Health Library

Croup

A croup cough often sounds like a seal “barking.” High-pitched or squeaking sounds (stridor) may be heard with each breath as air passes through the swollen airway. Children can also sound hoarse (lose their voice or get a scratchy voice) when they have croup.

Croup is caused by a virus and affects children 6 months to 5 years of age. Croup is most often seen in fall to early winter. Croup is spread easily from person to person when someone sick coughs or sneezes. The same viruses that cause the common cold also cause croup.

Your child may start having cold-like symptoms (fever, runny or stuffy nose) then progress to a barky cough. Most cases of croup are mild and can be treated at home. Children with mild croup usually improve in three to seven days.

What are the Signs and Symptoms of Croup?

As the upper airways—the voice box (larynx) and windpipe (trachea)—become irritated and swollen, your child may have the following symptoms:

• Cold-like symptoms—fever, cough, runny or stuffy nose, sore throat
• Hoarse cry or scratchy voice; may lose voice (laryngitis)
• Harsh barky cough and/or high-pitched squeaky noise (stridor) when breathing in
• Cough and stridor may be worse at night and when child is upset or agitated
• Rapid, quick breathing
• Fever
• Skin between ribs pulls in with breaths (retractions)
• Concerning symptom: pale skin or blue color around mouth

Although croup is frightening to the child and parents, try to stay calm. A crying, upset child tends to make croup worse. Parents can help to relieve croup symptoms by being calm themselves, which helps to quiet the child. This relieves the tightness around the larynx and allows the child to breathe more easily.

Treatment for Croup

At-Home Treatment for Croup

1. Take your child into the bathroom and shut the door.
2. Turn on the shower and hot water faucets to make steam. Be careful to keep away from the hot water. Cool mist will work, too, and is safer. If the mist seems to upset the child, stop and calm the child. You may also take the child outside to breathe in the cool night air.
3. Sit with your child and let them breathe in the steam.
4. Do not leave your child alone.
5. Have someone start a vaporizer or a humidifier in the child's room. Continue to keep your child's room humidified, especially if the air is dry.
6. When breathing is easier (10-15 minutes), give your child a popsicle. Later give them more clear fluids to drink. This will help keep the throat and airway moist.
7. If your child’s breathing does not improve, call your child’s doctor or go to the nearest emergency room.

Diet

• Avoid milk and thick liquids. These will make your child's phlegm (mucus) thicker and make them cough more.
• Encourage age-appropriate clear fluids: Pedialyte for children less than one year of age; juice for children over one year of age.

Activity

Activities such as coloring and looking at books together will help your child stay calm and quiet so they may breathe more easily.

Seek Emergency Care / Call 911 If:

• Your child's breathing does not improve after trying the home treatments for 15-30 minutes
• Your child's breathing problem gets worse
• Your child begins drooling
• Your child has trouble swallowing
• Your child becomes restless and cannot sleep
• A bluish color is seen around your child's lips

Your observations of your child are important. Tell the doctor what you have seen and what you have done. This information will help the doctor care for your child.