SwimInc, Cape Town (2026)

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