How to Recognize a Croup Cough in Kids

Wondering how to differentiate a croup cough from something else? Here are the telltale signs, plus advice for managing croup in kids.

Medically reviewed by Wendy L. Hunter, M.D.

Of all the surprising sounds that can come from a baby’s body, a croup cough may be one of the most concerning. The loud, harsh cough is unmistakable to medical experts, as well as any caregivers who have experience with it.

“Croup often has a distinctive ‘barking’ or ‘seal-like’ cough,” says Darby McElderry, MD, a pediatrician at the Children’s Hospital of Alabama. “It's often sudden-onset and worse at night, when the child is lying down."

What Is Croup?

Croup is a respiratory infection, usually brought on by a virus, that causes inflammation in the upper airways. Croup is typically seen in babies and children less than 5 years old because their smaller airways are more vulnerable to the infection. It's most common in the fall and winter.

In addition to cough, croup might also present with stridor (a high-pitched whistling sound when breathing in), runny nose, fever, hoarseness, and other symptoms typical of the common cold, says Dr. McElderry.

While mild cases can usually be managed at home, it’s important to recognize the symptoms of croup so you can quickly spot complications and seek medical care if needed. Keep reading to learn what a croup cough sounds like, other recognizable symptoms, and tips for treating the infection.

How to Recognize a Croup Cough

Croup typically affects babies and young children, whose smaller airways are especially vulnerable to the infection. When coughs are forced through the swollen voice box (larynx) and windpipe (trachea), the result sounds like a seal barking.

Here are other ways to describe the croup cough sound:

• Barking

• Dry

• Harsh

• Deep

• Tight

• Low-pitched

• Worsened when your child is crying or agitated

If you’re still uncertain, YouTube is full of videos posted by helpful parents hoping to educate others about croup cough. Once you’ve heard the sound of croup cough in a child, it’s really not difficult to identify.

Other Symptoms of Croup

Coughing isn’t the only symptom of croup. Another common side effect is stridor, notes Esther K. Liu, MD, FAAP, chair of pediatrics at the University of Maryland-Baltimore. “Stridor is the noisy, gasping, high-pitched sound that children make when trying to force air into a partially occluded airway.”

Because croup is usually associated with a viral infection, children may have cold-like symptoms that show up "even before they develop the barky cough and stridor,” adds Dr. Liu.

Croup symptoms can include the following:

• Nasal congestion

• Sore throat

• Fever

• Hoarseness

• Retractions (the skin between the ribs pulling in when your child breathes) in serous cases

Your child's croup symptoms will generally last for three to five days. They might get worse at night or when your child is upset.

Treating a Croup Cough in Babies and Kids

Croup is usually diagnosed based on its symptoms without any other testing needed, according to Jessica Snowden, MD, MS, MHPTT, a pediatric infectious disease expert at Arkansas Children's Hospital and the University of Arkansas for Medical Sciences.

The prognosis is typically good. “Children usually have croup symptoms for three to five days and improve without needing any medical care,” says Dr. Snowden. “Sitting with your child in cool mist, such as from a humidifier, in a room with a shower running, or outside in cooler weather, can help with the cough in many children.”

Your child should also get plenty of fluids, and if they have a fever, you can give medication like acetaminophen or ibuprofen. Avoid over-the-counter cough medicines, which can be dangerous in young children, according to the American Academy of Pediatrics (AAP).

Call the doctor if your child is having trouble breathing; they may prescribe a medication such as a steroid to help with the symptoms. Breathing treatments might also be necessary in severe cases.

Dr. Liu also recommends seeking medical care if your child has stridor, retractions (sucking in of the muscles between ribs or above their sternum), excessive drooling, or signs of dehydration like decreased urine volume. 

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