a coughing baby in highchair.

What is croup and what symptoms should you watch for in children?

When you’re a parent, you know the familiar sounds of kids in the house: giggling, high-pitched squeals and the pitter-patter of their little feet.

What you may not expect to hear, however, is something that sounds like a barking seal on a wildlife TV show.

But that’s a definite possibility if your child has croup. It’s a common respiratory illness that occurs mostly during fall and winter and causes inflammation in the upper airway.

Croup symptoms

“There are two hallmark characteristics of croup,” said Jaya Wadhawan, MD, a pediatrician at OSF HealthCare. “The first sign: the cough. Croup cough sounds like a loud, barking seal.

The second sign of croup: stridor. Stridor is the high-pitched sound your body makes when you can only partially breathe through your airways, thanks to stuffiness or blockage. It also sounds like a wheezing or whistling sound, which can be a sign of difficult breathing.

“While no parent likes to see their child sick, it’s important to stay calm. If a child with croup gets anxious, it can make breathing even harder for them.”

Other symptoms vary as the illness moves from the nose to the lungs. These symptoms include fever, runny nose and losing your voice. Symptoms tend to get worse as the day progresses into the evening.

Who gets croup?

Croup tends to affect children from age 3 months to 5 years, but it’s most common in 2-year-olds.

“The reason younger children are impacted is because of the small size of their airways,” Dr. Wadhawan said. “Since their airways are smaller than those in older kids and adults, any inflammation restricts their breathing. That results in the barking cough and stridor.”

Croup is contagious, so it’s important to keep children out of school and their child care centers while they have croup.

How long does croup last?

Like many viruses, croup lasts about three days to a week. However, the cough may linger for a few weeks.

How long croup is contagious for varies depending on the severity. Your child is considered contagious for three days after their symptoms first appeared or until their fever is gone.

How to treat croup

Since croup is caused by a virus, the main treatment for croup is to let the illness run its course. However, there are two effective medications for addressing the symptoms.

The barking cough is treated with a steroid that’s taken orally or as an injection. Stridor is treated with an inhaled medication, which reaches the lungs and larynx immediately.

But there are also a couple of easy home remedies to provide temporary relief of symptoms.

“It’s funny, but dry, cold air and warm, moist air both work well in reducing inflammation in the airways and, as a result, reduce coughing and stridor,” Dr. Wadhawan said.

“Cold air works immensely well. You can open a window of your home, bundle a child up and take them outside, or even take them for a ride in the car with the window cracked open. Any of those options will allow the cold air into their airways and immediately reduce inflammation.

“On the other hand, steam works very well, too. Parents can sit with their child in a bathroom with a hot shower running. The steam will reduce inflammation, open their airways and break up any mucus.”

When you should take your child to the doctor

Croup rarely leads to complications, but it’s possible if an obstruction is bad enough. So, it’s important to know when to see a doctor.

Is it a case of croup?
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“If symptoms are mild and a child is responding well to home remedies, it’s not always necessary to see their pediatrician,” Dr. Wadhawan said.

It’s time to see the doctor when they’re

  • Not responding to treatment
  • Starting to have trouble breathing
  • Having a hard time swallowing
  • Are unable to speak
  • Stridor is becoming louder

If symptoms seem severe enough, call 9-1-1.

Also, if your child has croup more than two times during the year or is battling croup at age six or older and isn’t improving, they should be seen by a doctor to determine if there’s an underlying condition, such as:

  • Allergies (food, environment): Symptoms – coughing, wheezing and stridor – can be mistaken for croup.
  • Asthma: The wheezing can be confused for croup.
  • Foreign bodies: Young children tend to put things in their mouths, so it’s important to make sure there isn’t an object obstructing their airway.

How to avoid croup

Like many other viruses, croup is spread through coughing and airborne droplets. So, it’s important to teach kids to cough into their elbow, wash their hands often and to use hand sanitizer.

It’s also important to keep sick children away from babies, because croup can impact babies worse than older children.

Last Updated: November 10, 2023

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About Author: Katie Faley

Katie Faley is a Writing Coordinator for OSF HealthCare. She graduated from Illinois State University with a degree in English Studies. Before joining OSF HealthCare in 2021, she worked in magazine editing, digital marketing and freelance writing.
Katie is often found listening to ‘60s folk music, deciding on a new skill to learn, losing track of time in a library or spending time with her family and friends.

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Categories: Kids & Family, Lung & Respiratory Health