Croup and the throat

The larynx sits at the top of the windpipe and helps create the voice. When tissue around it becomes swollen, the child’s voice may sound hoarse and coughing may take on a barking quality. Narrowing near this area can produce stridor, a harsh sound most noticeable while breathing in. A sore throat or runny nose may accompany the illness. The child may appear more comfortable between coughs, but breathing effort still matters.

Let the child sit upright and encourage quiet, calm breathing. Give cool fluids in small sips if swallowing is comfortable. Avoid pressing a spoon into the throat and do not use steam, smoke or unprescribed medicines. Listen for whether noisy breathing happens only during crying or also while settled. Note changes in voice, cough, drinking and alertness so you can describe them accurately to a clinician.

Get emergency help for stridor while the child is calm, visible pulling in at the ribs or neck, drooling with difficulty swallowing, blue or grey lips, pauses in breathing, or severe drowsiness. Seek same-day advice if the cough is worsening, the child cannot drink normally, or fever accompanies a child who looks unwell. Do not wait for the throat sound to disappear if breathing is becoming harder.

Ask whether the sound is stridor or a different throat noise, how to position the child, and which symptoms mean emergency care. Ask whether a child health consultation or nebuliser treatment has any role in the assessment.