Croup is a respiratory infection that usually affects children between the ages of six months and five years. It is estimated that up to 1 in 50 children will get croup in their first year of life. Croup is more common in winter. Most infections get better in three to four days without treatment.

What causes it?

Croup is usually caused by a virus. The virus causes swelling of the larynx (voice box), trachea (windpipe) and bronchi (the large airways in the lungs) which makes it hard to breathe.

Signs and symptoms

Croup often starts with one to two days of common cold symptoms (mild fevers and a runny nose).

As the virus spreads a child with croup may experience the following:

  • barking cough (may sound like a seal)
  • hoarse voice
  • noisy sounds when breathing in
  • harder to breathe than normal
  • fast breathing

Children with croup may also complain of a sore throat or not want to eat or drink.

Symptoms are often worse at night and may go away in the day.

How is it diagnosed?

A doctor can diagnose croup by examining your child. Tests are not usually required.

What is the treatment?

Children are usually better within three to four days without any treatment. Liquid steroid medicine can help your child get better within a few hours. Children with severe symptoms will need treatment at a hospital where they may get medicine through a mask (nebuliser).

Care at home

  • try to keep your child calm – symptoms will get worse when your child is upset
  • encourage your child to sit upright – this may make breathing easier
  • consider giving your child Paracetamol (Panadol) if they are uncomfortable with a fever (follow the dosing instructions on the bottle)

Vaporisers and steam treatment (such as positioning your child in the bathroom with the shower running) are not recommended as they have not been shown to help croup symptoms.

When should I see a doctor?

Call 000 immediately if your child:

  • is breathing very quickly
  • is struggling to breathe
  • is very pale

See your local doctor or visit your nearest hospital emergency if your child has:

  • a cough that concerns you
  • noisy breathing
  • hoarse voice
  • any other health concerns

If your child has been sent home after being diagnosed with croup and their symptoms get worse you should see a doctor again.
For non-urgent medical advice, call 13 HEALTH (13 43 25 84) to speak to a registered nurse 24 hours a day, seven days a week for the cost of a local call.

Things to remember

  • Croup is a common viral infection in children that affects the airways.
  • Most infections get better in a few days or without treatment.
  • Medication can help children get better faster.

Resource No: FS011. Developed by Emergency, Queensland Children’s Hospital. Updated: August 2019. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.