Stridor breathing with croup: what to know

In croup, swelling near the voice box can make breathing in noisy. The sound is often sharp, raspy, or high-pitched and may be easier to hear when a child cries. Croup commonly follows a viral upper-respiratory illness, including a [Common Cold](/conditions/common-cold/). A barking [Cough](/symptoms/cough/) and hoarse voice can occur as well.

The sound, breathing effort, and the child's behaviour matter together. Stridor while relaxed, ribs pulling in, difficulty speaking or drinking, or unusual tiredness suggests a more urgent problem. [Fever](/symptoms/fever/) can accompany croup but does not explain away breathing difficulty.

Hold the child upright, use a calm voice, and reduce unnecessary handling. Crying can make the sound and effort worse. Do not put anything in the mouth, force fluids, or rely on steam. Arrange medical assessment if stridor is present, particularly when the child is quiet. Clinicians may consider medicines or [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) depending on the examination. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) can help with recovery advice.

Get emergency help if the child is gasping, has blue or grey lips, cannot swallow, drools heavily, becomes hard to wake, or has pauses in breathing. Stridor that continues while resting needs urgent assessment even if the child is still responsive. Worsening chest indrawing or exhaustion is also a reason to act immediately.

Was the stridor present at rest or only with crying? How can I recognise increased breathing effort? What treatment should be used if the sound returns? How long should the cough and hoarseness last? What is the safest way to settle the child?