Croup is a common respiratory infection in young children that causes a distinctive barking cough, hoarse voice and sometimes noisy breathing called stridor.
It usually affects babies and toddlers and often gets worse at night. Most cases are mild and improve at home, but swelling in the airway can sometimes make breathing difficult.
Understanding the symptoms of croup, what causes it and when to seek care can help you know how to manage your child’s illness and when to call a provider.
Croup is a contagious viral infection that causes swelling in the upper airway, including the voice box (larynx) and windpipe (trachea). This infection can make the airway swell and narrow, leading to a unique barking cough, hoarseness and breathing problems.
Croup usually affects children under 3 years old and isn’t seen as often in older children. This is because their windpipes get larger and swelling is less likely to get in the way of their breathing.
The most common cause of croup is viruses. Croup viruses include parainfluenza, influenza (the flu), respiratory syncytial virus (RSV), measles, adenovirus and SARS-CoV-2 (COVID-19).
These viruses spread easily through the air when someone who is infected coughs or sneezes. Your child can also get croup by touching infected surfaces or objects (i.e., tabletops and toys).
Croup is usually seen in babies and children between 6 months and 3 years. Some things that can increase the chance of getting croup include:
The most recognizable sign of croup is a barking cough that sounds like a seal or dog bark.
Other symptoms of croup can include:
If your child has stridor when resting, trouble breathing or bluish lips, seek emergency care right away.
At first, your child may have a stuffy or runny nose, a low fever and a slight cough. These symptoms get worse as the virus moves from the nose to the lungs.
These signs could be:
Croup often becomes worse at night and may last several days. However, the cough may stick around for a few weeks.
RSV, croup and whooping cough are all respiratory illnesses, but their causes, symptoms and treatment are different.
RSV can affect people of all ages but is especially severe in infants and older adults. RSV can cause runny nose and cough and sometimes can cause the barking cough of croup. RSV often affects the lungs while croup usually only involves the upper airway.
Whooping cough (pertussis) is caused by the Bordetella pertussis bacteria, making it a bacterial infection rather than a viral one like croup. While it also causes a very particular cough, whooping cough can often make your child throw up after a long coughing spell. In some babies it can cause them to stop breathing. There are no medicines or vaccines to prevent croup, but the good news is that there is a vaccine to prevent whooping cough, and antibiotics to stop the spread of whooping cough among people known to be exposed to the bacteria.
Health care providers can usually tell if your child has croup by listening to their symptoms and doing a physical exam.
They might ask about your child’s symptoms and how long they’ve been going on. They’ll check your child’s breathing, listen for certain sounds and might use a light to look at their throat.
Usually, other tests like X-rays or specific viral swabs aren’t needed.
In most cases, croup can be diagnosed based on symptoms and the characteristic barking cough.
Croup treatment will depend on your child’s age, symptoms and how serious the condition is. If your child has a history of respiratory problems or was born prematurely, that may also affect their treatment.
Mild symptoms can usually be treated at home. Here are some tips on what you can do to make your child more comfortable as they heal:
If your child’s symptoms don’t improve or get worse, call their provider. Some children may need a breathing treatment or steroid medication to calm swelling in the airway.
Call 911 or take your child to the closest emergency department if your child:
In an emergency, Banner Children’s offers 24/7 pediatric emergency services. If your child is struggling to breathe, visit one of our nearby emergency departments for immediate care.
Croup is spread just like the common cold, so it is difficult to prevent.
Keep your child home from school or daycare when they’re ill or if it’s known that an illness is spreading.
Regular hand washing and teaching your child to sneeze and cough into their elbow can help stop the spread of viruses. Also try to get your child to avoid touching their face, especially their nose and mouth.
Make sure your child is up-to-date with all recommended shots. These immunizations can help reduce the risk of some of the infections that can lead to croup.
Because croup is caused by viruses, the same steps that prevent colds and flu can also reduce the risk of croup.
Most cases improve within three to five days, though the cough may last a little longer.
Yes. The viruses that cause croup spread through coughs, sneezes and contact with contaminated surfaces.
Croup is rare in adults because their airways are larger and less affected by swelling.
Cool air or humidified air may help reduce airway swelling and ease breathing for some children.
Banner Children’s caring staff is here to help treat, diagnose and guide you through every phase of your child’s life. Not sure if your child needs to see a doctor in person? Banner Children’s offers telehealth services for expert advice from the comfort of your home. Learn more about virtual visits.
Most children with croup recover at home with supportive care. If your child's symptoms worsen or you're unsure whether they need medical attention, Banner Children's pediatric specialists are here to help.
You can schedule an appointment or connect with a provider through Banner Children's telehealth services for guidance from home.
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