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Am Fam Physician. 2018;97(9):online

See related article on croup

What is croup?

Croup (“kroop”) is a common infection in children that causes swelling in the trachea (windpipe) and larynx (voice box). It is caused by a virus, so it can spread through coughing and sneezing. It can also spread by dirty hands, sharing toys, and sharing drinking glasses or eating utensils.

Who gets croup?

Croup is most common in children six months to three years of age.

How can I tell if my child has croup?

Symptoms of croup include:

  • A mild fever

  • Runny nose

  • Hoarseness

  • Wheezing

  • A “barking” cough

In more severe cases, you may hear a harsh, loud, high-pitched noise when your child takes a breath. Other symptoms of severe croup include:

  • Fast or difficult breathing

  • Flaring nostrils

  • Unusual restlessness

  • Retractions (your child's chest and stomach muscles suck in)

  • A blue tint to the lips and fingernails

Symptoms may be worse at night.

How is it treated?

Children with mild cases of croup can be treated at home. Your child may feel better when he or she is sitting up or being held upright. Crying can make the symptoms worse, so try to keep your child quiet and comfortable. He or she should get lots of rest and plenty to drink. Cough medicines usually don't help. You can give your child acetaminophen (one brand: Children's Tylenol) or ibuprofen (one brand: Children's Advil) for fever or chest discomfort. Your doctor may prescribe a steroid medicine to make the symptoms go away faster.

How long does it last?

Croup usually lasts two to five days. Some children have a mild cough that lasts a few days longer. Most children with croup get better without problems.

How can I prevent croup?

To help prevent croup, you should:

  • Make sure everyone in your house washes their hands often.

  • Throw away dirty tissues from runny noses and sneezes right away.

  • Wash toys in hot soapy water if a sick child has had them in his or her mouth.

  • Ask people with a cough to avoid kissing or playing with your child.

When should I call the doctor?

Watch your child closely and call the doctor right away if you notice any of these symptoms:

  • Drooling or trouble swallowing

  • Blueish lips or fingernails

  • Restlessness or confusion

  • Trouble breathing

Where can I get more information?

Your doctor

American Academy of Pediatrics

Centers for Disease Control and Prevention

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