Croup and fast breathing: what to do

Croup causes swelling near the voice box, narrowing the passage used for breathing. A child may compensate by breathing faster or working harder. Listen for a harsh sound when breathing in and look for skin drawing in between the ribs, under the ribs, or at the base of the neck. Fever, crying, and fear can also temporarily speed breathing, so observe again when the child is calm. Fast breathing does not by itself identify the cause; a clinician may need to examine the child.

Keep the child upright and calm, loosen restrictive clothing, and offer small sips of fluid if swallowing is easy. Avoid forcing food or drink if breathing is difficult. Stay nearby while checking whether the fast breathing settles when the child is quiet. Do not rely on steam or over-the-counter cough remedies. Contact a child health clinician promptly if breathing remains fast, the cough is worsening, or your child seems unable to rest.

Call emergency services for severe breathing difficulty, fast breathing that does not ease at rest, stridor at rest, pronounced chest or neck pulling, pauses in breathing, inability to swallow, unusual drowsiness, or blue, grey, or very pale lips or skin. Keep the child upright while waiting for help. If the breathing is noisy but comfortable, obtain same-day medical advice because the pattern can change.

Ask how to judge breathing effort, whether your child needs an examination or nebuliser treatment, and which symptoms mean you should return urgently. Share whether fast breathing occurs during sleep, rest, crying, or fever.