What are the treatment options for croup?

Croup is usually a viral inflammation around the voice box and upper airway. A barking cough, hoarse voice, and noisy breathing can become more noticeable when a child cries or is unsettled. A clinician assesses the sound and effort of breathing, alertness, colour, and ability to drink. Children with mild symptoms may need observation and supportive care; a prescribed steroid can reduce airway swelling. Antibiotics do not treat the usual viral cause.

Keep your child upright and calm, offer frequent drinks, and use age-appropriate fever relief only as directed. Stay nearby to watch breathing, especially at night, and avoid steam because it can burn the skin and has not been shown to reliably settle the airway swelling. Arrange a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) if the cough is worsening, noisy breathing occurs at rest, or you are unsure how severe it is. A [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) may be used by clinicians for more marked breathing difficulty.

Call emergency services if the child is struggling to breathe, the skin between or below the ribs is pulling in, the child becomes unusually sleepy or difficult to wake, lips look blue or grey, drooling prevents swallowing, or breathing pauses. Do not force food, drink, or medicine when breathing is severely distressed.

Ask how to recognise noisy breathing at rest, when to give any prescribed steroid, how to manage fever, and which changes mean your child needs immediate help.