Stridor at rest with croup: what to know

Stridor is a harsh, high-pitched noise caused by air moving through a narrowed upper airway. In [Croup](/conditions/croup/), swelling around the voice box and windpipe often follows a viral illness such as a [Common Cold](/conditions/common-cold/). A barking cough and hoarse voice may accompany it, but stridor while calm and resting is more concerning than noise only during crying or activity.

Listen for the sound when the child is settled, and notice chest pulling, fast breathing, colour change, drooling, or difficulty speaking or drinking. A [Cough](/symptoms/cough/) or [Fever](/symptoms/fever/) may be present, but their presence or absence does not determine the urgency of stridor at rest.

Keep the child upright and calm; crying can increase airway noise and effort. Stay with them, loosen tight clothing around the neck, and avoid forcing food or drink. Do not use steam or give cough medicines unless a clinician has specifically advised them. Seek urgent assessment so the child can be observed and treated if needed. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) can support follow-up, while [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) may be used by clinicians in selected situations.

Call emergency services immediately if the child is struggling to breathe, has blue or grey lips, becomes floppy or difficult to wake, cannot swallow saliva, or has pauses in breathing. If stridor remains audible at rest without those signs, seek urgent medical assessment now rather than waiting for it to settle at home.

How severe is the airway swelling? What treatment was given, and when should it start helping? Which breathing changes mean we should return immediately? How should we position and comfort the child tonight? When is follow-up needed?