Croup is an inflammation of the upper airway in which the voice box is narrowed by swelling due to an upper respiratory tract infection. In severe cases the airway may close totally.

Another severe form of croup is epiglottitis (inflammation of the epiglottis just above the larynx), which is generally caused by a bacterial infection. This condition may also lead to total airway obstruction and generally requires a stay in hospital under close supervision until the child starts to recover.

Croup is usually worse at night or when the outside air temperature falls and the child reacts to a sudden cold change in the weather. On some the child may seem to be fully recovered, only to deteriorate again in the evening.

Symptoms and signs – Not all may be present

• a high-pitched squeal sound, especially when breathing in
• a harsh, barking cough followed by a period of breathlessness
• bluish colouration of the lips, ear lobes and fingertips
• visible breathing effort with drawing-in of the ribs when breathing in
• use of the muscles in the neck to assist with breathing
• anxiety and distress
• fever

How you can help

1.    Relieve the breathing difficulty

• Reassure and calm the child.
• Cool the child if fever is present.
• Close all windows and doors to reduce draughts.
• Run the shower or hot tap to create a steamy bathroom. Nurse the child on your lap in the humid atmosphere.

Avoid getting too close to the shower or tap and risking a burn or scald.

2.    Obtain medical advice and care

• While the child is in a humid atmosphere, the breathing distress should be reduced. Even though the child may seem to be better, contact a local doctor for advice on further treatment.
• Ensure that the child stays in a warm room.
• Give frequent drinks of clear fluids – e.g. cordials – to avoid dehydration from the effort of breathing and having a high temperature.

If the child does not improve with the humid environment – call 111 for an ambulance.

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