What should you know about moderate croup?

Croup is usually linked to a viral upper-airway infection. Swelling near the voice box can produce a harsh barking cough, a hoarse voice and a high-pitched sound when breathing in. Symptoms may be worse at night or when a child is upset and crying. Fever or cold symptoms can occur, but their presence does not define how much the airway is narrowed.

Moderate croup means the breathing noise or effort is more than a mild episode. A clinician should assess the child’s breathing, alertness, hydration and response to treatment.

Keep the child calm and upright on your lap, offer small sips of fluid if they can swallow comfortably, and watch their breathing closely. Follow the treatment plan given by the clinician; prescribed steroid medicine may reduce airway swelling. A child health consultation can provide an examination and a clear safety plan.

Avoid forcing food, placing anything in the throat, or relying on hot steam. Keep the child away from smoke and arrange review if the cough, fever or breathing noise is worsening.

Call emergency services if the child struggles for each breath, has noisy breathing while resting that is worsening, pulls in at the ribs or neck, cannot speak or cry normally, drools or cannot swallow, becomes unusually sleepy, pale or blue, or has pauses in breathing. Keep them upright and calm while help is coming.

Ask how to recognise noisy breathing at rest, when prescribed medicine should take effect, how much fluid to offer, and whether the child needs observation or follow-up. Confirm exactly when to call emergency services.