Croup

Croup is a common illness that affects babies and young children's breathing. It makes their airways swell up, which causes a very distinctive cough that sounds like a barking seal.

What causes croup?

Croup is usually caused by a virus - the same type that gives children colds. The virus makes the airways in the throat and voice box swell up. This swelling makes it harder for air to get through, which creates the barking cough sound.

What are the symptoms?

The main signs of croup are:

• A barking cough - this really does sound like a seal barking
• A hoarse voice - your child's voice sounds rough and different
• Trouble breathing - they might find it hard work to breathe
• A high-pitched, rasping sound when breathing in - this sounds different from normal breathing

Your child will often start with cold-like symptoms first, such as:

• A high temperature
• Runny nose
• Normal cough

The croup symptoms usually start after a few days of having these cold symptoms. The symptoms are often much worse at night.

How do I know if it's croup or something else?

Other illnesses can look similar to croup:

• Common cold: runny nose, sneezing, cough and temperature
• Bronchiolitis: cold-like symptoms with wheezing, fast breathing, and poor feeding
• Whooping cough: cold-like symptoms with bouts of coughing, and a "whoop" sound when breathing in

If you're unsure what your child has, speak to your GP or call NHS 111.

When should I get help?

Call NHS 111 or ask for an urgent GP appointment if:

• You think your child might have croup - doctors can give medicine to help
• Your child is getting worse or not getting better after seeing a GP

Call 999 or go to A&E immediately if your child:

• Is struggling to breathe (you might hear grunting noises, see their tummy sucking in under their ribs, or their breathing sounds different)
• Has blue, grey, pale or blotchy skin, lips or tongue
• Is much sleepier than normal or hard to wake up
• Is unusually quiet and still
• Is limp, floppy or not responding normally
• Is very upset, having trouble breathing and can't be calmed down
• Is unwell and drooling more than normal, finding it hard to swallow, or wants to sit up rather than lie down

Don't drive to A&E yourself - ask someone else to drive you or call 999 for an ambulance.

How can I help my child at home?

If your child has mild croup, you can help them feel better by:

• Keeping them sitting upright - don't let them lie down flat
• Comforting them and keeping them calm (crying makes symptoms worse)
• Giving them plenty to drink
• Checking on them regularly, especially at night
• Giving paracetamol or ibuprofen for high temperature or discomfort

Don't put them in a steamy room or make them breathe steam - this doesn't help with croup.

Most children with croup get better on their own within 48 hours. However, it's important to speak to your GP if you think your child might have croup, as they may need treatment.

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.