How is croup treated?

Croup causes swelling around the voice box and upper airway, often after a viral infection. A barking cough, hoarse voice and noisy breathing may be worse at night or when a child is upset. A clinician judges severity by listening to breathing and checking effort, colour, alertness and drinking.

For milder croup, keeping the child calm, sitting upright and offering frequent fluids can help. A clinician may prescribe a steroid medicine to reduce airway swelling. Severe symptoms may need observation, oxygen or nebuliser treatment in an urgent-care setting.

Hold or sit with your child in a comfortable upright position and speak quietly, because crying can make noisy breathing worse. Offer small, frequent drinks if swallowing is comfortable. Use medicines for fever only when suitable for your child and follow the label or clinician’s instructions. Avoid steam because it can burn the skin and does not reliably treat airway swelling.

Arrange a child health consultation if the cough is worsening, fever persists, drinking falls or you are unsure whether breathing is noisy at rest.

Call emergency services for struggling or very fast breathing, ribs pulling in, pauses in breathing, blue or grey lips, unusual sleepiness, drooling with difficulty swallowing, or a child who cannot speak or drink because of breathlessness. Keep the child upright and calm while help is coming.

Ask how severe the croup appears, whether a steroid is needed, how to recognise noisy breathing at rest and what to do if symptoms return overnight. Ask when your child can return to nursery or school and whether another review is needed.