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Croup

Coughing baby lying on his side
Photo credit: Thinkstock

What is croup?

Croup (also known as laryngotracheobronchitis) is a common childhood condition, usually caused by a viral infection. It causes the voice box (larynx) and airway to the lungs (trachea) to swell, making it more difficult to breathe. The result is a distinctive, bark-like cough that usually clears up within a few days (NICE 2017).

Croup usually affects children aged between six months and six years, although it can occur in older children (NICE 2017). Your baby may be most likely to get it between September and December, though it can happen all year round (NICE 2017). It's possible to get it more than once (Knott 2015)

What are the signs and symptoms of croup?

If your baby has croup, you’ll know that something's not right. The barking cough is easy to recognise, and sounds a bit like the noise a seal makes (NICE 2017). Although it’s frightening to hear your baby cough like this, in most cases, it sounds worse than it is.

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Other symptoms of croup can include:

  • a loud, high-pitched rasping sound when breathing in (known as stridor)
  • runny nose
  • sore throat
  • fever
  • unusual tiredness
  • pale skin
    (NICE 2017)

Croup is often worse at night (NICE 2015). You may also notice that your baby's symptoms seem to get worse when she's crying (NICE 2017).

How can I treat croup?

In many cases, croup gets better on its own without treatment (NICE 2017). However, if you're at all concerned about your baby's health, it’s best to speak to your health visitor or take your baby to the GP, even if she's had croup before (NHS 2017a). Your GP may give your baby a single dose of steroid soluble tablets, which work by reducing the swelling in her airways (NICE 2017).

Your doctor will also advise you to try some treatments at home to relieve your baby’s symptoms and help her to feel more comfortable:

  • Encourage your baby to take extra fluids to keep her hydrated (NICE 2017). If your baby's breastfed, offer extra feeds. If she's formula-fed, offer extra water instead; but be sure to boil it first if she's under six months (NHS 2015).
  • Liquid infant paracetamol or infant ibuprofen can help make your baby more comfortable if she has a fever and seems to be in pain. Your baby can have infant paracetamol from two months if she was born after 37 weeks and weighs more than 4kg (9lb) (MHRA 2011). She can have infant ibuprofen if she's three months or older and weighs at least 5kg (11Ib) (MRHA 2016). Read the dosage information on the packet, or check with your doctor or pharmacist if you’re unsure how much to give your baby.
  • If your baby is crying and upset, her cough could become worse. Comfort and reassure her with lots of hugs and kisses. Sitting her upright on your lap, or holding her upright over your shoulder may help her to breathe more easily (NHS 2017a, NICE 2017).
  • Keep an eye on your baby during the night to make sure that her breathing isn't getting worse (NICE 2017).

Don't use steam to try to relieve your baby's croup (Knott 2015, NHS 2017a). This is unlikely to help, and no matter how careful you are, there's a risk that the steam could scald your baby (Knott 2015). Don’t give your baby cough medicines or decongestants, as these won’t help in treating croup (NHS 2017a).

Can croup cause any complications?

Most cases of croup are mild and will get better in a few days, with or without treatment (NICE 2017). However, sometimes a severe bout of croup can cause serious breathing difficulties. Phone for an ambulance straight away if your baby:

  • is struggling to breathe
  • suddenly seems very sleepy or lethargic
  • has a blue tinge to her lips and face
  • appears to have a drawn-in neck and ribcage
    (NICE 2017, NHS 2017a)
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Once in hospital, your baby will be given oxygen to help her breathe. She will also be given steroids to reduce the swelling in her airways (Knott 2015, NICE 2017).

How long does croup last?

Croup often gets better within a few days, but in some cases it can last for as long as two weeks (Knott 2015, NICE 2017). During this time, continue the home treatments to relieve your baby’s symptoms. Once you both get over the surprise of this nasty cough, it will usually run its course and leave you all a little tired, but well.

Not sure if it's croup? Check out the symptoms of:
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BabyCentre's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organisations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies.

Knott, L. 2015. Croup. Patient, Professional Reference. patient.infoOpens a new window [Accessed March 2018]MHRA. 2011. Liquid paracetamol for children: revised UK dosing instructions have been introduced. Medicines & Healthcare products Regulatory Agency, UK Public assessment report. www.mhra.gov.ukOpens a new window [Accessed April 2018]

MHRA. 2016. Ibuprofen 100 mg/5 ml oral suspension. Medicines and Healthcare products Regulatory Agency, UK Public assessment report. www.mhra.gov.ukOpens a new window [Accessed April 2018]

NHS. 2015. Drinks and cups for babies and toddlers. NHS Choices, Health A-Z. www.nhs.ukOpens a new window [Accessed March 2018]

NHS. 2017a. Croup. NHS Choices. Health A-Z. www.nhs.ukOpens a new window. [Accessed March 2018]

NICE. 2017. Croup. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.ukOpens a new window. [Accessed March 2018]
Polly Logan-Banks
Polly Logan-Banks is an experienced editor with a keen interest in producing evidence-based content. Polly is passionate about ensuring that every child gets the best start in life.
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