Croup

Croup is a viral infection that causes swelling of the voice box (larynx) and windpipe (trachea). It is most often caused by a parainfluenza virus. The swelling causes your child to have a barking cough and can sometimes cause difficulty breathing. The barking cough often begins in the middle of the night and is occasionally accompanied by a noise called stridor. Stridor is a high-pitched sound that occurs when your child breathes in.

Croup is very common in young children. It usually lasts 2–5 days and can often be treated at home.

Tips and treatment for croup

Because croup is a virus, antibiotics do not help. Giving your child over-the-counter cold medications will not help either. However, the following tips may help the cough and stridor:

• Run a hot shower to create steam. Do NOT put your child in the hot shower. Instead, close the bathroom door and let the room fill with steam. Have your child breathe in the moist air for 10–15 minutes.
• If your child's breathing does not get better with steam, take him or her outside. Cold, moist air can decrease the swelling and help the coughing and stridor. Be sure to dress your child warmly before going outside.
• Offer cold liquids and popsicles to help with the coughing.
• Try to keep your child calm. Getting upset and crying may make the cough and stridor worse.

When to see the doctor for croup

You should take your child to the emergency room if:

• Stridor is occurring while your child is calm. It is okay to hear the high-pitched sound when your child is crying or upset as long as it goes away when he/she is calm
• He or she cannot talk
• Stridor is getting worse
• Cough and/or stridor is NOT helped by steam or cold outside air
• He or she cannot catch his or her breath
• You think your child is getting worse

If the skin around your child’s mouth, fingers, or toes looks blue or if your child has severe trouble breathing, call 911.

If your child has stridor, the doctor may use steroids or a breathing treatment containing epinephrine to decrease swelling.

If your child has a barky cough, your pediatrician can decide if giving steroids can help prevent croup from worsening.

Additional resources:

• 9 Different Cough Types in Children (Fauquier ENT)

Written by Julia E. Madison-Williams, MD

Updated by Sydney Ryckman, January 2022