Helping Hand Logo

Croup is an illness that is usually caused by a virus. The tissues of the windpipe (trachea) and voice box (larynx) become swollen. The swelling narrows the trachea, which makes it harder for air to get into the lungs.

It often starts as a “cold.” Croup can cause a barky cough or hoarse voice and is usually worse at night.

Croup occurs most often during the fall and winter seasons, but it can occur year round. It usually affects children 3 months to 5 years of age. Croup is contagious (can be spread to others). A child can get croup more than once.

What You will Hear and See

At first, your child may have a stuffy or runny nose and may have a low fever. As the swelling gets worse, he or she will get a barky cough and his voice may sound hoarse.

When your child breathes in, you may hear a "crowing" or a high-pitched squeaking sound, called stridor. He may also breathe very fast or have retractions. Retractions are when the skin of the child’s neck or ribs pulls in when breathing in. Your child may become frightened or upset.

What to do

There is no medicine that will get rid of the virus, but you can do some things to help your child breathe easier until the infection goes away.

  • Stay calm and try to keep your child calm. Crying and tension can trigger coughing.

  • Offer fluids to keep him hydrated.

  • Have him breathe in cool night air (dress appropriately) or humidified air.

  • Avoid exposing your child to tobacco smoke or other irritants.

Call 911 or go to the emergency room if your child’s lips or face turns bluish, if he is working hard to breathe, cannot speak or drink, or is drooling.

Treating Croup with Medicines

  • If your child is uncomfortable or has a fever, medicines such as ibuprofen (Advil®, Motrin®) or acetaminophen (Tylenol®) can be used. Follow the dosing directions for your child. See Helping Hand HH-I-105, Fever for more information.

  • Avoid over-the-counter cough medicines. They do not help and may cause harm.

  • If your child goes to the hospital or to urgent care, he may be given a steroid treatment and watched for a few hours to see if his breathing improves. Steroids help reduce the swelling and thus make breathing easier.

  • Since croup is a viral illness, antibiotics would be ineffective and are unnecessary.

When to Call the Doctor

Call the doctor if your child:

  • Gets worse

  • Has stridor constantly when resting

  • Is less than 1 year old with stridor or a croupy cough

  • Seems to not be able to catch his breath

  • Cannot speak because breathing is so difficult

  • Drools and cannot swallow his saliva

  • Has trouble swallowing liquids and refuses to drink

  • Skin is blue around the mouth or fingernails during coughing

  • Has nonstop coughing

  • Has retractions after each breath and his chest hurts

  • Is very tired and difficult to wake

  • Croup cough lasts more than 10 days

If you have any questions, please call your health provider.

Croup (PDF)

HH-I-19 4/78, Revised 3/17 Copyright 1978 Nationwide Children’s Hospital