What are the first signs of croup?

Croup is swelling around the voice box and upper windpipe, usually during a viral illness. A child may first have a runny nose, mild fever, hoarseness, or an ordinary [Cough](/symptoms/cough/). The cough can then sound harsh or barking, and breathing in may produce a high-pitched noise called stridor. Symptoms are often more noticeable at night or when a child is upset. [Fever](/symptoms/fever/) may occur but is not required.

Keep the child calm and sitting upright, because crying can make noisy breathing worse. Offer frequent fluids and check on breathing regularly. Avoid forcing food or using steam, which can cause burns. Arrange a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) if the barking cough or noisy breathing persists, returns, or concerns you. A clinician may discuss treatments such as [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) when airway swelling is significant.

Get urgent help if the child has noisy breathing while resting, struggles to breathe, pulls in at the ribs or neck, drools or cannot swallow, becomes unusually sleepy, or develops blue or grey lips. Do not wait for the cough to become severe if breathing effort is increasing. If symptoms are mild but worsening, seek same-day clinical advice.

Ask how to recognise stridor at rest, how to position and comfort your child, when to return for review, and what breathing changes require emergency help.