsh cough that sounds like a seal. The voice can become husky, and a high-pitched sound when breathing in is called stridor. Symptoms may sound louder when a child cries because agitation increases the effort of breathing. A cold can precede croup, but a cold alone does not explain every breathing sound.

Keep your child calm and upright on your lap, because crying can make noisy breathing worse. Offer small, frequent sips of fluid if swallowing is comfortable. Watch the chest and neck while the child is resting, and notice whether the skin pulls in between the ribs or above the breastbone. Avoid steam and do not give cough medicines unless a clinician has advised them. Arrange a child health consultation if the cough or voice change is new, worsening, or affecting sleep.

Seek emergency help if your child has stridor while resting, struggles to breathe, has marked pulling-in around the ribs or neck, cannot speak or cry normally, drools or cannot swallow, or becomes unusually sleepy, pale, or blue around the lips. Do not wait for a barking cough to become severe. If breathing is comfortable at rest but symptoms continue, contact a clinician promptly for advice and assessment.

Ask whether the breathing sound is stridor, whether treatment is needed, and what changes should prompt immediate reassessment. Tell the clinician when the cough began, whether noisy breathing occurs at rest, and whether your child can drink normally.