Croup: what to do when symptoms start

Croup is a viral upper-airway illness that can begin with a runny nose, cough, or fever and then produce a barking cough, hoarseness, or stridor. Symptoms can seem more noticeable at night. The key question is how the child breathes when calm and resting. A child who settles, drinks, and breathes comfortably can often be observed with advice from a clinician. A child who works hard to breathe needs prompt assessment, even if the cough itself sounds familiar.

Sit the child upright on your lap or beside you and use a calm voice. Reduce noise, crying, and unnecessary handling. Offer small sips of fluid if the child is alert and swallowing normally. Keep the environment free of smoke and strong scents. Check breathing regularly, especially after the child falls asleep, and note whether noise occurs at rest. Do not use hot steam, force drinks, or give cough medicine without professional advice. Contact a child health clinician if you need help judging the symptoms.

Get emergency help if the child has stridor while resting, ribs or the neck pull in with breaths, breathing pauses, lips look blue or grey, swallowing is difficult with drooling, speech or crying is impaired, or the child is unusually sleepy. Seek prompt medical advice for worsening symptoms, reduced drinking, ongoing fever, or a cough that repeatedly wakes the child. Take any prescribed croup medicine according to the clinician’s instructions and ask what to do if it does not help.

Ask how often to check breathing, how to recognise stridor, which treatment is appropriate, and where to go after hours. Tell the clinician the child’s age, symptom timeline, fluid intake, and whether breathing noise occurs only during crying or also at rest.