Croup is a common childhood illness

Croup can cause babies to suffer a bark-like cough. It can also cause difficulty breathing, which can be frightening for both you and your child.

Croup is most commonly caused by parainfluenza viruses, which affect the airways to the lungs including the air tubes of the lungs (bronchi), windpipe (trachea) and voice box (larynx). The virus causes them to swell and become narrower. It usually affects children between the ages of six months and three years old, with most cases occurring in one-year-olds. As children become older, their breathing tubes become firmer and wider, and thus croup becomes uncommon after the age of six.

Autumn, winter and spring are prime times for this condition, thanks to the prevalence of colds and flu around these times of the year.

What are the symptoms?

Your child will have a harsh, barking cough. Many people liken this sound to the noise seals make. Raspy-sounding breathing difficulties are also common. Croup symptoms cause the airways to narrow, which may cause harsh grating sounds when breathing in, called stridor. These croup symptoms are generally worse at night.

Other symptoms may include runny nose, sore throat, fever and a lack of appetite.

How can you manage croup?

There are a few treatments you can try to help manage croup:

• Stay calm. This will reassure your child no matter how young he or she is. Children with croup may become distressed and crying may make symptoms worse.
• Sit your child upright on your lap if breathing is noisy or difficult. Let them find the most comfortable position.
• Soothe their throats and keep them hydrated with cool drinks little and often. However, do not force fluids as this can distress the child.
• Stay with your child or check on him or her regularly as you need to be aware if symptoms are getting worse.

Doctors will advise parents to manage mild cases of croup at home. Croup tends to get better on its own within 48 hours, although a very mild but irritating cough may persist for a further week or so.

What medications can treat croup?

Give your child paracetamol to lower a fever and to treat any pain. Make sure you follow the instructions on the bottle.

Your GP may also prescribe a single dose of an oral corticosteroid. This will treat the swelling of the throat and make your child much more comfortable.

What you should not do:

• Do not put anything in your child’s mouth to look at the throat. This may significantly worsen the symptoms.
• Do not give your child cough medicines. These will dry the mucus making the airways even smaller.

You should see the GP if:

• You are worried/unsure about a case of croup (or at least call NHS 111)
• Your child has a temperature above 39°C or looks distressed/ill
• Your child is drinking less fluids than normal for him or her
• Your child is under 6 months

What are the complications?

It is rare for complications to develop from croup. However severe cases can cause a child to struggle to breathe and will require hospitalisation.

Go to A&E or call 999 if:

• Your child is struggling to breathe (you may see their chest or tummy sucking inwards/their breathing sounds different)
• Their skin or lips start to look blue/grey
• They are unusually quiet and still

How can you prevent croup?

Croup itself cannot be prevented. It spreads like colds and flu. Washing your hands and cleaning surfaces can help. Routine vaccinations will help protect against some of the infections that can lead to croup.

Main Points

• Croup is a common childhood illness that can cause a distinctive bark-like cough and difficulty breathing.
• Croup is commonly caused by parainfluenza viruses that affect the airways to the lungs. It is most common in children between six months and three years old.
• The symptoms of croup include a harsh, barking cough and raspy-sounding breathing difficulties. Croup may also cause stridor, a harsh grating sound when breathing in.
• You can manage your child’s croup at home by keeping calm (panicking and distressing your child is likely only to make symptoms worse), sitting them upright on your lap, and providing them with cool drinks little and often.
• Your GP may prescribe an oral corticosteroid to treat swelling of the throat, but you should never try to put anything in your child’s mouth to examine their throat yourself or give them cough medicine, as this can make the airways smaller.
• Call 999 if your child is struggling to breathe, their skin or lips start to look blue or grey, or they are unusually still.