Croup is an infection of the upper airways that causes inflammation of the vocal cords (larynx), windpipe (trachea) and bronchial tubes, usually in children.

Croup’s cough typically sounds like a ‘bark’ and the intake of breath produces a high-pitched whistling sound, known as stridor.

Croup is usually caused by a viral infection, most notably the parainfluenza virus, which starts in the nasal passages and progresses to the upper airway passages. Children between the ages of six months and three years are most susceptible to developing croup.

Fortunately most cases of croup are mild and can be treated at home.

What are its symptoms?

Croup symptoms include the following:

  • Presence of a typical cold
  • Barking cough, often worse at night
  • Fever
  • Hoarseness
  • Noisy breathing

Symptoms of croup usually last three to five days.

Medical attention should be sought if the following symptoms occur:

  • High-pitched breathing sounds when inhaling and exhaling
  • Drooling or difficulty swallowing
  • Difficulty breathing
  • Faster breathing rate than normal
  • Anxiety, agitation or fatigue
  • A blue or grey colour around the nose, mouth or fingernails

How is it diagnosed?

A croup diagnosis is made by a doctor after they listen to a child’s chest with a stethoscope, examine the throat and observe how the child is breathing. Your doctor will also ask about any recent cold or flu infections, fever, runny nose, and so on. 

A neck X-ray may be done to rule out other possible illnesses, such as the presence of a foreign object in the throat, or an abscess in the throat or epiglottis. If a child has croup, the X-ray will show the airway narrowing to a point – this is what is referred to as a ‘steeple sign’.

What are your treatment options?

Croup usually runs its course from between three to five days. Most cases are mild and treatment may include the following home remedies:

  • Comfort and calm your child by playing a quiet game or reading to her (crying worsens symptoms).
  • Offer fluids – for babies use water, breast milk or formula, and for older children soup or frozen fruit pops.
  • Inhaling moist air may help your child feel better – use a cool mist humidifier, or sit them in a steam-filled bathroom for about 10 minutes.
  • Encourage rest, as sleep helps your child to fight the infection.
  • Use an over-the-counter pain reliever – ask your pharmacist what is appropriate for your child’s age. Please note that over-the-counter cold and flu preparations should not be given to children under the age of five.
  • If you are concerned, sleep in the same room with your child for a night or two.
  • If your child’s symptoms persist beyond three to five days or worsen, see your doctor, who may prescribe a glucocorticoid to reduce inflammation in the airways.
  • In severe cases, a child may need to be hospitalised for observation.

Can it be prevented?

Take the same steps to prevent croup as you would to prevent colds and flu, that is:

  • Encourage the whole family to wash their hands regularly
  • Avoid contact with people who have a cold or flu.
The accuracy of this information was checked and approved by physician Dr Thomas Blake in December 2015