That Barky Cough: Understanding Croup in Kids

That Barky Cough: Understanding Croup in Kids

Kids are heading back to school and as a pediatrician, one of the most common illnesses I see during the fall and winter months is Croup. I have already begun seeing Croup already this year! If your child suddenly wakes up in the night with a barking cough that sounds like a seal, you’re not alone—it’s a classic sign of croup, and it can be scary for parents the first time it happens. Let’s walk through what croup is, what you can do at home, and when it’s time to call the doctor.

Understanding Croup in Kids: What is Croup?

Croup is caused by a virus (most often caused by the parainfluenza virus but other ones can cause the sound too!). It causes swelling of the upper airway, so the parts in your throat, around the voice box (larynx) and windpipe (trachea). This swelling leads to:

• A barking cough (often sounds like a seal’s bark)

• Hoarse voice

• Stridor (a harsh, high-pitched sound when breathing in, especially noticeable at night or when the child is upset). I try to describe it as a loud "wheeze" when a child breathes IN.

  
  

Croup is most common in children 6 months to 3 years old, but older kids can get it too, they just might not have the same croup sounds.

What Parents Usually Notice

• It often starts like a regular cold—runny nose, mild fever, congestion.

• Then, at night, the barky cough suddenly appears. It can occur during the day too but is often worse at night.

• Some children may have noisy breathing or appear to struggle more when upset or crying.

  
  

Home Care for Mild Croup

The good news: most cases of croup are mild and can be managed at home. Here’s what helps:

🌬 Calm and comfort your child. Crying makes things worse. Hold them, rock them, or sing to them softly.

🌡 Cool or moist air

• Take your child outside into cool night air for a few minutes. Not cold outside? Open up the freezer and let them stand in front of it!

• Or run a hot shower, sit in the bathroom with the door closed, and let your child breathe in the warm steam before bedtime.

• Switching between cool and warm moist air often helps reduce airway swelling.

  
  

💧 Keep them hydrated. Offer frequent sips of water, breast milk, or formula, pedialyte, etc.

😴 Rest. Encourage quiet play and rest while they recover.

When to Call the Doctor!

Now sometime Croup can become dangerous and that occurs when the airway becoems so swollen that the child cannot breathe. You can usually tell that your child needs help with the following symptoms, so please do not hesitate to seek care!

Seek medical care if your child has:

• Stridor (noisy breathing) at rest, not just when upset (The inspiratory wheeze sound when they are RESTING/SLEEPING).

  • It is actually common to hear them with stridor when they are worked up or upset and this is not generally a cause for emergency care. However, you should call your doctor at this point.

• Difficulty breathing (chest pulling in with each breath, belly breathing, flaring nostrils)

• Drooling or trouble swallowing

• Appears very tired, pale, or agitated

• A high fever or looks more ill than expected

• Any concern that “something isn’t right" (Use your mom gut!)

Reassurance for Parents

Croup can be a frightening sound to hear, but most cases are mild and short-lived—usually resolving within 3–5 days. The classic barking cough often sounds worse than it is, except in the case of stridor. With comfort, hydration, and sometimes a little help from your pediatrician, your child will recover fully.

👉 Bottom line: If your child has mild croup, comfort them, try steam or cool night air, and keep them hydrated. If breathing becomes more difficult, call your pediatrician right away or seek emergency care.

As a Pediatrician I always want to hear when a child has stridor whether at rest or when upset! We can help!

Dr. K