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What is croup?

Samantha Wild
Clinical Lead for Women's Health and Bupa GP
11 May 2022
Next review due May 2025

If your child has been up in the night coughing, you might be wondering if they could have croup. It’s a common illness in young children. But it can be worrying to see your child finding it hard to breathe. So here’s what to expect if your child does have croup, and information about when to seek further medical treatment.

What causes croup?

Croup is caused by a viral infection. It causes inflammation in the upper airways (voice box and windpipe). This can lead to swelling and restricted air flow that affects your child’s breathing. Croup mainly affects children between six months and three years but can affect older children too. It’s a seasonal illness, mainly occurring in the late autumn.

How is croup diagnosed?

There’s no test for croup – it can only be diagnosed from the symptoms. Croup symptoms may begin with a cold, such as a runny nose, sore throat and mild fever. But the key feature of croup is a distinctive seal-like barky cough, which may come on suddenly. Your child may also have a hoarse voice and a harsh, high-pitched wheezing sound (called stridor) when they breathe in. These symptoms are usually worse at night.

If you think your child has croup, it’s important to speak to a GP. They’ll be able to advise on the right care and treatment. They will also check there’s no other reason for the symptoms, such as something stuck in your child’s throat.

If your GP surgery is closed, call 111 for assistance.

How is croup treated?

Some children may need to go to the hospital immediately, your GP will let you know if this is the case for your child.

But croup can usually be managed at home. The most important thing you can do is to keep your child relaxed and calm, as otherwise their coughing will get worse. If it helps, sit them in your lap to help soothe and comfort them. Keep your child well hydrated with plenty of drinks and give them junior painkillers if a fever is causing them distress.

Remember to keep a close eye on your child, checking them regularly, including during the night. It’s important to understand that croup is caused by a virus and not bacteria, so it can’t be treated with antibiotics.

Your child’s breathing

It’s natural to feel anxious when your child has croup. But the cough usually sounds worse than it is. As long as your child’s windpipe isn’t completely inflamed, they will still be able to breathe in enough oxygen themselves. Your GP will prescribe a single dose of a steroid medicine to help your child with their breathing. They may also arrange a follow up appointment to check-up on your child.

When croup is an emergency

In most children, croup is mild and will usually get better within 48 hours. However, you should take your child to the hospital if:

  • you can hear the stridor sound all the time
  • the skin between their ribs is pulling in with each breath
  • they’re restless or agitated

Call for an ambulance if:

  • your child’s face is very pale, blue or grey for more than just a few seconds
  • they’re having a lot of trouble breathing – you may notice their nostrils flaring in and out, their belly sinking in while they breathe, or the skin over their windpipe or ribs pulling in
  • your child’s breathing is very quick or rapid
  • they’re unusually sleepy or not responding
  • they refuse to lie down and want to sit instead
  • they can’t talk or swallow
  • they begin to drool

Common childhood viruses [Podcast]

In this podcast, Specialist Health Editor, Alice Windsor, is joined by Bupa GP, Dr Samantha Wild, to discuss common childhood viruses. Find out why children pick up so many viruses and illnesses during childhood, how to manage them and when to seek medical advice.


Here at Bupa we understand how important your family is. So with our family health insurance you can rest assured knowing that eligible treatment and support is available to you and your loved ones when you need it.

Samantha Wild
Dr Samantha Wild
Clinical Lead for Women's Health and Bupa GP

    • Croup – summary. BMJ Best Practice. www.bestpractice.bmj.com, updated 15 November 2019
    • Croup – epidemiology. BMJ Best Practice. www.bestpractice.bmj.com, accessed 21 April 2022
    • Croup – approach. BMJ Best Practice. www.bestpractice.bmj.com, accessed 21 April 2022
    • Croup: Diagnosis. NICE Clinical Knowledge Summaries. www.cks.nice.org.uk, revised February 2019
    • Croup: Scenario: Management. NICE Clinical Knowledge Summaries. www.cks.nice.org.uk, revised February 2019

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