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Croup is very common in young children.

Croup is very common in young children.
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Croup is very common in young children, mainly in children under 5 years old. It’s usually not serious. The inflammation is usually caused by the same viruses that cause the common cold, and is therefore more common in winter.

What is croup?

Croup is an infection caused by a virus. It causes swelling of the windpipe (trachea), the airways to the lungs (the bronchi) and the vocal cords (voice box). This swelling makes the airway narrower, so it is harder to breathe.

A child with croup has a distinctive barking cough and may make a harsh sound, known as stridor, when they breathe in.

Croup is often only a mild illness, but it can become serious quickly.

What are the symptoms of croup?

Children may have symptoms of a cold before the onset of croup, including a runny nose, sore throat, fever and irritability. They then develop a harsh, barking cough, sometimes a hoarse voice.

The noisy breathing and cough are usually worse at night. They can also get worse if your child gets upset. In most children, the symptoms improve over a few days then disappear.

Children with croup may have noisy, squeaky breathing that is worse when breathing in. This is called stridor. It generally indicates some obstruction or narrowing of the windpipe. Stridor is also occasionally caused by a condition called epiglottitis. It might also be caused by an inhaled foreign body.

When should I see a doctor about croup?

Get medical help immediately if you notice any of the following:

  • your child has difficulty breathing
  • your child has noisy breathing when at rest
  • the effort of breathing is tiring your child
  • your child has a high temperature and starts dribbling
  • your child cannot swallow
  • your child becomes pale or blue (which usually happens after a coughing spell)
  • your child becomes floppy
  • you notice your child’s breastbone being sucked right back
  • your child becomes restless, distressed, irritable and/or delirious
  • you are worried or concerned for any reason

You should call an ambulance by dialling triple zero (000) immediately if:

  • your child looks very sick and becomes pale and drowsy
  • your child's lips are blue in colour

What causes croup?

Croup is caused by the same viruses that cause a cold. These are spread through coughing, sneezing and touching infected objects.

How is croup treated?

Most children with croup don’t need treatment. You can manage the symptoms in exactly the same way as for a cold. Encourage them to drink plenty of fluids and keep them calm, because your child can have more trouble breathing if they are upset, frightened or stressed.

If your child's croup gets worse or you are worried, take your child to their doctor or the nearest emergency department for help.

Your doctor may prescribe medicines that can help reduce the inflammation and swelling such as oral corticosteroid medicine. Antibiotics won’t work because croup is caused by a virus. Antibiotics treat only bacterial infections.

A few children with croup need to go to hospital for observation, to ensure that they continue to be able to breath without difficulty. While in hospital, your child might initially receive nebulised adrenaline (adrenalin given via a face mask) to relieve the spasm and swelling until the steroids work.

Steam therapy, including the use of vaporisors, is no longer recommended.

Can croup be prevented?

There’s no way to prevent children from getting croup. However, there are a few things you can do to try to limit the spread of infection:

  • wash your hands regularly
  • always cough and sneeze into a tissue, before throwing it away immediately
  • clean surfaces regularly to keep them free of germs
  • avoid sharing unwashed cups, plates, cutlery and other kitchen utensils

If your child has croup, keep them away from childcare and school until 3 days after the illness started. This will prevent them from spreading it to others.

Are there complications of croup?

There won’t be any permanent damage from having croup.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2019

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Croup & stridor: babies & children | Raising Children Network

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