b'ChapterCroupCroup is a viral infection of the throat (upper airway). The virus causes swelling of the voice box (larynx) and windpipe (trachea). This swelling makes the airway more narrow, so it is harder to breathe.Croup often begins like a normal cold followed by a harsh, barking cough, described as croupy. This often happens at night when the air is cooler.It usually affects children up to 5 years old. Some children get croup many times. There is no way to prevent croup as it is caused by different viruses. There is no immunisation against croup. Croup may last for 3 to 4 days.How to Recognise High pitched seal like barking noises when breathing in and out accompanied by coughing that is normally worse at night.Often develops after a cold or during the night in cold weather. Child is unwell and may have a runny nose. The breastbone may be sucked in slightly as the child breathes in. Cyanosis.Mild Croup Harsh barking or high pitched cough with a runny nose.Mild distress.Severe CroupA continued harsh barking cough with no relief. Breathing is quite noisy and laboured with adistinct drawing in of the spaces between the ribs and above the collar bones with each effort of breathing.The child becomes increasingly distressed with continued breathing difficulty. Cyanosis may develop.How to ManageKeep the child calm, warm and at complete rest.Give frequent clear fluids to help minimise dehydration.Continue to monitor general condition.A note about steamIn the past some doctors recommended exposure to mist or steam therapy,including the use of vaporisers. Research evidence now shows this to be of no benefit and it is no longer recommended.If the croup does not settle and the child becomes more distressed, call an Ambulance 000.220 Common Illness and Ailments'