Croup: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Croup?
A pediatrician, a children's doctor, usually treats croup. Severe cases may be treated by an emergency doctor or a children's hospital team. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is croup?
Croup is an inflammation of the vocal cords and windpipe. The vocal cords are in the larynx, or voice box. The windpipe is also called the trachea. It causes trouble breathing, a barking cough, and a hoarse voice.
The cough results from swelling around the vocal cords. Croup is common in infants and children.
Symptoms
The main symptom is a cough that sounds like a seal barking. Croup often starts out like a cold. Most children have a mild cold and a low-grade fever for several days before the barking cough and hoarse voice.
As the cough gets more frequent, the child may have trouble breathing. The child may also have stridor, a harsh, crowing noise made when breathing in.
Croup is typically much worse at night. It most often lasts up to 3 nights but may last up to 7 nights. The first night or two are most often the worst.
Causes and who gets it
The cause is usually a virus, often parainfluenza virus. Other viruses include influenza, RSV, measles, and adenovirus. More severe cases may be caused by bacteria.
Other causes include allergies and reflux.
Croup affects children ages 3 months to 5 years. It can occur at any age. Children between the ages of 6 months and 3 years have the highest risk. They may also have more severe symptoms. It is most common between October and April.
How doctors diagnose it
Your provider will take a medical history and ask about your child's symptoms. They will examine your child's chest. They check for trouble breathing, wheezing, and decreased breath sounds. In a few cases, x-rays or other tests may be needed.
Treatment
Most cases of viral croup are mild and can be treated at home. Most cases can be safely managed at home with telephone support from your provider. If you are worried about your child's symptoms, contact your provider, even in the middle of the night.
At home, acetaminophen can make your child more comfortable. It also lowers a fever so your child will not have to breathe as hard. Avoid cough medicines, which will not help and may be harmful. Cool or warm moist air may help your child feel better, but no studies show that it helps reduce symptoms.
Your provider may prescribe medicines. These include steroid medicines. In the hospital, oxygen and IV fluids may be used. Rarely, a breathing tube is needed.
When to see a doctor
Contact your provider if your child is not responding to home treatment or is acting more irritable. Talk to your provider if croup lasts longer than a week or comes back often.
Call 911 or the local emergency number right away if your child:
- Has bluish lips or skin color.
- Is drooling.
- Has trouble swallowing.
- Has stridor that is getting worse or that occurs at rest.
- Has the muscles between the ribs tugging in when breathing in.
- Is struggling to breathe.
Call 911 also if croup symptoms may have been caused by an insect sting or an inhaled object.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can answer questions about your child's symptoms and help you decide when to seek urgent care. They can also see your child again if croup comes back.
Common questions
Is croup serious?
Most cases are mild, but rarely it can become serious and interfere with your child's breathing.
How long does croup last?
Croup most often goes away in 3 to 7 days. Symptoms usually last about three to five days.
Does croup get worse at night?
Yes. Croup is typically much worse at night.
Can croup be prevented?
Some steps can help. Wash your hands often and avoid close contact with people who have a respiratory infection.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
