What is Croup?

Croup is a childhood illness that affects the trachea (windpipe), the airways to the lungs and the larynx. It presents with a harsh sounding cough that usually occurs in infants under four years old.  The term ‘croup’ comes from the old English term meaning to ‘cry hoarsely’, as it refers to the sound the child makes when breathing in. Typically, the illness presents with a barking cough and an abnormal ‘seal like’ wheeze on inspiration, known as ‘stridor’.

Croup usually develops as the result of a viral infection (most often a parainfluenza virus) which is also causes the common cold.  An alternative name for croup is laryngo-tracheo-bronchitis. The infection causes the larynx to become swollen and the trachea to become blocked.

The condition is most common during late autumn and early winter months, and it can reoccur throughout childhood.


Croup often starts as a simple cold, but if this descends to the larynx and lungs and causes enough swelling and irritation a child can develop the following symptoms:

  • A loud barking cough, which sounds like a seal barking on inspiration, worse for crying.
  • Anxiety and distress due to blocked airways
  • Fever
  • Hoarse voice
  • Noisy or laboured breathing
  • Worse at night
  • Usually lasts for 3-5 days

General Advice

  • Stay with your baby at all times.
  • Some people recommend sitting in a warm bathroom with the hot shower running to create steam, this can ease the cough

When to seek Medical Attention

Croup is usually a mild, self-limiting illness that usually gets better within 48 hours. However, take your child to your nearest emergency medical department if the following symptoms present:

  • if you can hear the stridor sound all the time (not just on inspiration)
  • your child’s chest sinks in when trying to breath in
  • your child’s lips or face or fingertips turn blue along with anxiety
  • your child is dribbling and cannot swallow
  • your child cannot speak
  • they’re making a whistling sound which gets worse with each inspiration



Homeopathic remedies can work quickly and effectively in croup.  It is important to look at your child’s full picture when selecting a remedy – so look to match their mental state as well as their physical symptoms to the remedy picture.  Give one dose of the chosen remedy every three hours for up to three doses, if symptoms don’t change, then change the remedy.  If symptoms improve, but there are still some remaining symptoms, you can repeat the selected remedy again until it resolves.  Remember in acutes the symptoms change through the stages of the illness and different remedies will be needed for the different stages.



Use aconite for the first stage of any illness, particularly in croup during the first 24-48 hours. Fright, shock or exposure to cold, dry winds can bring on an aconite state. Babies needing aconite will usually wake before midnight with a cough in an anxious and distressed state.  There will be a frightened look on the face, restlessness and pupils may be dilated.  Aconite is useful for the first stage of fever in croup with a dry, barking, irritating short cough.  Breathing will be fast and there will be a hoarse voice.  The child will be worse at night before or around midnight, during fever and for cold air. The child may be thirsty.

Parents can also take aconite if they feel frightened by the sudden onset of their baby’s illness.


As croup progresses from the initial stages, the typical seal bark and stridor sound of croup will occur, this is where the remedy Spongia can help.  The Spongia cough is a dry, barking cough that is constant and hollow sounding, and can come in fits.  It is irritating and can sound like a ‘saw going through wood’.  There will be difficulty breathing and there may be some whistling with the breathing and is very dry – there is no lose edge to the cough. The child will be worse for cold wind; after sleeping on waking; for sweet things; for cold foods and drinks, and around a full moon.  They will be better for eating and drinking warm foods and drinks, and better for lying with the head low. The child can wake from a sleep with a sense of suffocation and anxiety with difficulty catching their breath, they will also be intolerant of tight clothing.  Emotionally they will be anxious and tearful during fever.

It can sometimes be difficult to differentiate between Aconite and Spongia as they present very similarly in croup with dry cough with acute anxiety.  Spongia is a much deeper in its action than aconite, and has a slower onset, taking several days for development of symptoms.  Aconite comes on suddenly, Spongia comes on over a few days.  If you’ve tried aconite one night, but symptoms return the next night – go to Spongia at this point.


This remedy comes in at the later stage in croup when there is mucus production and follows well after Spongia.  For this remedy, the cough is worse early in the morning, at the slightest draft of cold air, and for uncovering. You will hear rattling and wheezing in the chest but bringing up the mucus is difficult.  When coughing the child may choke with every coughing fit and there will be thick, yellow phlegm.  Emotionally the child may be irritable, even angry and doesn’t want to play.

Other remedies to consider in croup:

Kali Bichromicum

Helpful for conditions with copious amounts of yellow stringy, thick phlegm.  The catarrh forms tenacious, thick crusts in the nostrils, which leave sore patches around the nose.  The mucus drips down the back of the throat in the night, which then accumulates, and is difficult to hawk up in the morning.   The cough is croupy, with ropy mucus which is thick and tough, and there may be pain in the chest when coughing – the child may hold the chest with their hands on coughing.


The cough of Lachesis has a sensation of a lump in the throat, which is worse after sleeping and on waking.  The voice is hoarse and the air passages feel irritated.  The cough will be choking on falling into a deep sleep, dry and hacking.  It may be suffocative from violent tickling in the larynx.  The child will be anxious on waking and have an aversion to being touched, but may be lively, chatting a lot.


If your child needs phosphorus, the cough will be dry at night with a hacking, irritating, racking sound.  It will have a tickling in the larynx which wakes the chid up at night. The larynx is raw, better for heat and worse for cold air.  The child coughs up copious amounts of sputum, especially in the morning, and fever may be present throughout.  Emotionally these children don’t like to be alone, they desire company and are afraid of the dark at night. They may be clingy, excitable, and uncommunicative.

If you need any advice or help in treating your infant or child with croup, please do get in touch for an acute consultation.