Croup in children

This is for anyone looking after a child with croup.

What is croup?

Croup is a common, infectious childhood illness usually caused by a virus.  It mostly commonly affects children between 6 months and 5 years.

Croup can cause swelling of the upper airways, often around the voice box. This can make breathing difficult and noisy.

Croup is usually mild. Most children with croup will get better by themselves in three to seven days. Sometimes croup needs treatment.

What are the symptoms of croup?

The symptoms can include one or more of the following.

• A barking cough (sometimes described as a ‘seal-like’ cough).
• A hoarse or raspy voice.
• A loud high-pitched noise when your child breathes in. This may happen all the time or just when they are upset.
• Problems with breathing. This can be breathing faster than normal, or sucking in their chest when they breathe.
• A high temperature (above 38 degrees C).
• Symptoms are usually worse at night and better during the day.  It is common for symptoms to start in the middle of the night.
• Symptoms usually peak after one to three days and then improve.  A mild but irritating cough may continue for a further week or so.
• Some bacterial infections, for example tonsillitis, can cause similar symptoms.

What can I do if my child has signs of croup?

If your child displays signs of croup you can do the following.

• Stay calm and try to keep your child calm.
• Sit your child upright.
• If they have a high temperature, treat them with paracetamol (for example Calpol) or ibuprofen (for example Nurofen).  Always follow instructions on the packet carefully, and do not exceed the recommended dose for their age group.
• Allow your child to drink to soothe their throat. Do not force them to drink.
• Keep a close watch on your child. Seek medical attention if your child’s condition does not improve.

What is the treatment for croup?

Croup is caused by a virus so it cannot be treated with antibiotics.

Some children need medication (steroids) to help reduce the swelling and inflammation in their throats. Steroids are usually given by mouth in liquid form. 

We do not recommend using steam to treat croup. There is no evidence that it helps and it may burn your child’s face and throat.

When to get help

Make an urgent GP appointment or go to your nearest Emergency Department (A&E) if your child:

• is breathing noisily even when they are not upset
• is breathing quickly or sucking in their tummy when they breathe
• is irritable, restless or extremely tired
• has a persistent high temperature of 38 degrees C or above, even after you have treated them with paracetamol or ibuprofen
• seems to be getting worse and you are worried
• is under 6 months of age and has breathing difficulties or a high temperature. For babies aged under 3 months, a high temperature is above 38 degrees C. For babies aged 3 to 6 months a high temperature is above 39 degrees C.

When do I call 999?

Call 999 if you notice that your child:

• is struggling to breathe
• has skin or lips that start to look blue, grey or pale
• is very sleepy and difficult to wake or suddenly unusually quiet or still
• is drooling and finding it hard to swallow
• suddenly has difficulty breathing and you think they are choking on something.

More information

NHS information on croup www.nhs.uk/conditions/croup/
NHS information on how to stop a child choking www.nhs.uk/conditions/baby/first-aid-and-safety/first-aid/how-to-stop-a-child-from-choking/

_{Image by Freepick}

Contacts

Your GP
Paediatrics Admin Team, Monday to Friday, 9 am to 5 pm	020 8934 6403 khft@paediatricadmin@nhs.net