What is croup?

Croup is an infection that causes the lining of the voice box (larynx)  and windpipe (trachea) to swell­ making breathing difficult and noisy. Croup is usually brought on by a viral illness, such as the flu or a bad cold. It most commonly affects children between one and six years of age, usually during the fall and winter months.

What do I look for?

Croup usually begins after your child has had a cold for 1-4 days. Your child’s voice will gradually become hoarse and s/he will have a cough that sounds harsh and barky (like a seal’s bark). Between coughs, your child may have difficulty drawing air into the lungs. You may hear a rough or raspy sound when s/he breathes in-this is called stridor.

What do I do?

Many cases of croup are not serious and may be treated at home. Try to reassure your child and give small sips of water or juice. You may also give acetaminophen (Tylenol®, Tempra®, Panadol®  and others). Give 10-15 mg for every kilogram your child weighs (one kilogram equals about 2 pounds).

Since croup symptoms can get better in moist air, you may take your child into the bathroom, close the door and turn on the hot water faucets. Be sure not place your child too close to the hot water source. Sit there in the steam for at least 10 minutes.

Cool air also may help, so you can bundle your child up and sit outside in the cool night air for about 10 minutes.

When should I get medical help?

On occasion, some children will need treatment at the doctor’s office or the hospital.

Call your doctor if:

  • your child makes a high-pitched sound (stridor) even when breathing quietly
  • your child’s breathing doesn’t sound better after mist treatment, or going outside, for 10 minutes your child is cranky or constantly uncomfortable
  • your child appears to be getting worse despite medical treatment you are worried or frightened.

Go to the nearest hospital emergency department if:

  • your child has difficulty breathing
  • your child starts drooling or has trouble swallowing
  • your child’s lips are bluish or turn dark or dusky

Adapted from: Croup, Johns Hopkins Health Information 1996.

Croup and Your Child, American Academy of Family Physicians 2000.