Understanding Your Child's Croup Symptoms

Learn the difference between a regular cough and a croup cough

Girl coughing into her arm

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Croup (“kroop”) is a viral infection in children that causes swelling in the trachea (windpipe) and larynx (voice box). Besides being quite common, croup is also often scary for both kids and parents. Luckily, it's not usually serious.

Like some other childhood viral infections—such as roseola, which causes a fever followed by a rash, or fifth disease, which causes a bright-red rash on the cheeks—croup has distinctive symptoms and is generally easy to recognize. There's no formal test for croup. Your child's pediatrician will most likely diagnose it based on the presence of certain telltale symptoms. 

Symptoms of Croup

Children with croup are usually about 6 months to 6 years old, have a few days of a low-grade fever, coughrunny nose, and then suddenly—typically in the middle of the night—develop:

  • A bark-like cough
  • A hoarse voice
  • Difficulty breathing and inspiratory stridor. This harsh, loud, high-pitched noise that kids with croup can make when they take a breath may be confused with wheezing.
  • Continued fever, which can be low-grade or up to 104 degrees Fahrenheit, although some kids with croup don't have any fever at all

If your child has croup, their symptoms are likely to be worse at night, when they're agitated, and better during the day, when he or she calms down. Symptoms can also get better when your child is exposed to cool air, which explains why many children get better on the way to the emergency room.

Although most cases of croup are mild and go away when treated with home remedies, some children have more severe symptoms and need immediate medical attention.

These more severe symptoms can include:

  • Difficulty breathing or stridor when your child is sleeping or calm
  • Unusual restlessness or fussiness
  • Drooling and difficulties swallowing
  • Visible pallor or a bluish discoloration of their fingernails or around the mouth
  • Lethargy

Distinguishing Between a Cough and Croup

Croup produces a very distinct cough, said to sound like a barking seal. If you're not sure what that sounds like, you can search for "a croup cough" videos on YouTube.com to get a better idea. A croupy cough sounds much different than any another cough your child will have with a cold, asthma, or bronchitis.

The distinctive cough occurs as the infection progresses from the nose and throat to the windpipe, and the space available for air to enter the lungs narrows.

If you suspect your child may have croup—especially if you think your child may have severe croup symptoms—call your child's pediatrician right away. Your child's doctor can help diagnose croup, and figure out the best way to treat the condition so your little one can feel better fast. 

Treating Croup

If your child has croup, your doctor may prescribe a steroid to help reduce any inflammation in his or her airway. A child with a severe infection may need to be hospitalized. At home, you can make your child more comfortable by setting up a humidifier or sitting him or her in a bathroom (not in the shower) filled with steam generated by running water from the shower. If he or she is agitated, try and remain calm as to better help him or her relax—anxiety can worsen symptoms. Fluids and fever reducers can help manage symptoms as well. If you're concerned your child's infection is not clearing up, don't hesitate to call your doctor.

Prevention

Croup is caused by a virus, so it can spread through coughing and sneezing, as well as by dirty hands, sharing toys, and sharing drinking glasses or eating utensils. To help prevent croup, the American Academy of Family Physicians recommends that you:

  • Make sure everyone in your house washes their hands often.
  • Throw away dirty tissues from runny noses and sneezes right away.
  • Wash toys in hot soapy water if a sick child has had them in his or her mouth.
  • Ask people with a cough to avoid kissing or playing with your child.
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