What You Need to Know About Croup

coughing child
Young girl coughs in bed. DesignPics/Don Hammond/Getty Images

Croup is swelling around the vocal cords that leads to a particular type of cough in infants and young children.


  • The hallmark symptom of croup is the "barky cough." It is often described as sounding like a seal's bark. This cough almost always occurs at night.
  • Stridor is another symptom that is seen in croup. It is a harsh, musical sound that occurs when the child inhales or breathes in (unlike wheezing, which occurs when a person exhales). This sound can be particularly scary for parents because it sounds like the child is having difficulty breathing.
  • During the day, children with croup will typically have symptoms of a cold, such as runny nose, congestion, cough and sometimes fever.


The most immediate treatment for croup when a child wakes up with a barky cough or stridor during the night is cool or moist air.

Take the child into the bathroom and run the hot water so the room fills with steam. Sit in the steamy bathroom with him for 15 to 20 minutes, but do not put him in the water. You may also have the child breathe in cold air — outside if it is cool (just bundle him up first) or, as I learned from my nursing experience, have him breathe air from the open freezer.

If your child has not had croup before, call your doctor for guidance, even in the middle of the night.

How Your Doctor Might Treat Croup

When your child has croup, many times they will need to be seen in the doctor's office the next morning. In some cases, the doctor might prescribe oral steroids to help relieve the swelling.

Inhaled steroid treatments may also be needed, but these are usually given in an emergency room or hospital.

Serious cases of croup may require hospitalization. If your child is showing serious signs of difficulty breathing, seek medical attention immediately.

When to Be Concerned

Most of the time, croup is a relatively mild illness that can be treated at home.

However, it can have some serious complications that you should be aware of.

Severe swelling of the vocal cords and airways can lead to significant difficulty breathing. If you notice signs of difficulty breathing, such as a bluish color to the skin or the skin pulling in between the child's ribs, seek medical attention immediately.


Although croup is not usually serious, it can lead to severe complications. These may include:

In the most severe cases, croup can be fatal when swelling closes off the airway completely and the child does not receive immediate medical attention.

How to Prevent Croup

Most cases of croup are caused by viruses, so the best way to avoid them is by washing your hands and by keeping infants and young children away from others who are sick.

The DTaP, HIB and measles vaccines have virtually eliminated these illnesses as causes of croup, but continuing to vaccinate young children against these diseases is important to prevent a comeback.


"Croup". Medline Plus 13 May 10. National Institutes of Health. 21 Feb 11.

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