Croup
Croup
Croup is a childhood illness that affects the windpipe (trachea), the airways leading to the lungs (bronchi) and the voice box (larynx).
It usually affects young children between 6 months and 3 years old, though it can happen a bit earlier or later too. Most cases are seen in 1 year olds, and it's more common in late autumn and early winter. Boys tend to get it more often than girls, and a child can have croup more than once.
Croup in adults is rare.
Common Symptoms
Symptom information is not available for this condition yet.
Emergency Warning Signs
Phone 999 or go to A&E if your child:
- has lips or skin turning pale, blue or grey. On brown or black skin, this is often easier to notice on the palms of their hands
- is having severe difficulty breathing. You may notice grunting noises, or their stomach sucking in under the ribcage
- is breathing fast, or their breathing stops or pauses
- is pulling in at the throat area (tracheal tug), or their windpipe looks more prominent than usual
- is limp, floppy or not responding as they normally would. They may struggle to focus on you, or be harder than usual to wake up
- is under 3 months old with a temperature of 38°C (101°F) or above, and has not had a vaccination in the past 2 days
- is under 3 months old with a temperature of 36°C (97°F) or below, and has not had a vaccination in the past 2 days
Contact your GP practice urgently if your child:
- is more short of breath than usual
- has pain when breathing in or coughing
- seems confused, dizzy or lightheaded
- feels sick or is being sick, for example if they cannot keep food or fluids down
- is coughing up blood
- has had a dry nappy for 12 hours or more, or shows other signs of dehydration
- has a very high or low temperature, for example feeling hot or cold to the touch, or shivering
- has a distinctive barking cough
If your GP practice is closed, phone 111.
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
When to See a Doctor
Phone 999 or go to A&E if your child:
- has lips or skin turning pale, blue or grey. On brown or black skin, this is often easier to notice on the palms of their hands
- is having severe difficulty breathing. You may notice grunting noises, or their stomach sucking in under the ribcage
- is breathing fast, or their breathing stops or pauses
- is pulling in at the throat area (tracheal tug), or their windpipe looks more prominent than usual
- is limp, floppy or not responding as they normally would. They may struggle to focus on you, or be harder than usual to wake up
- is under 3 months old with a temperature of 38°C (101°F) or above, and has not had a vaccination in the past 2 days
- is under 3 months old with a temperature of 36°C (97°F) or below, and has not had a vaccination in the past 2 days
Contact your GP practice urgently if your child:
- is more short of breath than usual
- has pain when breathing in or coughing
- seems confused, dizzy or lightheaded
- feels sick or is being sick, for example if they cannot keep food or fluids down
- is coughing up blood
- has had a dry nappy for 12 hours or more, or shows other signs of dehydration
- has a very high or low temperature, for example feeling hot or cold to the touch, or shivering
- has a distinctive barking cough
If your GP practice is closed, phone 111.
Causes
What causes croup?
Croup is usually caused by a virus. Several different viruses can lead to it, but the parainfluenza virus is behind most cases.
The virus spreads through close contact with someone who is infected, and also through contaminated objects and surfaces. Most often, it passes on when a person breathes in droplets released from an infected person's cough or sneeze.
Other viruses that can cause croup include:
- influenza A and B (the flu viruses)
- the measles virus, in children who have not been immunised against measles
- rhinovirus (the common cold virus)
- enteroviruses
- respiratory syncytial virus (RSV), which can lead to severe breathing problems and pneumonia in babies
Less commonly, croup can also be caused by:
- breathing in a small object, such as a peanut or a pen cap (an inhaled foreign body)
- inflammation of the epiglottis (the flap at the base of the tongue that stops food from entering the windpipe)
- a severe allergic reaction (anaphylaxis), for example to certain foods
- breathing in irritants such as chemicals
- acid leaking back up from the stomach into the throat (acid reflux)
Diagnosis
Croup can usually be diagnosed by a GP. They'll check your child's symptoms, especially the sound of their cough. If you can, record the noise your child is making on your phone so your GP can hear it. This can be helpful if your child only coughs at night.
Your GP may also:
- check your child's temperature
- ask whether your child has recently had a cold or viral infection
- do a pulse oximetry test to check your child's oxygen levels (this involves clipping a sensor onto your child's earlobe or finger; it does not hurt)
- rule out other conditions with more tests
Your GP will decide whether your child needs to go to hospital or whether their croup is safe to treat at home.
You should not try to check your child's throat yourself. It could trigger a spasm (sudden narrowing) of the airway. This could make breathing even more difficult.
Treatment
Most cases of croup are mild and can be treated at home.
Sitting your child upright and comforting them if they are distressed is important, since crying can make symptoms worse. Your child should also drink plenty of fluids to prevent dehydration.
Usually, your child will be prescribed medication to help reduce the swelling in their throat. This medication is a single dose of an oral corticosteroid called dexamethasone or prednisolone. Side effects of these medications can include restlessness, vomiting, upset stomach and headache.
Steam treatment is not recommended.
You should seek urgent medical advice if you notice your child's symptoms getting worse.
Pain relief for children
Children's paracetamol can ease pain and may help lower your child's temperature if they have a fever.
Children under 16 years of age should not be given aspirin.
Speak to your pharmacist or GP if you are unsure about what type of pain relief is right for your child.
Do not use cough medicines or decongestants, as these do not help ease the symptoms of croup. These treatments often have drowsy side effects, which can be dangerous when a child has breathing difficulties.
Hospital treatment
In severe cases of croup, treatment in hospital may be needed. This might include your child being given adrenaline or oxygen.