What should you know about croup in a newborn?

Croup is swelling in the upper airway, around the voice box and windpipe, often after a viral illness such as a common cold. A newborn may have a harsh, seal-like cough, a hoarse cry, or a high-pitched sound when breathing in. Babies can become tired quickly because their airways are small. A cough or fever can occur with croup, but these symptoms can also occur with other illnesses, so an examination is needed to tell them apart.

Keep the baby calm and upright while arranging medical advice. Crying can make upper-airway noise worse. Offer normal feeds only if breathing is comfortable and swallowing is safe; do not force a feed. Avoid steam, smoke, and non-prescribed cough medicines. A clinician may assess oxygen levels and breathing effort, then decide whether treatment such as a nebuliser or another medicine is appropriate. Arrange a child health consultation promptly, even if the cough settles between episodes.

Seek emergency help immediately if the newborn is struggling to breathe, has pauses in breathing, blue or grey lips, marked chest pulling-in, unusual sleepiness, poor responsiveness, drooling with difficulty swallowing, or cannot feed because of breathlessness. Urgent assessment is also needed when noisy breathing continues while the baby is settled. Do not wait for a fever to appear; serious breathing problems may occur without it.

Ask what is causing the noise, whether the baby needs observation, which signs should prompt emergency help, and how to support feeding and sleep safely at home.