Should I use this page, or get help now?
Use this page if a young child has a barking cough and you need home care versus 111. Skip it and call 999 if they are struggling to breathe, going blue or grey, floppy, or hard to wake. NHS advice is to call 111 or see a GP if you think it is croup, because they may need medicine.
This page cannot listen to a chest. Steam is not treatment.
What is croup and what does it sound like?
Croup is swelling of the voice box and windpipe, usually from a virus, mainly in babies and young children. It often starts like a cold, then a barking cough, a hoarse voice, and sometimes a harsh sound when breathing in. It is often worse at night. Most mild cases improve within about 48 hours.
Bronchiolitis and whooping cough can sound different. If you are unsure, use 111.
How should I look after them at home?
Sit them upright. Keep them calm — crying narrows the airway further. Offer fluids. Check them regularly, including at night. Paracetamol or ibuprofen can ease fever — follow the pack. Do not put them in a steamy room or make them inhale steam. NHS says not to. Hot water scalds.
Do not give cough medicines unless a clinician advises. Find a GPhC-registered pharmacy on Pick My Pharmacy for age-appropriate fever medicine only — not as a substitute for 111.
When is it 111 or 999?
Call 999 if they are working hard to breathe, have blue, grey or blotchy skin or lips, are floppy or hard to wake, cannot be calmed while struggling, or are unwell and drooling more than usual. Use 111 or a GP if you think it is croup even when they seem milder — they may need a steroid medicine.
In England, Scotland and Wales call 111 (NHS 24 in Scotland). In Northern Ireland there is no general 111 — use GP out-of-hours on nidirect. See pharmacy, GP, 111 or A&E if you are stuck on the door.
Will they need hospital treatment?
Sometimes. Younger babies and children who are more unwell may be seen in hospital. A single dose of steroid medicine can reduce swelling quickly. That does not mean you waited too long at home. After mild croup, the cough may last a few more days. It can return with the next cold because the airway stays sensitive for a while.
Keep them off nursery while they have a fever or feel too unwell.
How is croup different from bronchiolitis or whooping cough?
Croup is a barking cough and noisy breathing in, often worse at night, in babies and young children. Bronchiolitis is more a chesty wheeze and feeding problem in babies, usually in winter. Whooping cough is coughing bouts that can last weeks, sometimes with a whoop. Overlap happens.
Use 111 if you are not sure — the red flags for breathing are the same. Do not run a steamy bathroom to decide. Keep them off nursery while they have a fever or feel too unwell. Hand washing helps, but you cannot always prevent the next winter virus.
Will they need steroids or hospital?
Mild croup confirmed by 111 or a doctor often settles with comfort care. More significant noisy breathing may be treated with a steroid medicine given by a GP or in hospital to reduce airway swelling. That is not a failure of home care. Follow the dose you are given.
Younger babies and children who are more unwell may be seen in hospital. After mild croup, the cough may last a few more days. It can return with the next cold because the airway stays sensitive for a while.
Who should skip this page?
Skip this page if breathing is already hard or they are blue, grey or floppy — call 999 now. It is not a steam tutorial, not an asthma inhaler plan, and not a whooping-cough diagnosis for a cough that has lasted weeks. A baby with fever still needs the children’s fever pathway as well as croup advice.
Common questions about croup
- What does croup sound like?
- The cough is often described as barking, like a seal. The voice may be hoarse. Breathing in can make a harsh, high-pitched sound (stridor). It often follows a day or two of cold symptoms and is worse at night. Whooping cough and bronchiolitis can sound different — if you are unsure, use 111 rather than guessing from a video.
- What causes croup?
- A viral infection inflames the voice box and windpipe. Young children have smaller airways, so a little swelling makes a lot of noise. It spreads like a cold. Keep them home while they have a fever or feel unwell. Hand washing helps, but you cannot always prevent the next winter virus.
- How can I treat croup at home?
- Sit your child upright and keep them calm — crying makes breathing harder. Offer plenty of fluids. Check them at night. Paracetamol or ibuprofen can ease fever — follow the pack. Do not put them in a steamy bathroom or over a bowl of hot water. Do not give cough medicines unless a clinician advises.
- Will my child need steroids for croup?
- Mild croup confirmed by 111 or a doctor often settles with comfort care. More significant noisy breathing may be treated with a steroid medicine given by a GP or in hospital to reduce airway swelling. That is not a failure of home care. Follow the course or single dose you are given.
- Is steam good for croup?
- No. NHS advice is not to put your child in a steamy room or get them to inhale steam. It does not treat croup and hot water can scald. Sit them upright, comfort them, and get medical advice. If breathing is already hard, call 999 rather than running a shower.
- How is croup different from bronchiolitis or whooping cough?
- Croup is a barking cough and noisy breathing in. Bronchiolitis is more a chesty wheeze and feeding problem in babies. Whooping cough is coughing bouts that can last weeks, sometimes with a whoop. Overlap happens. Use 111 if you are not sure — the red flags for breathing are the same.