Croup is a respiratory illness that affects young children. It causes a barking cough, hoarseness, and difficulty breathing. It is usually caused by a viral infection.

What Is Croup?

Croup is an illness caused by a virus that may start as a cold. It makes the windpipe (trachea) and voice box (larynx) swell and narrow. This makes it harder for air to get into the lungs.

Croup can occur at any time of the year, but it’s more common in the fall and winter. It usually affects children from 6 months to 10 years of age. Croup is contagious. That means it can spread to others. A child can get croup more than once.

What Are the Signs and Symptoms of Croup?

At first, your child may have a stuffy or runny nose and a low fever. When the trachea and larynx swell and your child breathes in, you may:

  • Hear a barky cough, hoarse voice, crowing, noisy breathing, or a high-pitched squeaking sound (stridor).
  • See them breathe very fast or have chest retractions. Retractions are when the skin of the child’s neck or ribs pulls in when breathing in.
  • See that they are frightened or upset.

How Is Croup Treated?

There is no medicine to get rid of the virus, but you can do some things to help your child breathe easier and feel better.

  • Stay calm, and try to keep your child calm. Crying and stress can trigger coughing.
  • Offer your child fluids to drink often. This will help  keep them hydrated.
  • Have them breathe in cool night air (dress them for the weather) or humidified air. Sit with them in a steamy bathroom or use a humidifier.
  • Don’t smoke or let anyone smoke around them.

Treating Croup with Medicines

  • If your child is uncomfortable or has a fever, you can give them ibuprofen (Advil®, Motrin®) or acetaminophen (Tylenol®).
    • Give the dose their doctor or health care provider prescribed or read the label to know the right dose for the age of your child.
    • Do not give ibuprofen to children younger than 6 months old.
    • Do not give any medicine that contains aspirin.
  • Avoid over-the-counter cold and cough medicines. They don’t help and may cause harm.
  • Never give your child medicine for adults.
  • Your child may get a steroid treatment and be watched for a few hours. Steroids help reduce the swelling, which makes breathing easier.
  • Since croup is a viral illness. Antibiotics will not help.

When to Call the Doctor

Call the doctor or health care provider if your child:

  • Gets worse, is very tired, is hard to wake, or looks very sick.
  • Is younger than 12 weeks old and has a fever of 100.4º Fahrenheit (F) or 38º Celsius (C) or higher.
  • Coughs nonstop, always has noisy breathing when still, or coughs for more than 10 days.
  • Is younger than 1 year old and has noisy breathing or a croupy, barking-sounding cough.
  • Can’t catch their breath or speak because breathing is hard.
  • Has retractions after each breath, and their chest hurts.
  • Drools and can’t swallow their spit, has trouble swallowing liquids, and will not drink.
  • Skin is blue around the mouth or fingernails while coughing.

When to Call 911

Call 911 or take your child to the closest emergency department it:

  • It's hard for them to breathe, speak, or drink
  • Their lips or face turn a bluish color
  • They're drooling

Helping Hands Patient Education Materials

Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.

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