How is croup different in children?

Croup commonly follows a viral upper-respiratory infection and affects the voice box and nearby airway. Swelling in a child's smaller airway can produce a harsh barking cough, a hoarse voice and a high-pitched sound when breathing in, called stridor. Symptoms often become more noticeable at night and may worsen when a child is upset or crying.

A child's breathing can change quickly because even modest swelling takes up more space in a small airway. Croup is not the same as a simple cough, and stridor while resting is more concerning than noisy breathing only during crying.

Keep the child calm and upright, offer small sips of fluid and stay nearby to observe breathing. Avoid forcing food or examining the throat if this causes distress. Do not use steam treatments or give cough medicines unless a clinician specifically recommends them. A clinician may prescribe medicine to reduce airway swelling when symptoms warrant it.

Get urgent help if the child has stridor while resting, pulls in the skin between the ribs or at the neck, drools or cannot swallow, becomes unusually sleepy, has blue or grey lips, or struggles to speak or cry. Emergency care is needed if breathing pauses or the child is becoming exhausted. Contact a clinician promptly for a worsening cough or any concern about breathing.

Ask whether the child's breathing sound is stridor, what to monitor overnight, when prescribed medicine should be used, and which changes require emergency help.