30/04/2026
🐶😮💨 That Barking Cough at Night? It Could Be CROUP
If your child suddenly wakes up at night with a harsh, barking cough…
almost like a seal or dog bark…
👉 Don’t ignore it.
It could be croup— a common but sometimes serious airway infection in young children.
🫁 What is croup?
Croup is a viral infection of the upper airway (voice box and windpipe).
👶 Most common in:
• Children under 4
• But can happen in older kids too
👉 Younger children are more affected because their airways are smaller, even a little swelling can make breathing difficult.
🦠 What causes it?
Usually caused by the parainfluenza virus
👉 The same viruses that can also cause chest infections
🌙 How it typically starts
• Child goes to bed fine 😴
• Wakes up suddenly between 11pm–2am
• With:
• A barking cough
• Noisy breathing when breathing in (stridor)
• Hoarse voice
• Sometimes fever
👉 Symptoms are often worse at night and better during the day
🚨 When to act FAST
If your child has:
• Noisy breathing when breathing in (stridor)
• Struggling to breathe
• Chest pulling in with breaths
• Looks anxious or distressed
👉 This is a medical emergency
➡️ Go to ER immediately
❄️ A strange but true tip
Some children improve on the way to hospital
👉 Cooler air can temporarily reduce airway swelling
BUT:
⚠️ This does NOT mean the problem is gone
📉 What happens over the next few days
Croup can move lower into the chest:
• Barking cough → becomes wetter
• May develop:
• Phlegmy cough
• Wheezing
• Shortness of breath (especially in babies)
🏥 How it is treated
Treatment focuses on opening the airway:
• Cortisone (very effective)
• Inhalations
• Adrenaline (in more severe cases)
👉 Most children improve quickly with treatment
⚠️ Important
Other serious conditions can look like croup and must be excluded by a doctor.
Most children:
• Improve quickly
• May go home the next day
• Recover fully with treatment
💬 If your child has ever had that barking cough at night, you’ll never forget it.
Dr Willem Smit
Paediatrician
