FAQ: Croup in Infants and Older Babies


Sometimes a cough is just a cough, but other times it can be a sign of a more significant condition that may require medical treatment. Croup is an inflammation of the upper airways that can cause your young child to cough with a barking sound. Find out more about what croup is, what its symptoms are, and how it can be treated.

What Is Croup in Babies and What Causes It?

Croup is an inflammation of the larynx (voice box), trachea (windpipe), and bronchi (bronchial tubes) that is quite common in children as young as 3 months and as old as 5 years. The inflammation causes these passageways to narrow, which can make breathing more difficult.

Croup is most often caused by the parainfluenza virus, which is more likely to spread during the fall and winter. Your child can catch the virus by coming into contact with another infected child. Just like other respiratory viruses, it’s passed through contact with droplets, so when your child touches their nose or mouth, there is a chance they may get the virus.

Although this infection can be uncomfortable for your little one, croup typically lasts from three and five days and can often clear without treatment from your baby’s healthcare provider. If it does linger any longer or if your child has a more severe bout, take them to the provider for diagnosis and treatment.

What Are the Symptoms of Croup and How Long Do They Last?

You may think your child has the common cold at first, because the early symptoms of croup can include a stuffy nose.

Eventually the following symptoms can develop and are often worse in the evening:

  • Fever

  • A barking cough that can get worse with crying, coughing, agitation, and anxiety

  • A squeaking or whistling sound (known as stridor) when breathing

  • Fast breathing that may cause the skin between your child’s ribs to retract

  • A hoarse-sounding voice

  • Heavy breathing.

How Can You Treat Croup at Home?

Since croup is caused by a virus, there is no specific at-home treatment for it. It can’t be treated with antibiotics, which are used to treat bacterial infections but are not effective for viral infections.

Experts also recommend avoiding over-the-counter medicines like cough syrup, as these will not work and may be unsafe.

When your child has croup, focus on keeping them comfortable and calm. Agitation and crying can make symptoms worse, as they may cause the airway to tighten even more. These are some things you can try:

  • Reading or singing to them

  • Hugging them

  • Offering a favorite toy or blankie

  • Speaking in a soft, soothing voice.

In the past, parents may have followed the advice to bring their child into a steamy bathroom or to take them outside for moist night air. Though some parents find this to be helpful, there is no actual evidence that this is effective in treating croup.

If your child (who is older than 6 months) has a fever of 100.4 degrees Fahrenheit or higher, you can try to bring it down with acetaminophen or ibuprofen. But be sure to check with their healthcare provider first. Always check with the provider when your baby is 3 months old or younger and has a fever. During a fever, make sure your child is getting lots of fluids so they don't become dehydrated.

When Should You See Your Healthcare Provider?

If your little one’s symptoms worsen or linger for longer than five days, it’s time to contact their healthcare provider.

To make a diagnosis, the provider may observe how your child breathes, listen to their chest, and examine their throat. In some cases, the provider may order an X-ray to rule out the possibility of another condition.

If croup is diagnosed, your child’s healthcare provider may prescribe one of the following medications:

  • A steroid, which helps reduce the airway swelling. After a dose, your child may begin to feel better in a matter of hours.

  • Epinephrine, which can also reduce inflammation. This may be given with a nebulizer so that your child inhales the medication, resulting in quick relief.

In very severe cases, if your child is having breathing difficulties, the provider may recommend your little one be hospitalized until their breathing improves.

When Should You Take Your Child to the ER?

Croup can cause your child’s airway to swell and narrow, which can make breathing difficult. Difficulty breathing may also result in your child stopping eating and drinking. They may even become too tired to cough.

If you see the following, take your child to the emergency room right away:

  • They struggle to breathe

  • They breathe faster than normal

  • They make a whistling sound (stridor) when they inhale or exhale, even when they are not crying or agitated

  • Swallowing is difficult or they drool excessively

  • They have trouble speaking

  • They are very sleepy or fatigued, or even anxious

  • Their skin looks blue around the nose, mouth, or fingernails.

The Bottom Line

Croup may be an uncomfortable childhood illness, but in time it will go away. In the meantime, all you can do is comfort your little one while you wait for the infection to pass and see their healthcare provider if the condition worsens. In typical cases, a child will be back to their usual self in less than a week.

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How We Wrote This Article The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.

About Terri L. Major-Kincade

Dr. Terri Major-Kincade is a double-board certified neonatologist and pediatrician. She is an Associate Professor of Pediatrics at UT Health, Houston, McGovern Medical School where she serves as the Medical Director for Pediatric Palliative Care at C...

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