What should you know about spasmodic croup and asthma?

Croup affects the upper airway around the voice box and windpipe, so a child may develop a harsh barking [Cough](/symptoms/cough/) or a high-pitched sound when breathing in. Asthma affects the lower airways and commonly presents with [Wheezing](/symptoms/wheezing/), breathlessness, cough, or [Chest Tightness](/symptoms/chest-tightness/). Viral illness, allergy, activity, cold air, and irritants can influence symptoms. Some children can have more than one airway problem, so the sound and timing of symptoms matter.

Keep the child calm and upright, since distress and crying can make noisy breathing harder. Offer small sips of fluid if swallowing is comfortable, and follow the child’s written asthma plan if one exists. Do not use someone else’s inhaler or assume a barking cough is asthma. A clinician may recommend a [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) in selected situations, but the equipment and medicine should be chosen for the child’s condition.

Get emergency help if the child struggles to breathe, has blue or grey lips, becomes unusually sleepy, cannot speak or drink, pulls in the skin between the ribs, or makes noisy breathing while resting. Seek prompt assessment when symptoms are new, repeatedly waking the child, or not responding to the prescribed reliever plan. A cough alone does not show whether the problem is croup or asthma; breathing effort is the key concern.

Ask whether the pattern fits croup, [Asthma](/conditions/asthma/), allergy, or another airway condition. Clarify which medicine to use, how to recognise worsening breathing, and whether [Allergic Rhinitis](/conditions/allergic-rhinitis/) or [House Dust Mite Allergy](/conditions/house-dust-mite-allergy/) could be contributing.