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Croup Cough in Kids: Causes, Symptoms, Treatment & When to Worry 

By Dr. Sarthak Soni +2 more

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Introduction

Hearing your baby or child wake up in the middle of the night with a loud, barking cough can be frightening. This can often be a sign of croup cough, which is an inflammation of the windpipe. This blog will cover interesting facts, causes, symptoms, types, diagnosis, treatment, home remedies, and prevention of croup cough1.

What Is Croup?

Croup is an upper airway infection that is characterised by hoarseness and coughing that sounds like a seal barking. It is usually caused by viruses such as parainfluenza and RSV but can also be caused by bacteria. It is common in children under the age of 6. Most children with croup exhibit mild symptoms and can be treated at home, but in a few severe cases, hospitalisation is required1,2.

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Did You Know?

  • The annual incidence of croup is around 532 cases per 100,000 individuals. 
  • The parainfluenza virus is responsible for more than two thirds of croup infections2
  • Croup is more prevalent in boys than girls. 
  • Croup infection is most common in early winter and fall2

What Causes Croup?

Croup is caused by viruses such as1,2:

  • Parainfluenza  
  • RSV 
  • Measles  
  • Adenovirus 
  • Influenza 
  • Rhinovirus 
  • SARS-CoV-2 

Croup can also be caused by a bacterium, usually Staphylococcus aureus. In this case, it is called bacterial tracheitis.  

Croup Symptoms

Croup symptoms include2,3

  • Cough that sounds like a seal barking 
  • Cold 
  • Fever 
  • Hoarse voice 
  • Difficulty in breathing 
  • Stridor (A harsh and crowing noise made while breathing in) 

Types of Croup

The common types of croup that may occur in babies and kids include2:

  • Spasmodic croup: This type mostly occurs abruptly at night for a short duration. It may recur in the same night and continue for 2-3 days. It is sometimes called allergic croup because it is associated with a positive family history of allergies. 
  • Viral croup: This type of croup is most often caused by the parainfluenza virus, usually type 1 and 2. In this case, the symptoms are continuous, unlike spasmodic croup. 
  • Recurrent or atypical croup: In this, frequent episodes of symptoms that resemble croup appear more than twice a year.  
  • Bacterial tracheitis: This is most often caused by the bacteria Staphylococcus aureus. It usually occurs after a viral upper respiratory infection4.

        Diagnosis of Croup

        Croup is diagnosed with the following examinations and laboratory tests1:

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        • Chest examination: The doctor will examine your child’s chest to check for wheezing, reduced breath sounds, and difficulty breathing. 
        • Throat examination: A throat examination may show a red epiglottis, which likely indicates croup. 
        • Neck x-ray: This may reveal narrowing of the trachea, which may be indicative of croup. 

        Croup Treatment

        The options for croup treatment in babies and children include2:

        • Steroids: The steroid dexamethasone may be given orally to children with croup. It is safe, effective, and can be easily administered.  
        • Epinephrine: This is shown to improve symptoms within minutes when given via nebuliser. 
        • Intubation: In rare cases, when a child is hospitalised for croup, endotracheal intubation may be required. 
        • Antibiotics: Antibiotics are administered to children when primary or secondary bacterial infection is suspected. 

        Home Remedies for Croup

        Home remedies that may help soothe the symptoms of croup include3:

        • Encourage your child to drink plenty of fluids, such as water, to help keep them hydrated. 
        • Warm fluids may help soothe the throat and make your child feel more comfortable. 
        • Make sure your child’s head is elevated when lying down for ease of breathing. You can use pillows in children older than 12 months. Do not use pillows in babies younger than 12 months. 
        • Sit with your child in a steamy bathroom for 15 to 20 minutes. Ensure that you do not leave your child alone. 
        • You may try using a humidifier in your child’s room as dry air may worsen the cough. 
        • Take your child outside at night to breathe in the cool night air. Make sure to cover up your child.  
        • If your child is over 12 months of age, a spoonful of honey may help to soothe the cough.  
        • Avoid smoking at home as it can worsen the cough. 
        • Stay next to your child at night in case the cough worsens.  
        • Stay calm and comfort your child. Try to avoid anxiety in the child. 
        • Keep your child as calm as possible to avoid worsening of cough.  
        • Acetaminophen can be administered to the child for comfort and to reduce fever1,3,5,6,7.

