Croup cough: symptoms, care & when to seek help

That distinctive, seal-like barking cough can be unsettling to hear, especially when it's coming from your little one. Croup is a common infection in babies and young children, but knowing what to look out for can help you understand when to seek medical advice. With advice from Dr Kate Smith, we explain the symptoms of croup, when to get help and how to care for mild cases at home.

Croup is a common childhood illness, usually caused by a virus, that affects the upper airways and can make breathing more difficult.¹ It’s best known because of its distinctive ‘barking’ cough. Croup causes inflammation and swelling in the tissues around the voice box and trachea.² It mainly affects babies and young children, since their airways are smaller and even a small amount of swelling can make it harder for them to breathe.³ However, sometimes older children (between five and eight years old) can develop croup too.

Note: If your child is struggling to breathe, is difficult to wake or has blue, grey or unusually pale skin or lips, call 999 immediately.

According to Dr Smith, “a croup cough is distinctive from other coughs because it can be described as a barking cough – a bit like how a seal bark may sound.”⁴ Unlike a typical cough, which might sound dry, tickly or chesty, a croup cough often has a harsh, barking sound. You might also notice your child's voice sounds hoarse or hear a high-pitched, rasping noise when they breathe in (known as stridor).⁴

Most children will have mild cold-like symptoms for a few days before the barking cough appears.⁵ Other signs and symptoms of croup can include: ⁶

• a rasping, high-pitched noise when breathing in (stridor)

• a hoarse voice

• difficulty breathing

Symptoms can also be worse at night.⁴

“Although mild cases may be able to be managed at home, the NHS advises that you still call 111 or see your GP if you think your child might have croup, as they might need treatment,” says Dr Smith.⁶

When to contact your GP or NHS 111

You should seek medical advice if:

• you think your child might have croup, even if their symptoms seem mild

• your child's symptoms are getting worse or aren't improving after seeing a GP

When to call 999 or go to A&E

“In severe cases of croup, the NHS advises you to call 999 or go to A&E,” says Dr Smith. Seek emergency medical help if your child:⁶

• is struggling to breathe, including making grunting noises or their tummy sucking in under their ribs

• has blue, grey, pale or blotchy skin, lips or tongue

• is unusually sleepy, difficult to wake or not responding as they normally would

• is very distressed, struggling to breathe and can't be calmed

• is unwell and drooling more than usual, struggling to swallow or wanting to sit rather than lie down

You can find the full list of emergency warning signs on the NHS website.

If your GP or NHS 111 advises that your child can be cared for at home, the NHS provides the following guidance: ⁶

• sit your child upright where possible

• give them lots of fluids

• keep your child as calm as possible, as crying can worsen symptoms

• give them children's paracetamol or ibuprofen, if suitable, to help ease a high temperature or discomfort. Always follow the instructions on the label or ask a pharmacist for advice

• check on your child at regular intervals, even overnight

The NHS also discourages using steam or hot air for children with a croup cough.⁶ Some people claim this is a good form of croup treatment, but there’s no solid evidence that your child breathing in humid air will help. Steam can also cause serious burns or scalds, so it's best avoided.

Croup often starts to improve on its own within around 48 hours, although some symptoms, particularly the cough, can last longer.⁶ If your child is getting worse or isn't improving after seeing a GP, contact your GP or NHS 111 for further advice.

Hearing your little one develop that distinctive barking cough can be worrying, especially if it's the first time you've come across croup. Thankfully, most cases are mild and improve within a few days – and you don't have to work out what to do on your own. If you think your child has croup, speak to your GP or NHS 111 for advice as they may need treatment.

If you're advised to care for them at home, keeping them comfortable, calm and well hydrated can help while they recover. And remember, if their symptoms worsen or you're concerned about their breathing, it's important to seek medical help promptly.

Still curious about immune health? Learn whether it’s possible to prevent a cold or discover our tips to support your child’s immunity...

Disclaimer – This article provides informational advice and is not a substitute for medical care. Working with experts for accuracy, we take great care to ensure the information is up-to-date and relevant. However, you should always consult your GP or healthcare professional before using supplements or alternative products, particularly if you have medical conditions or are under supervision.