When your child has croup

Read our guide below to help you understand what to do when your child has croup.

You can also download a PDF version of this patient information by following the link on the right.

What is croup?

It’s an infection of the upper airway, usually caused by a virus, often the parainfluenza virus.

Croup causes swelling of the larynx (voice box), trachea (windpipe) and bronchi (bronchial tubes).

Children typically get croup between the age of 6 months and 6 years. Many children will have two or more episodes of croup in their childhood.

The same virus can affect children over 6 years old but it’s unlikely to cause croup as their windpipe is wider and stronger.

Symptoms usually resolve within 48 hours but occasionally, they may last for up to a week. Symptoms of upper respiratory tract infection usually follow croup.

What are the signs and symptoms?

It usually starts with cold-like symptoms, for example, a temperature, runny nose and a cough. Croup symptoms start after a few days and include a:

• barking cough that sounds like a seal
• noisy breathing (stridor), rasping sound especially when breathing in
• hoarse voice
• sore throat.

Symptoms are often worse at night.

Does my child need any tests to confirm the diagnosis?

No. Your child’s GP should diagnose croup from the information you give and the barking cough.

What treatments are available?

Some children with croup will need a dose of steroid medicine. This medicine helps reduce the swelling in the airway, which reduces difficulty breathing. The steroid doesn’t reduce the length of illness.

In more severe cases, children may also need a nebuliser of medicine (adrenaline), which quickly reduces swelling. Children who need this nebuliser must stay in hospital as the effects of this medicine only last a couple of hours.

What happens if my child doesn’t get treatment?

Most children will get better without treatment in a few days. You should always see a doctor if your child:

• has continuous noisy breathing when they are not upset
• has breathing symptoms that gets worse, for example, getting faster, needing more effort – chest or neck muscles may pull in with each breath
• is restless or agitated
• looks unusually pale
• has a constant fever lasting longer than 5 days.

Call an ambulance if your child:

• struggles to breathe
• has blue looking skin or lips
• is very sleepy, unusually quiet or still
• drools and can’t swallow.

Is there anything I can do to help my child?

Yes. You should:

• stay calm and reassure your child as they may become upset and scared with croup.
  sit your child upright on your lap if their breathing is noisy or difficult. Crying can make their symptoms worse
  encourage your child to drink fluids regularly.
  reduce fever with paracetamol or ibuprofen only if your child is distressed

You must carefully follow the instructions that come with the medicine.

What doesn’t help?

This includes:

• antibiotics. Croup is a viral illness and antibiotics do not kill viruses
• cough medicines, particularly those that have ingredients that cause drowsiness
• steam inhalation. There’s little evidence that it helps and it can cause scalds.

Reducing associated healthcare infections

Find out how you can help to reduce healthcare associated infections when visiting hospital