Is your child’s cough croup?

Croup can give your baby, toddler or pre-schooler a barking cough. Our GP explains what causes it and how it can be treated

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Hearing your baby or toddler cough all night is heartbreaking, but once you find out what’s causing it, treatment is easy. So, could it be croup that your child has?

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Croup is a childhood illness which typically affects youngsters between the ages of 6 months and 6 years, although it’s most common, and more severe, in children under 3 because their airways are narrowest. It’s also more common in boys.

Some children suffer from croup every year – but as they mature and their airways become larger they grow out of it.

What is croup?

Croup is a viral infection that causes inflammation with swelling and narrowing of the voice box and airways. It affects about 2% of children under 5 every year. It occurs most frequently in the winter and early spring.

Unfortunately there’s no way to prevent your child getting croup, although washing your hands does help stop the spread of the virus that causes it.

What are the symptoms of croup?

Your child will often have a cold with a stuffy or runny nose and mild temperature. She may be off her food and a bit clingy.

The characteristic ‘barking’ cough of croup – it sounds a bit like a seal – will develop within a few days. Coughs are usually worse at night and caused by inflammation of the vocal chords. She may also have a croaky, hoarse voice.

Although frightening while it lasts, croup is usually bad for only one to three days. However, the cold symptoms can persist beyond this.

What should I do if my child has croup?

Talk to your doctor or NHS Direct for advice – most mild cases need no medical treatment and clear up on their own. In some cases, your doctor may give steroids.

About one in 10 children need hospital admission – oxygen may be needed and steroid medicine given – but the hospital stay is usually brief. Only one in 100 children have more severe croup requiring further support. Occasionally, a secondary infection, such as pneumonia, may occur.

Even mild croup can seem very frightening – especially in the middle of the night. Although it’s distressing, try to stay calm. Sit your child upright to help her breathe more easily and, if you’re worried, seek medical help.

Avoid places where people are smoking and encourage drinking in between bouts of coughing to prevent dehydration.

When should I worry about croup?

As the airways become swollen and inflamed, breathing may become more difficult for your child. She will have more trouble breathing in than out. If it’s a severe case, she may make a harsh noise when breathing in.

As she makes more effort to breathe she’ll also start to use more muscles and you may see the soft tissues between her ribs or in her neck pull inwards.

If her breathing becomes faster, she has difficulty swallowing and starts to drool, or becomes agitated, drowsy or blue, seek medical help immediately.

If she seems to be getting worse or you’re worried, it’s best to get medical attention.

Mum’s story:

“We were frightened by our son’s awful barking cough but talking to NHS Direct helped us relax.”

“Steven had croup when he was 18 months. At first I thought he had a cold, but then one evening he started this awful barking cough – it sounded frightening, although he didn’t seem that unwell. We rang NHS Direct, who told us to give him paracetamol, keep him in a humid room and to take him to the doctor the next day. We did – but he was better by then!”

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Charmaine, 37, mum to Steven, 5

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