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What is croup?Croup is a common childhood virus. It causes the voice box (larynx) and airway to the lungs (trachea) to swell, making it difficult to breathe. The result is a distinctive, bark-like cough. In adults it’s called laryngitis.
Croup usually affects children aged between six months and three years, although it can occur in older children (NHS 2008). It’s normally caused by a viral infection, so your baby could get it a couple of times or more during childhood (NHS 2008, Wallacy 2008).
How will I know if my baby has croup?If your baby has croup, you'll know. The barking cough is easy to recognise. Although it's frightening to hear your baby cough like this, in most cases, it sounds worse than it is.
Other symptoms can include:
- runny nose;
- sore throat;
- a loud, high-pitched rasping sound when breathing (this is called stridor).
Croup usually comes on in the middle of the night (Wallacy 2008). You may discover that the slight cold your baby went to sleep with has turned into the unmistakable bark. Don't hesitate to respond: you'll probably find your baby awake, sitting up, coughing, and frightened (CKS 2008).
How can I treat croup?It’s best to take your baby to the doctor as soon as you can, even if your baby has had it before. The doctor may give your baby a single dose of a steroid, which works by reducing the swelling in her airways (CKS 2008). This is perfectly safe for your baby if given in the correct dose.
Your doctor will also advise you to try some treatments at home to relieve your baby’s symptoms and help her feel more comfortable:
- Encourage your baby to take extra milk or water to keep her hydrated. For babies who have started solids and children, juice and warm soup may taste especially good if they have lost their appetite for food (CKS 2008, NHS 2008).
- Give your baby liquid infant paracetamol or ibuprofen if she has a fever or seems in pain. Read the dosage information on the packet, or check with your doctor if you’re unsure how much to give your baby (CKS 2008, NHS 2008). You may have heard about a link between paracetamol and babies developing wheezing or asthma. Be assured there is no evidence paracetamol causes these problems (NHS 2010, Wickens 2010).
- If your baby is crying and upset, her cough could become worse. So comfort and reassure her with lots of hugs and kisses. Sitting her upright on your lap, or holding her upright over your shoulder may help her to relax, and therefore breathe more easily (NHS 2008).
A couple of things which won’t help your baby’s croup:
- Don’t give your baby cough medicines or decongestants, as these won’t help in treating croup (CKS 2008, NHS 2008).
- Using a humidifier or steam inhalation is unlikely to help your baby. These old-fashioned methods don't help to relieve symptoms (Moore et al 2006, Scolnik et al 2006). There is also a risk of babies being scalded by steam inhalation (Greally 1990). Guidelines now advise doctors not to recommend humidification or steam inhalation as treatment for croup (CKS 2008).
Can croup cause any complications?Very rarely, a severe bout of croup can cause serious breathing difficulties. Take your baby straight to the accident and emergency of your local hospital if she:
- is struggling to breathe;
- makes a loud, high-pitched rasping sound when breathing (stridor);
- suddenly seems very sleepy or lethargic;
- has a blue tinge to her lips and face;
- appears to have a drawn-in neck and ribcage.
Once in hospital, your baby will be given oxygen to help her breathe, and oral or inhaled steroids to reduce the swelling in her airways (CKS 2008, NHS 2008, Wallacy 2008).
Croup can also occasionally lead to bacterial infections of the throat and lungs, such as pneumonia or inflammation of the windpipe (tracheitis) (NHS 2008, Wallacy 2008). Call your doctor if your baby:
- looks pale;
- has a rapid heartbeat;
- has a high fever of 39 degrees C or higher;
- has stridor, particularly if she's drooling as well.
How long does croup last?Your baby may have croup for as long as four to six days, peaking on the second or third night. During this time, continue the home treatments to relieve your baby’s symptoms. Once you both get over the surprise of this nasty cough, it will usually run its course and leave you all a little tired, but well.
Last reviewed: October 2013
CKS. 2008. Clinical Knowledge Summaries. Clinical topic – Croup. www.cks.nhs.uk [Accessed December 2009]
Greally P, Cheng K, Tanner MS et al. 1990. Children with croup presenting with scalds. www.pubmedcentral.nih.gov. BMJ 14;301(6743):113
Moore M, Little P. 2006. Humidified air inhalation for treating croup. Cochrane Database of Systematic Reviews. Jul 19;3:CD002870. mrw.interscience.wiley.com/cochrane
NHS. 2010. Paracetamol asthma link 'uncertain'. NHS Choices, Health News. www.nhs.uk [Accessed December 2010]
NHS. 2008. Croup. NHS Choices, Medical Encyclopaedia. www.nhs.uk [Accessed December 2009]
Scolnik D, Coated AL, Stephens D et al. 2006. Controlled delivery of high vs low humidity vs mist therapy for croup in emergency departments: a randomised controlled trial. jama.ama-assn.org. JAMA 15;295(11):1274-80
Wallacy H. 2008. Croup. Patient UK. www.patient.co.uk [Accessed December 2009]
Wickens K, Beasley R, Town I, et al. 2010. The effects of early and late paracetamol exposure on asthma and atopy: a birth cohort. Clinical & Experimental Allergy 29 Sept, online ahead of print