What are the symptoms of croup?

Croup is an upper-airway illness in children. It often begins with cold-like symptoms such as a runny nose, then the voice becomes hoarse and the cough sounds seal-like or barking. The noisy breathing is called stridor and may be louder when the child cries or becomes unsettled. Fever can occur. Symptoms are often worse at night, but any breathing difficulty deserves close observation. A Common Cold can have similar early features without the distinctive barking cough or stridor, so the child's breathing effort matters more than the sound alone.

Keep the child calm and upright, offer frequent sips of fluid, and check breathing regularly. Crying can make noisy breathing worse, so use a quiet reassuring voice. Do not use steam or force food and drink if breathing is difficult. Contact a Child Health Consultation service for advice when the cough is persistent, the child is uncomfortable, or you are unsure whether the noise is stridor. A clinician may consider Nebuliser Treatment when airway swelling is significant.

Call emergency services for struggling or very fast breathing, sucking in between or below the ribs, blue or grey lips, pauses in breathing, unusual sleepiness, drooling with difficulty swallowing, or inability to speak, cry, or drink normally. Urgent assessment is also needed when stridor is present while the child is calm, not only during crying, or when symptoms are rapidly worsening. Stay with the child while help is arranged.

Ask how to distinguish stridor from ordinary congestion, what breathing changes should prompt emergency help, how to keep the child hydrated, and whether prescribed treatment is needed. Mention the onset, fever, noisy breathing at rest, and any previous episodes.