Croup

Croup is a childhood illness that is caused by the same viruses that cause the common cold and infect the upper airways.

Summary

Infants and toddlers between 6 months and 3 years of age are at most risk of getting croup – but children who are younger or older can also get it.

Children with croup can become seriously ill.

  • If your child has croup, they’ll probably have the symptoms of a cold for a few days, then develop a seal-like barky cough, hoarseness and noisy breathing.
  • Croup usually lasts for 5–6 days and is more common in colder weather.

Many children who come in contact with the viruses that cause croup will not get croup, but will just have symptoms of a cold.

Symptoms

There are 2 types of croup: viral and spasmodic.

Viral croup

  • This begins with a cold that develops into a barky cough.
  • The child’s airway will swell, making breathing noisy and more difficult.
  • Your child may have a temperature as high as 40°C.

The greatest danger is if your child’s windpipe swells so much that they cannot breathe.

Spasmodic croup

This type of croup causes spasms that occur during the night and early morning.

  • Epiglottitis
    This is a form of croup caused by Haemophilus influenzae (Hib). It is now rare due to immunisation, but can be very serious. It may look similar to croup, but the child may look unwell and feverish.
    Your child will wake up, gasping for breath, within a few hours of going to bed.
  • During the spasms, you’ll hear hoarseness and a barky cough.
  • You might also hear a rasping noise (called ‘stridor’) when your child breathes in.

The spasms usually don’t occur during the day – and your child may seem better in their breathing and hoarseness during the day as well.

Treatment

When croup is serious

Take your child to the nearest emergency department or call 111 immediately if:

  • they seem to be struggling to breathe (worse than the noisy breathing)
  • they appear extremely anxious or frightened, or look blue
  • they’re dribbling and cannot swallow
  • they cannot speak
  • their chest sinks in when trying to breathe in
  • they make a whistling or crowing sound while breathing in.

Self care

  • If your child is upset, cuddle them in your lap and try to keep them calm (reading them a story might help). If they’re upset, it can make their breathing worse.
  • If it’s cold outside, open a window or door so your child can breathe the cold air – make sure they’re dressed warmly so they don’t get chilled.
  • If they have a sore throat, give them a cool drink to sip on – this can help soothe the throat.
  • You can give your child paracetamol if they’re in pain or are miserable with fever. Make sure to follow the dosage instructions on the package – taking more than the recommended dose is dangerous.

Keep your child calm and don’t panic. If your child has serious croup and needs to go to hospital, it is safest to go by ambulance.

Call Healthline 0800 611 116 if you are unsure what you should do.

Note: We no longer recommend using steam for croup – there is no evidence it actually helps, and in some cases children have been badly burned by the hot water.

Prevention

How croup spreads

  • Croup is contagious (catching) for 4–6 days, until the fever settles.
  • It spreads through the air when people with croup sneeze or cough.
Immunisation against Haemophilus influenzae (Hib) significantly reduces the risk of epiglottitis.

Keep your child at home and away from other children and adults if they’re coughing or sneezing.

Your child can return to day care or school after the fever is gone and they’re feeling better.

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