Croup is an infection of the upper airway and is usually viral in origin. The term “croup” comes from an old English term meaning “to cry hoarsely”. Typical features include a barking cough and an abnomal noise that sounds a little like a wheeze on breathing in.

Dr Tim Ubhi explains that the younger child usually presents with a runny nose followed by a cough and then wheeze. The wheeze in a young child (particularly those less than 18 months) is usually as  a result of the increased movement of air through an airway that has narrowed slightly due to inflammation and secretions. This is the same way that a whistle makes a noise when air is blown rapidly through it. The noises that a child makes during breathing can be split into 2 main groups, those made when the child breathes in (which originate at the top end of the airway including the area around the throat) and those that are made when the child breathes out (which originate in the lower parts of the airway).

Croup specifically refers to the inspiratory noise (when you breathe in) and a typical “barking cough” that occurrs after a common viral infection affecting the upper airway. Sometimes there are rarer causes for this condition including allergic reactions but these can usually be relatively easily identified following an assessment by a healthcare professional.

The following video demonstrates the typical cough and increased work of breathing experienced with croup.


Symptoms usually start with a runny nose and then progress to difficulty breathing and a barking cough (sometimes described as sounding like a seal). There may also be a temperature but this is usually below 38.5 degrees centigrade if the infection is viral.


Treatment is generally supportive. Your child may not feel like eating but having an adequate intake of fluid is important. A good rule of thumb is to ensure that they are getting at least half of their normal fluid intake.

Paracetamol syrup and or ibuprofen can be very useful to help treat a sore throat and also bring the temperature down.

A single dose of oral steroids has been shown to be very effective in reducing the length and severity of symptoms experienced by the child. Occasionally, health professionals may use nebulised steroids instead. If the child is working hard with their breathing, alternative types of nebulisers may also be used (eg salbutamol or Ipatropium bromide).


These infections are very common in childhood and are part of the process of the body learning about common environmental infections.

It is however prudent to keep your child away from nursery or school whilst they are infectious.

Being prepared

The Children’s e-Hospital has developed  The HOTPOD® Child Health Moitoring Kit which helps you to determine how unwell your child is. This allows measurement of heart rate, oxygen levels, temperature, breathing rate, ECG, blood pressure and blood sugar.

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Authored by: Dr Tim Ubhi

Published: 8th March 2019

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