Croup in children: what you need to know

Samantha Wild
Clinical Lead for Women's Health and Bupa GP
18 April 2019
Next review due April 2022

Your child has been up in the night coughing. Could they have croup? And if so, will they be able to breathe okay? Here’s the lowdown on what to expect.

Spotting the signs

Croup is caused by a viral infection. It triggers inflammation in the upper airways (voice box and windpipe), which 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.

There’s no test for croup – it can only be diagnosed from the symptoms. Croup 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 your GP. They’ll be able to advise on the right care and treatment and 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.

What can you do?

Some children may need to go to the hospital immediately – your GP will advise on this. But croup can usually be managed at home and lasts for around 48 hours. 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 isn’t caused by 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 to seek further medical help

In most children, croup is mild and will get better in time. 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. They also discuss the implications of the pandemic on general immunity and if the vaccination programme will extend to children.

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

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