Croup sounds scary but is usually MILD and treatable at home! That distinctive "barking" cough like a seal or dog and harsh breathing sound (stridor) often worsen at night, causing panic for parents. Most cases resolve within 3-5 days with simple home care. However, severe breathing difficulty needs immediate medical attention. This guide helps you recognize, treat, and know when to worry.
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Croup is:
Why children get it more:
Distinctive symptoms:
| Sound | Description | What It Means |
|---|---|---|
| Barking cough | Like seal/dog bark | Swelling of voice box |
| Stridor | High-pitched noise when breathing IN | Narrowed airway |
| Hoarse voice | Rough, weak voice | Inflammation of vocal cords |
Video parent tip: Record the sound on phone to show doctor if needed!
Most common causes:
How it spreads:
| Factor | Why It Increases Risk |
|---|---|
| Age 6 months - 3 years | Smaller airways |
| Previous croup episodes | Tendency to recur |
| Asthma history | More reactive airways |
| Premature birth | Smaller airways |
| Male gender | Slightly more common in boys |
Early stage (like a cold):
Croup develops (often suddenly at night):
| Severity | Signs | Action |
|---|---|---|
| Mild | Barking cough, no stridor at rest, happy when not coughing | Home care |
| Moderate | Stridor at rest, some chest pulling, fussy | May need doctor |
| Severe | Severe stridor, significant retractions, pale/blue, very agitated or listless | EMERGENCY |
Method 1 - Steamy bathroom:
Method 2 - Cool night air:
Why it helps: Moist air soothes inflamed airways
Critical: Crying and agitation make croup WORSE!
Keep child calm by:
| Don't | Why |
|---|---|
| Give cough medicines | Don't help with croup, may harm |
| Use very hot steam | Burn risk |
| Let child cry extensively | Worsens symptoms |
| Put anything in child's throat | Dangerous |
| Give honey under 1 year | Botulism risk |
| Ignore severe symptoms | Need medical attention |
Medications used:
| Treatment | What It Does | When Used |
|---|---|---|
| Steroids (dexamethasone) | Reduces airway swelling | Moderate-severe croup |
| Nebulized epinephrine | Rapid airway opening | Severe croup, emergency |
| Oral steroids | Reduces inflammation | Single dose often enough |
Important: One dose of steroid often dramatically improves croup!
May be needed for:
In hospital:
Timeline:
Hard to completely prevent but:
Some children get croup repeatedly:
A: This is likely croup! First: STAY CALM (crying makes it worse). Try steam - run hot shower and sit in steamy bathroom 10-15 min. If not helping, try cool night air - bundle up and step outside. Keep child upright and calm. If breathing difficulty severe, blue lips, or no improvement with steam, go to emergency. Most croup is mild and improves with steam.
A: Typically 3-5 days, sometimes up to a week. Worst on night 1-2, then gradually improves. Barking cough may linger 1-2 weeks as a mild cough. If getting worse after day 3, fever continuing, or new symptoms developing, see doctor. Each night may be slightly better than the previous one.
A: The VIRUS that causes croup is contagious (spreads through coughs, sneezes, touch). However, not every child who catches the virus will get croup - it depends on their airway size and response. Older children/adults may just get a cold. Keep sick child away from younger siblings and babies. Wash hands frequently.
A: Over-the-counter cough medicines don't help croup and aren't recommended for young children. For fever/discomfort: paracetamol (Crocin/Calpol). Main treatment is steam, calm, and fluids. For moderate-severe croup, doctor may prescribe steroid (dexamethasone) which works very well. Don't give any medicine not prescribed for your child.
A: GO IMMEDIATELY if: blue/grey lips or nails, severe breathing difficulty, child can't talk or cry from breathing trouble, drooling/can't swallow, child very listless or agitated, no improvement with steam/cool air. See doctor same day if: stridor continues at rest, multiple severe episodes same night, not drinking, symptoms worsening. When in doubt, get child checked!
---
This article was reviewed by a pediatrician. Last updated: January 2025
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