What is croup? Diagnosis and symptoms

With the cold and flu season upon us, your little one may likely catch one of the bugs. Croup is a common childhood illness that can have some worrying symptoms for parents. 

If you are not familiar with it, croup is a viral infection that causes swelling of the voice box (larynx) and windpipe (trachea), making the airway below narrower and causing breathing to be noisy and difficult. 

Children between the ages of six months and three years old are most likely to get croup. It’s not as common after age three because the windpipe is larger, so it’s less likely to get affected by swelling. Croup can occur at any time of the year, but it is more common during winter.

Croup is known for a ‘barking’ cough in kids

Croup often begins as a typical cold. If there is enough inflammation and coughing, a child will develop a loud barking cough known as a croup cough. When a cough forces air through this narrowed passage, the swollen vocal cords produce a noise similar to a seal barking. 

Croup in babies

Babies, due to their smaller airways, are particularly predisposed to croup. Croup is most common in children ages six months to three years old when interacting with other children in communal environments. 

Our urgent care centers are here to help evaluate and diagnose children six months and up. We also have specialty pediatric centers that can see and treat infants younger than six months. 

Symptoms of croup

In addition to the barking cough, there are a few other symptoms of croup. These include: 

  • A runny, stuffy knows
  • Fever
  • Laryngitis or loss of voice
  • Stridor or a high-pitched whistling sound when breathing

Symptoms are typically worse at night and are further aggravated by crying and coughing, as well as anxiety and agitation, setting up a cycle of worsening symptoms. 

Croup symptoms usually last for three to five days. The majority of cases of croup can be treated at home.

How is croup diagnosed?

Croup is typically diagnosed by evaluating the symptoms, particularly the barking cough and stridor. The provider may ask about other symptoms, such as fever and difficulty breathing.

There is not a specific croup virus. Many different respiratory viruses can cause croup. The most common virus that causes croup is the parainfluenza virus. During your visit at any of our urgent care centers, your provider may also run tests for viruses to determine the underlying cause of the croup. 

Croup treatment to ease cough in children

Croup can be scary, especially if it lands your child in the doctor's office, urgent care, or emergency room. In the meantime, you can help keep your child comfortable with a few simple measures:

  • Stay calm. Comfort or distract your child — cuddle, read a book, or play a quiet game. Crying makes breathing more difficult.
  • Moisten the air. Although there's no evidence of benefit from this practice, many parents believe that humid air helps a child's breathing. You can use a humidifier or sit with the child in a bathroom filled with steam from running hot shower water.
  • Hold your child in a comfortable upright position. Hold your child on your lap, or place your child in a favorite chair or infant seat. Sitting upright may make breathing easier.
  • Offer fluids. For babies, water, breast milk, or formula is fine. For older children, soup or frozen fruit pops might be soothing.
  • Encourage rest. Sleep can help your child fight the infection.
  • Try a fever reducer. Over-the-counter medicines, such as acetaminophen or ibuprofen, may help if your child has a fever.
  • Skip the cold medicines. Over-the-counter cold preparations aren’t recommended for children younger than age two. Plus, nonprescription cough medicines won't help croup.

If your child's symptoms are severe or last beyond three to five days and worsen, your healthcare provider may prescribe steroids to reduce inflammation in the airway. Benefits will usually be felt within six hours, so your child can start to feel better quickly.

Croup FAQs

Here are some frequently asked questions about croup.

Is croup contagious?

Yes, the respiratory viruses that cause croup are contagious. A child can remain contagious for approximately three days after symptoms begin or until the fever is gone.

Can kids go to school with croup?

No, a child should stay home until their fever is gone or at least three days after the symptoms begin.

Can adults catch croup from kids?

Yes, adults can catch the croup virus. However, it will not cause the same symptoms, such as the barking cough, because adults have larger airways. 

When to visit urgent care for croup cough

Croup is just one of several respiratory infections that children can catch. Most children can recover by resting at home. 

If your child is having worsening symptoms such as difficulty breathing, blue lips, signs of dehydration or difficulty swallowing, it is best to seek medical attention. 

Our pediatric specialty clinics offer croup testing and evaluation for all infants and children. However, any of our urgent care centers can treat children ages six months and up. Just find the center nearest you and walk in or save your spot online. Our caring providers are here to help your child feel better soon and give you peace of mind.


  1. https://www.hopkinsmedicine.org/health/conditions-and-diseases/croup
  2. https://www.aafp.org/pubs/afp/issues/2018/0501/p575.html
  3. https://www.uptodate.com/contents/croup-in-infants-and-children-beyond-the-basics

Written by Sarah Thebarge, Physician Assistant