What should you know about croup-like symptoms?

Croup is an illness that affects the voice box and windpipe, often after cold symptoms. The cough may sound like a seal bark and can become more noticeable at night. A child may also have a runny nose, hoarseness, or fever. Croup is often caused by a viral infection, but similar noisy breathing can have other causes, including an allergic reaction or an object inhaled into the airway.

Stridor is a high-pitched or harsh sound when breathing in. It can happen when the upper airway is narrowed. The sound may be heard only when a child is upset or active, or it may continue while the child is calm. The pattern, speed of onset, and the child’s breathing effort help a clinician decide what is happening. See information about [Croup](/conditions/croup/) and [Common Cold](/conditions/common-cold/) for related symptoms.

Keep your child calm and upright, because crying can make noisy breathing and coughing worse. Offer frequent drinks if swallowing is comfortable, and check the child regularly, including during the night. Follow the label or a clinician’s instructions for any fever medicine; never give a child medicine intended for someone else. Avoid smoke and do not use steam, which can burn the skin or airways. A clinician may recommend treatment after assessing the breathing pattern; some children need a medicine to reduce airway swelling. Read about [Cough](/symptoms/cough/) and [Fever](/symptoms/fever/) if those symptoms are also present.

Seek emergency help if your child is struggling to breathe, the skin between or below the ribs is pulling in, the lips look blue or grey, the child is unusually sleepy or difficult to wake, or they cannot speak, cry, or drink because of breathlessness. Drooling, trouble swallowing, or a sudden onset after choking or a possible allergy also needs urgent assessment. If noisy breathing is present while your child is resting, arrange urgent medical care. If symptoms are mild but persistent, a child health clinician can examine the airway and listen to the chest. Treatment may include [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) when clinically appropriate, but a nebuliser should not delay emergency care.

Ask what is most likely causing the noisy breathing, whether the sound occurs at rest, and which changes should prompt urgent help. You can also ask whether your child needs an examination today, how to manage fever and fluids, and whether any prescribed treatment should be repeated if symptoms return. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) can provide a focused assessment.