Croup in children: symptoms, care, and warning signs

Croup is inflammation and swelling in the upper airway, commonly linked with a viral infection. The cough may sound like a seal bark, while the voice can become hoarse. Stridor is a rough or high-pitched noise when breathing in. It may appear mainly during crying or activity, but noise at rest is more concerning. A child can have a runny nose or fever as well. The diagnosis is usually based on the story and examination rather than a scan.

Stay close, speak quietly, and keep the child sitting upright if that feels easier. Offer frequent sips of fluid and let the child rest. Cool, clean air may feel soothing, but do not use smoke, irritant vapours, or hot steam. A clinician may recommend medicine that reduces airway swelling. Nebuliser treatment can be considered in a medical setting when symptoms are severe. Keep a note of changes in cough, voice, breathing noise, drinking, and alertness so the child health consultation is focused.

Call emergency services for stridor while resting, severe pulling in beneath the ribs, blue or grey skin, pauses in breathing, inability to speak or cry normally, drooling with difficulty swallowing, or unusual drowsiness. Arrange same-day medical advice when the cough is repeatedly disturbing sleep, the child is drinking poorly, or fever is accompanied by worsening breathing. Do not leave a struggling child alone while arranging help.

Ask how to recognise stridor, whether prescribed medicine should be given at home, how long to monitor breathing, and when the child can return to school or childcare.