An Overview of Croup

In This Article

If you are a parent, chances are you've been rousted out of bed at least once by the barking cough of croup. Croup is a catch-all term for childhood inflammation and swelling of the area of the throat that includes the vocal cords.

This swelling blocks airflow through the windpipe (trachea) and triggers coughing that sounds a lot like a seal. Sometimes it might make sense to take your child to the doctor, but probably not. In most cases, croup is usually mild and will go away on its own.

Symptoms

There are only two symptoms of croup:

  1. Barking cough
  2. Stridor

Stridor is a high-pitched sound that goes with breathing. It comes from swelling in the upper airway near the vocal cords. In severe cases with very pronounced stridor (which is very rare), the patient can exhibit shortness of breath.

Causes

In the United States, approximately three percent of children are affected by croup each year. It is most common in children between the ages of six months and three years. One of several viruses usually causes it, but 75% of all cases are caused by parainfluenza virus. However, not all kids who catch these viruses will get croup; some will simply have cold symptoms.

Additionally, bacteria can cause croup, but it's much less common. And since croup is most likely caused by a virus, antibiotics won't help. It will just need to run its course.

Diagnosis

Croup is diagnosed by the doctor doing a thorough history and physical exam. There is no test for croup. Instead, the doctor might do other tests to see if the child's symptoms could be related to some other respiratory condition. It's called a diagnosis of exclusion because croup is what is left over when all other causes for a barking cough have been ruled out.

Croup-like coughing and stridor can also come from objects that are stuck in your child's airway, as well as severe allergic reactions. Coins, erasers, marbles, Legos, and other little objects have been found in the airways of otherwise healthy kids who show up to the emergency department.

Treatment

There are, however, a couple of home remedies that you can try to help alleviate your child's symptoms. Be aware, though, that most of them don't have a lot of scientific evidence to support their use.

Breathe in Humid Air

Many health care providers suggest exposing your child to moist or humid air, like breathing steamy air from a hot shower or opening the windows on a cool night. But no evidence shows that moist air actually helps. (If using the shower is too awkward or difficult, try a humidifier.)

Drink Plenty of Fluids

Doctors also frequently advise patients with any form of viral infection is to push the fluids. Staying hydrated may help the body fight infection. However, research has found little evidence to support this advice and some evidence actually suggests that increasing fluid intake may actually cause harm.

When to See a Doctor

Anytime a child develops stridor they should see a doctor. In many cases of mild croup, children can be safely treated at home with supportive care. As long as kids aren't worsening, they will eventually get better.

If your child has a barking cough for more than three days or their croup is severely uncomfortable, the doctor may be able to prescribe steroids or inhaled epinephrine to help with the swelling.

Sometimes, croup can lead to a dangerously swollen throat and windpipe. In those cases, call 911 or go straight to the emergency department. And take your child to the doctor or call 911 if they also have any of the following:

And if a barking kid starts scratching or complaining of itching—or if redness or hives appear—call 911 immediately.

A Word From Verywell

Croup is an extremely common condition, but it isn't the only thing that can cause a barking cough. The bottom line is if you're worried about your child and aren't sure whether they should go to the doctor, go ahead and take them. Trust your instincts. When it comes to our kids, our guts are usually right.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Johnson DW. Croup. BMJ Clin Evid. 2014;2014

  2. Smith, DS, McDermott, AJ, and Sullivan, JF. Croup: Diagnosis and management. American Family Physician. 2018;97(9):575-580.

  3. Downs, MR, and Hong, KTD. Is humidified air helpful in the management of croup in children? Evidence-Based Practice. 2015;18(6):E4. doi:10.1097/01.EBP.0000540996.17076.46

  4. Guppy MP, Mickan SM, Del mar CB, Thorning S, Rack A. Advising patients to increase fluid intake for treating acute respiratory infections. Cochrane Database Syst Rev. 2011;(2):CD004419 doi:10.1002/14651858.CD004419.pub3

  5. Baiu I, Melendez E. Croup. JAMA. 2019;321(16):1642. doi:10.1001/jama.2019.2013

Additional Reading

  • Johnson DW. Croup. BMJ Clinical Evidence. 2014; 2014:0321.