Croup Cough in Kids: Symptoms and Treatment

Croup is a common infection that occurs in children, usually associated with a ‘barking cough’, and sometimes accompanied by a fever¹.

If your child has developed croup, don’t worry – there are things you can do to help. In this guide, we’ll outline what croup is, and what causes it. We’ll also explore common croup symptoms – and how to treat and prevent it.

What is croup?

Croup is a virus that makes a child’s airways swell in the upper part of the neck, causing a barking cough². The virus can occur in adults, but that’s quite rare³.

• Croup is most typical in infants and toddlers aged between six months and three years³, and can impact the windpipe (trachea), as well as the airways to the lungs (the bronchi) and the voice box (larynx)³. This is what causes tell-tale symptoms such as the distinctive croup cough, and difficulty breathing⁴.

• When the child coughs, because air is forced through a narrowed passageway and their vocal cords are swollen, they often make a seal-like barking noise⁵.

Most children with croup do get better within a few days or so2, but in some cases, the condition can last up to two weeks3. If you are concerned about your child’s cough or ability to breathe, be sure to seek medical advice.

How do you get croup?

Croup can actually be caused by the same viruses associated with the common cold². These viruses can spread easily between people, when someone sneezes or coughs and lets virus-filled droplets out into the air².

There are two types of croup – viral croup and spasmodic croup. Both can cause a barking cough, but while viral croup is triggered by viruses as the name suggests, spasmodic croup is usually caused by an allergic reaction or acid reflux⁶.

Other conditions can cause croup or croup-like symptoms too, such as¹:

• COVID-19

• Parainfluenza virus

• Respiratory syncytial virus (RSV)

• Adenovirus

• The flu (influenza virus)

• Enteroviruses.

Understanding the cause of your child’s croup can be helpful in determining the most effective treatment, so consulting your GP is advised.

What are the croup symptoms?

There are a few typical symptoms that can often indicate that your child has croup.

These can include a loud seal-like barking cough that's made worse by crying, as well as anxiety and distress caused by the symptoms⁵. Of course, croup symptoms are not always the same for everyone, and they can also change as the illness moves from the nose to the lungs¹.

You may notice a¹:

• Fever

• Hoarse voice

• Runny or stuffy nose

• High-pitched “creaking” or whistling sound when breathing

• Noisy or laboured breathing.

Symptoms of croup tend to get worse during the nighttime, so your child may need some extra care and attention in the evenings and after you put them to bed. Symptoms can often be mistaken for other health issues too, so always ensure you take your child to see a GP for an official diagnosis¹.

What is the treatment for croup?

Treatment for croup in kids can vary depending on the child’s age, their symptoms, and how severe their croup is¹.

Typically, symptoms of croup in kids will be mild and can be treated at home. However, in more serious cases, your child may need to go to the hospital¹.

Croup can be diagnosed by your GP, who will then decide on appropriate treatment options. They’ll usually check your child’s croup symptoms, particularly the sound of the cough³.

You doctor may prescribe croup medication such as¹:

• Inhaled medicines if your child is having trouble breathing

• Steroids to help prevent croup from getting worse

• Other medicines if the croup is a result of allergies or reflux⁶.

If your child has croup, there are a few things you can do at home to help them⁴:

• If possible, try to make sure your child sits upright– elevating their head slightly. You can also help them to do this at night in bed if the cough is keeping them awake.

• Comfort and calm them to reduce crying, as it can make symptoms worse.

• Make sure they get plenty of fluids.

• Give them paracetamol or ibuprofen to help soothe a high temperature, or any discomfort. Make sure you follow instructions on the packaging and use dosage guidance appropriate to their age. This could include CALPOL^® if appropriate.

• Check on them frequently, especially at night.

Please note that steam treatments, such as running a hot shower, are generally not recommended³.

If your child has a fever, your doctor may suggest paracetamol or ibuprofen to help soothe these symptoms. Products such as CALPOL® Infant Suspension can start to help with fever in just 15 minutes. Gentle on tummies, it’s designed for babies and children aged from two months to six years, who weigh more than 4kg and are not premature.

CALPROFEN® Ibuprofen Suspension can also be used to help with similar croup symptoms for children aged from three months to 12 years.

How to prevent croup

To try and prevent croup from happening in babies and kids, you can follow many of the same steps recommended to protect against cold and flu⁵.

These include⁵:

• Cleaning commonly touched surfaces such as counter tops, handles and toys.

• Washing your hands frequently with soap and water before touching your child. Ensure others do this too. You should also thoroughly wash hands before preparing food.

• Staying away from anyone who is sick, including friends and family.

• Getting your child to sneeze or cough into their elbow to avoid spreading the virus onto other people or surfaces.

Children can develop different types of coughs, and these may need to be treated differently. Find out more about chesty and dry coughs, what causes them, and how to treat them with our cough guide.

When to see a doctor

If your child displays any of the following symptoms, be sure to see a GP³.

• More short of breath than usual

• Pain when breathing in or coughing

• Confusion, dizziness, or light-headedness

• A distinctive barking cough

• Feeling sick or being sick

• A dry nappy for 12 hours or more, or is showing other signs of dehydration

• A very high or low temperature.

You should take your child to the hospital if they³:

• have lips or skin turning pale, blue, or grey. For brown or black skin, check the palms of hands too

• have severe difficulty breathing, accompanied by grunting noises or sucking in of their stomach under their ribcage

• are coughing up blood

• are breathing fast or have stops or pauses

• are showing signs of tracheal tug (pulling in at the throat), or their windpipe appears more visible or pronounced

• are limp, floppy or not responding as they normally would

• have difficulty focusing on you

• are harder to wake than usual

• is under three months old with a temperature of 38°C or higher, and has not had a vaccination in the past 2 days

• is under three months old with a temperature of 36°C or lower, and has not had a vaccination in the past 2 days.

Croup FAQs

How long does croup cough last?

Symptoms of croup can last for just a few days, but sometimes they may last up to two weeks³. Symptoms can worsen at night³, too, so regularly checking on your child during this time and offering extra care and comfort is advised.

Why does my child keep getting croup?

Younger children are more prone to getting croup because their airways are smaller. Even a small amount of swelling can make it very hard for a baby or young child to breathe. Around two years of age is the peak time for children to experience croup¹.

What does croup sound like?

Kids with croup tend to produce a seal-like barking cough accompanied by a harsh sound when they breathe in. You’re most likely to notice this when they cry or cough. Your child or baby may also sound hoarse and experience difficulty breathing because of their narrowed airway³.