                              How to Prevent Croup?

                              You may be able to avoid croup cough in your child by ensuring that they1,2

                              • Wash their hands regularly, especially before a meal. 
                              • Are not in close contact with people who have respiratory infections. 
                              • Are immunised with the diphtheria, influenza and measles vaccine on time. 
                              • Get appropriate care and treatment of croup to prevent a recurrence. 

                              Also Read: Home Remedies for Cold in Infants and Babies

                              When to Consult a Doctor?

                              It is important to consult a doctor if your child has croup and is not responding to any home remedies. If your child has trouble breathing, a high-pitched sound with every breath, extreme drowsiness, decreased consciousness, and bluish coloured lips and face, you should contact your doctor immediately3.

                              Conclusion

                              Although croup cases are usually mild and improve with care at home, some children may require hospitalisation. If your child develops breathing problems, extreme fatigue, and trouble swallowing, ensure that you go to the doctor as soon as possible. Recognising and diagnosing croup early, timely treatment, and appropriate care can help prevent complications. It is important to ensure hygiene and timely vaccinations for your child to avoid viral and bacterial infections in general. 

                              Frequently Asked Questions (FAQs)

                              How do you know if your kid has croup? 

                              If your child has a barking cough and hoarseness, it is likely that it is croup cough. Further tests, like a chest exam, may be needed to confirm the diagnosis1,3.

                              Can my child sleep alone with croup? 

                              Yes, but it is important that you keep constantly checking with them at night. Make sure your child is not crying as it can worsen the symptoms. If your child is older than 1 year, it is advisable to use a pillow to keep their head up while sleeping1,3.

                              Will antibiotics get rid of croup? 

                              Antibiotics are administered to children only when a primary or secondary bacterial infection is suspected2.

                              Is day 3 of croup the worst?

                              Yes, the most severe symptoms of croup usually appear on day 3 or 42.

                              What gets mistaken for croup?

                              Sometimes, conditions such as acute epiglottitis (epiglottis infection), deep neck space abscesses (a condition characterised by fever, drooling, and neck stiffness), presence of a foreign body in the throat, and allergic reactions may be mistaken for croup as they all have similar symptoms2.

                              Can croup turn into pneumonia?

                              Yes, complications such as pneumonia may occur as a result of croup2.

                              Reference

                              1. Croup: MedlinePlus Medical Encyclopedia. Accessed July 3, 2026. Available from: https://medlineplus.gov/ency/article/000959.htm 

                              2. Kadam S, Daley S, Carr B. Croup. StatPearls. Published online June 2, 2025. Accessed July 3, 2026. Available from: https://app-statpearls-legacy-prod.azurewebsites.net/point-of-care/20142 

                              3. Croup – discharge: MedlinePlus Medical Encyclopedia. Accessed July 3, 2026. Available from: https://medlineplus.gov/ency/patientinstructions/000994.htm 

                              4. Tracheitis: MedlinePlus Medical Encyclopedia. Accessed July 3, 2026. Available from: https://medlineplus.gov/ency/article/000988.htm 

                              5. Content – Health Encyclopedia – URochester Medicine. Accessed July 16, 2026. Available from: https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=90&contentid=p02942 

                              6. Treating Your Child’s “Barking Cough” at Home | University of Utah Health. January 2, 2023. Accessed July 16, 2026. Available from: https://healthcare.utah.edu/the-scope/kids-zone/all/2026/04/treating-your-childs-barking-cough-home 

                              7. The-PEARL-No.-33_-Croup. Accessed July 20, 2026. Available from: https://flemsc.emergency.med.jax.ufl.edu/wordpress/files/2024/02/The-PEARL-No.-33_-Croup.pdf 

                              Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof. 

                              Links and product recommendations in the information provided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.

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