If you’ve ever heard your child develop a harsh, barking cough, often in the middle of the night, you’ve likely met croup. It’s a common condition in young children, and while it can sound alarming, most cases are mild. Knowing how to tell mild from severe is what matters.
What is croup?
Croup is caused by a viral infection that leads to swelling of the windpipe (trachea) and voice box (larynx). This swelling narrows the airway and makes breathing harder. Its hallmark is a distinctive barking cough, often described as sounding like a seal, sometimes with a high-pitched sound called stridor when your child breathes in.
Croup most commonly affects children between 6 months and 5 years, though older children can get it too. Some children get it repeatedly, especially during cold and flu season.
Signs and symptoms
Croup often starts like a normal cold, then changes:
- A runny nose, mild cough, or low-grade fever to begin with
- A distinctive barking (seal-like) cough
- A hoarse or husky voice from the inflamed vocal cords
- Stridor, a high-pitched, squeaky noise when breathing in, often worse when upset
- In more severe cases, the skin between the ribs or at the base of the neck sucking in with each breath, and visibly laboured breathing
Managing mild croup at home
If your child has a barking cough but no stridor at rest and no breathing difficulty, you can usually manage it at home:
- Keep your child calm. This is the single most important thing. Crying and distress make the airway swelling, and the breathing, worse. Stay close, hold them, and speak softly. A calm child breathes more easily.
- Manage fever and discomfort. If they have a fever or seem uncomfortable, paracetamol or ibuprofen can help. Always check with your pharmacist or GP before giving medication for the first time, especially for children under 6 months.
- Croup often flares at night and in cold weather. Many children settle when someone simply stays with them.
When to call an ambulance
Croup can escalate quickly. Call Triple Zero (000) immediately if your child:
- Is struggling to breathe, with the skin sucking in between the ribs or at the base of the neck
- Has stridor (the squeaky noise) at rest
- Looks very unwell, drowsy, pale, or floppy
- Has lips or skin turning blue or grey
- Is drooling excessively or unable to swallow (this can signal a more serious condition and needs urgent attention)
The key things to remember
Most croup is mild and settles with calm and comfort at home. The things that turn it into an emergency are breathing difficulty, stridor at rest, blue colour, drooling, or a child who looks very unwell. Trust your instincts, if you’re worried, seek help.
Our Baby & Child First Aid course walks you through croup and the other breathing emergencies in children, so you know exactly what to watch for and when to act. You might also find our guide on how to recognise a sick child helpful.
This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Always follow the guidance of a qualified health professional. In an emergency, call Triple Zero (000) immediately.