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Where did that cough come from?

Published in Pediatrics, For the Health of It Author: Jill Amsberry, D.O.

It’s 2 a.m. You thought it was just a little cold. Now your child has a horrible cough. Could it be croup?

What is croup?

  • Inflammation of the upper airway, including the voice box (larynx) and windpipe (trachea), typically caused by a virus.
  • Most common in children ages 3 months to 5 years old.
  • Mainly seen in the fall and winter.


  • Cough characterized by its barking sound (like that of a barking seal) that is worse at night.
  • Hoarse voice because of the inflammation of the area around the vocal cords.
  • Stridor, which is a harsh and raspy sound when the child breathes in, is a more serious symptom and requires evaluation.
  • Fever, typically low grade but occasionally can reach temperatures up to 104F.

Home remedies

  • Sit with your child in the bathroom while running a hot shower. After about 10-15 minutes of exposure to this warm steam, your child’s symptoms should improve.
  • Put a cool mist humidifier in your child’s room.
  • Bundle up your child and go out into the cold night air.
  • Use medication such as a fever reducer to help with fever.
  • Keep your child as calm and comfortable as possible. Crying makes this barking cough sound worse.
  • Keep your child hydrated by continuing to offer clear liquids.
  • Do not use cough syrups or antihistamines. They do not help children with croup.


  • Your doctor may give your child a steroid by shot or liquid to help with inflammation.
  • Antibiotics are not helpful in the treatment of croup because it not caused by a bacterial infection.

Call your health care provider or seek immediate care if your child has:

  • difficulty breathing
  • stridor, a high pitched noise when breathing in
  • pale or bluish color around the mouth
  • difficulty speaking because she cannot catch her breath
  • an ill or worried appearance
  • has not improved after the third day of symptoms

When in doubt, call your child’s health care provider. For the most part, most cases of croup are mild. Your child may return to school or daycare once the fever has resolved and your child is ready to participate in daily activities. Frequent hand washing and avoidance of others with upper respiratory infections is the best prevention.