Health Bytes Series- 🦭 Croup

Croup is a common childhood illness, usually caused by a virus. It causes swelling around the voice box and windpipe, which gives croup its characteristic barking cough.

Most cases are mild and children recover quickly. However, because croup can occasionally cause significant breathing difficulties, it is important to know what to look out for and when to seek help.

🔎 What does croup sound like?

Croup often begins like an ordinary cold. Your child may initially have:

The cough then typically becomes harsh and barking – often described as sounding like a seal.

Some children also develop a harsh, high-pitched or rasping noise when they breathe in. This is called stridor.

🗣️ Barking cough = typical of croup

🌬️ Noisy, high-pitched breathing in = stridor

Symptoms are often worse at night, and your child may have a couple of unsettled nights.

⏳ How long does croup last?

Croup is usually a short-lived viral illness.

Many children improve significantly within 48 hours, although some symptoms can last longer and a mild cough may continue for a week or more.

Most children recover completely without any lasting problems.

🏠 What can I do at home?

If your child has been assessed and their croup is mild, they can usually be looked after safely at home.

🤗 Keep them calm

This is particularly important.

Crying and becoming distressed can make the symptoms of croup and noisy breathing worse.

➡️ Comfort and reassure your child.
➡️ Keep them close to you.
➡️ If their breathing is noisy, keeping them comfortably upright may help.

💧 Encourage fluids

Encourage your child to drink regularly.

🥤 Small, frequent drinks may be easier than large amounts at once.

If your child is breastfed, continue breastfeeding.

Don’t worry if they are less interested in food for a short time. Keeping them hydrated is more important.

Keep an eye on their urine or wet nappies. Passing significantly less urine than usual can be a sign of dehydration.

🌡️ Temperature and discomfort

If your child has a temperature, sore throat or appears uncomfortable, you can give:

💊 Children’s paracetamol or
💊 Children’s ibuprofen

if these are suitable for your child.

Always follow the instructions on the bottle or packet and use the correct dose for your child’s age/weight.

💨 What about steam?

❌ Do NOT use steam to treat croup.

You may previously have heard advice about sitting with a child in a steamy bathroom or allowing them to breathe in steam.

Steam is no longer recommended. There is little evidence that it helps croup, and hot water and steam can cause serious burns and scalds.

🌬️ Some parents find that cool, fresh air temporarily helps a child’s barking cough, but the important measures are keeping your child calm, comfortable and hydrated.

💊 Does croup need antibiotics?

Usually, no.

🦠 Croup is normally caused by a virus, so antibiotics do not usually help.

Some children with croup are prescribed a steroid medicine such as dexamethasone.

The steroid reduces swelling around the airway and can improve croup symptoms.

👩‍⚕️ If you think your child has croup, contact your GP or NHS 111 for advice, as they may need assessment and treatment.

🌙 Check your child during the night

Croup is often worse at night.

If your child has croup:

👀 check them regularly
🛌 stay close enough to hear changes in their breathing
💧 encourage regular fluids
🤗 keep them calm if they wake coughing or frightened.

The important thing is not simply how loud the cough sounds, but how your child is breathing and behaving.

🚦 Croup – when should I worry?

🟢 Mild symptoms

Your child has:

🦭 a barking cough
🗣️ a hoarse voice
🤧 cold-like symptoms
💧 is drinking reasonably well
😊 is alert and behaving fairly normally
🌬️ is breathing comfortably when settled.

Continue supportive care and monitor them closely.

If you think your child has croup, contact your GP or NHS 111 for advice because some children benefit from steroid treatment.

🟠 Seek medical advice urgently

Contact your GP or NHS 111 urgently if:

🚨 CALL 999 / GO TO A&E

Seek emergency medical help if your child:

🫁 Is struggling to breathe

You may notice their chest or tummy sucking in under or between the ribs, grunting, or obvious difficulty getting their breath.

🌬️ Has persistent stridor when calm

A harsh, high-pitched breathing noise that is present even when your child is settled is concerning.

🔵 Looks blue, grey, very pale or blotchy

Particularly around the lips or tongue. On darker skin tones, colour changes may be easier to see on the palms of the hands or soles of the feet.

😴 Is very sleepy or difficult to wake

Or is unusually quiet, floppy, confused or not responding normally.

🤤 Is drooling or cannot swallow properly

Particularly if they appear very unwell or want to remain sitting upright.

😰 Is extremely distressed and cannot be settled

Especially when this is accompanied by difficulty breathing.

🥤 Is too breathless to drink, feed or talk.

📞 If your child is seriously struggling to breathe, call 999.

🧼 Can croup spread?

The viruses that cause croup can spread between people in the same way as coughs and colds.

Help reduce the spread by:

🧼 washing hands regularly with soap and water
🤧 encouraging children to cough or sneeze into a tissue
🗑️ disposing of used tissues promptly
🧸 regularly cleaning frequently touched toys and surfaces
🥤 avoiding sharing cups, bottles or cutlery.

📌 Remember

🦭 A barking, seal-like cough is characteristic of croup.

🌙 Croup is often worse at night.

🤗 Keep your child calm – crying and distress can make their breathing worse.

💧 Encourage regular fluids.

💨 Do not use steam – it does not help and can cause burns.

💊 Antibiotics are not usually required, but some children benefit from a steroid medicine.

🌬️ Pay particular attention to your child’s breathing, not just their cough.

📞 If you think your child has croup, contact your GP or NHS 111 for advice.

🚨 If your child is struggling to breathe, has persistent noisy breathing when settled, becomes blue/pale, is difficult to wake, is drooling and struggling to swallow, or is too breathless to drink – seek emergency medical help.

🔗 Further information is available from the NHS website – Croup.