Mother holding baby

A child’s barking cough and labored breathing in the middle of the night is enough to send any parent running for the Emergency Department.

You may have heard of croup. It’s a common infection of the upper airway, which obstructs breathing and causes a barking cough.

Cases of croup tend to peak during flu and cold season, and is most common in younger children. We’ve already seen a flurry of cases in the pediatric emergency department. Croup can be scary, especially for new parents.

We chatted with Melissa Hodges, a pediatric emergency room RN and mother of two, for insight on croup. Here’s what she had to say:

What are the symptoms of croup?

It often starts with the common cold. Lots of coughing and inflammation can cause a child to develop a loud barking cough that’s aggravated by crying and anxiety, fever, hoarse voice and breathing that sounds labored or noisy. Symptoms tend to worsen at night and usually last three to five days.

When should I take my child to the doctor?

Call 911
If your child is struggling to breathe or is going blue.

Go to the emergency room if:

  • Your child is making noisy, high-pitched breathing sounds when breathing in or out, or high-pitched breathing sounds when not crying or agitated
  • Your child begins drooling or has difficulty swallowing
  • Your child seems anxious and agitated, or fatigued and listless

Call your doctor for an appointment:
Your child does not respond to home treatment call the doctor

What can I do for my child at home?

  • Bubbles and Unicorns
    First and foremost, stay calm. Crying makes breathing more difficult, so find ways to distract and comfort your child such as reading books, playing quiet games or watching a favorite show. Make it all rainbows and unicorns and bubbles
  • Positioning
  • Hold your kiddo in a comfortable upright position on your lap or in a favorite chair or infant seat to make breathing easier.
  • Make sure they get lots of fluids. Breastmilk is fine for babies. Older children can enjoy popsicles.
  • Sleep is key
    Like all of us, children need plenty of sleep to recover and to repair
  • Vaporize!
    Water that is. A vaporizer or humidifier can add moist air which can soothe the cough. If you don’t have a cool mist humidifier, try opening the freezer and standing in front of that, or just standing outside if it’s cool.
  • Forget the over-the-counter medication
    Over-the-counter cough medication will not help croup, and is not recommended for children despite being available in child dosages.
  • Reduce the fever
    If your child has a fever and is uncomfortable because of the fever, reduce it using acetaminophen (Tylenol) or Motrin.

Your child’s cough may improve during the day, but don’t be surprised if it returns at night. You may want to sleep near your child or even in the same room so that you can take quick action if your child’s symptoms suddenly become severe.

Melissa Hodges is a pediatric emergency room RN and mom to two young boys. Melissa has been at Tucson Medical Center since 2008. She is a knitting ninja apprentice who makes a mean chili and enjoys spending time with her family and friends in beautiful Tucson, Arizona.


If it’s the weekend, middle of the night, a holiday, or you just don’t want to drag your kids to the doctor’s office, consider downloading the TMC Now app. You can talk to a doctor using the camera on your phone, tablet or computer. The doctor will be able to listen to your child’s breathing and cough through the built-in microphone, and will be able to diagnose, treat and prescribe medications if necessary. A virtual doctor visit is $49.

Go here for info.