Croup symptoms and treatment for common condition with 'seal barking' cough

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Having a distinctive, loud cough that sounds like a seal barking is a classic symptom of croup, which is usually caused by the parainfluenza virus, inset. (Image: Getty Images)
Having a distinctive, loud cough that sounds like a seal barking is a classic symptom of croup, which is usually caused by the parainfluenza virus, inset. (Image: Getty Images)

Croup is a common childhood condition that often causes kids to have a distinctive, loud cough that sounds like a seal barking.

Most cases are down to the parainfluenza virus, which affects affects the windpipe (trachea), the airways to the lungs (the bronchi) and the voice box (larynx). Youngsters may also have a hoarse voice and find it difficult to breathe because their airway is blocked. Thankfully, the condition is usually mild but it's important to call NHS 111 if you think your child has croup as they may need treatment.

Croup mainly affects youngsters between six months and three years old, with most cases occurring in one-year-olds. But it can sometimes develop in babies as young as three months, and older children up to 15 years of age. It is possible - but rare - for adults to get croup.

Croup symptoms to look out for

The NHS says symptoms of croup include:

  • A barking cough
  • A hoarse voice
  • Difficulty breathing
  • A high-pitched, rasping sound when breathing in

Usually your child will have traditional cold-like symptoms at the beginning, such as a runny nose, high temperature and a cough. Signs of croup usually appear after a few days and are often worse at night.

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What is the best thing to do for croup?

Thankfully, most cases are mild and can be treated at home. Making sure your child sits upright and being there to comfort them is very important, as crying can make the symptoms worse. Also, make sure your child drinks plenty of fluids to avoid dehydration.

Often, a single dose of an anti-inflammatory oral corticosteroid will be prescribed to help reduce any swelling in the throat. It's important to note that your child may need hospital treatment if they have difficulty breathing. Check on them regularly, including at night, and give them paracetamol or ibuprofen to help ease a high temperature or any discomfort.

Is croup an emergency?

The majority of cases get better within two days, but sometimes symptoms can last up to a fortnight. It is extremely rare for a child to die from croup. There are several conditions that can follow croup, such as pneumonia and middle ear infection. If you have any concerns, call 111 for advice or 999 in an emergency.

Preventing croup

It's hard to prevent croup in the same way it is hard to prevent the common cold. As such, good hygiene is the best defence - such as regularly washing hands and cleaning surfaces.

A number of your child’s routine vaccinations also protect against some of the infections that can cause croup. These include:

  • MMR – protection from measles, mumps and rubella
  • DTaP/IPV/Hib – protection from diphtheria, tetanus, whooping cough, polio and Haemophilus influenzae type b

Call 999 or go to A&E if your child:

  • Is finding it difficult to breathe (you may see their tummy sucking under their ribcage, their breathing may sound different or you may notice grunting noises)
  • Has blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
  • Is more tired than normal or difficult to wake up
  • Is unusually still and quiet
  • Is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
  • Is very upset or restless, is having difficulty breathing and can't be calmed down
  • Is unwell and drooling more than they normally do, finding it hard to swallow, or prefers to sit rather than lie down

Paul Speed

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