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When you’re a parent, there are plenty of sounds you love to hear from your child: their first words, their innocent giggles, their sweet, imaginative play.

But there’s one sound no parent ever wants to hear from their child — a raspy, barking cough. Anyone who’s ever heard this seal-like bark emitting from their child’s mouth knows the terror it can strike into the parental heart.

A barking cough in children is typically caused by croup, a respiratory illness that makes the larynx and voice box swell. Though it’s not usually dangerous, it sure sounds awful — and, in some instances, requires medical attention.

If your child has been sounding the “call of the wild” of a barking cough, here’s what you need to know.

A cough that sounds like a bark is often a harbinger of croup. It’s often caused by a viral illness that attacks the upper respiratory system, leading to swelling of the trachea and larynx — thus producing a telltale raspy cough. It can also cause a squeaking sound upon inhaling (known as stridor).

Croup mostly affects kids of a very young age, and it’s extremely common.

Viral croup is the most common type of croup, affecting kids between the ages of 6 months and 6 years, with peak incidence before age 3. Croup accounts for 7% of the hospitalizations of kids under 5 years old each year, but 85% of croup cases are considered mild.

Other symptoms of croup may include a stuffy or runny nose, fever, swollen lymph nodes, or a hoarse speaking voice.

What is croup?

Croup is a respiratory illness that most commonly occurs in very young children. It’s most often caused by a virus that attacks a child’s upper airway, causing it to swell. This swelling makes it harder for air to move freely, leading to a characteristic barking cough.

Though croup is the most likely cause of a barking cough, it’s not the only possibility. Choking on food, swallowing a foreign object, or an infection of the epiglottis (the protective flap that covers the trachea) could all produce a cough with a similar sound.

Even the common cold can sometimes lead to a cough that has a barking sound.

If you’re uncertain of the underlying cause of your child’s hoarse, raspy cough, it’s best to have them evaluated by a pediatrician. And if your child is choking, has swallowed something dangerous, or is having difficulty breathing, call 911 or local emergency services immediately.

For starters, try to stay calm when your little one is experiencing a barking cough from croup. The more you can stay cool-headed, the more your child will feel at ease. This is especially important since anxiety and agitation can make croup symptoms worse.

In addition to maintaining a calm demeanor yourself, do what you can to help your kiddo stay outside the stress zone. Playing soothing music, snuggling, or encouraging quiet play can all go a long way toward keeping your child from getting upset or panicky.

Beyond emotional comfort, treating your child’s barking cough will depend on the level of its severity.

As an at-home treatment measure, you can try creating an environment with either cool or warm air. Try running a cool-mist humidifier in your child’s room or sitting them near a steamy shower for up to 20 minutes.

Both cool mist and warm steam may help alleviate swelling and relax the vocal cords. But be sure to supervise your child while in the bathroom.

Offering your child plenty of fluids and ensuring they get good rest can also help minimize symptoms.

If you decide to take your child to the pediatrician for their barking cough, your doctor may prescribe medications to treat croup. Steroids like dexamethasone are often used to get the swelling of the larynx and vocal cords to subside.

As a more urgent treatment — such as in the emergency room — your child might be given a breathing treatment with epinephrine. This fast-acting hormone works more quickly than steroids to bring down swelling, allowing your child to breathe more freely in less time.

In the COVID-19 era, you might be asking yourself whether your child’s barking cough is a harbinger of the viral illness that has caused a global pandemic.

It’s technically possible for a child to have croup and COVID-19 at the same time, and COVID-19 is now considered one of the possible causes of croup. While croup is most often caused by the parainfluenza virus, it’s worth ruling out COVID-19 if your child presents with a barking cough.

You’ll want to assess any other symptoms your child has. Croup may be accompanied by a fever, a hoarse voice, runny nose, or stridor.

COVID-19 can present with similar symptoms but also a variety of other symptoms, including:

  • gastrointestinal upset
  • fever
  • fatigue
  • body aches
  • chills
  • headache
  • loss of taste and/or smell
  • chest pain or pressure

The only way to know for sure if your child has COVID-19 is to administer a test, which you can do at home, at your doctor’s office, or at an official testing site.

If you’re concerned your child may have COVID-19, it may be worth the peace of mind to get a diagnostic test.

It’s the parental conundrum you inevitably face in the middle of the night — is your child’s barking cough serious or not?

Certainly, some instances of barking cough are quite grave, such as those caused by choking or swallowing a foreign object. Life threatening illnesses like diphtheria and whooping cough can produce coughs that sound like a bark, too.

On the other hand, if your child is otherwise well, staying hydrated, and has no symptoms of respiratory distress, you can probably wait it out, monitoring closely at home.

Despite its scary sound, not all cases of barking cough require a call to the pediatrician. That said, croup sometimes requires prompt medical attention. Call your doctor if you notice the following signs in your child:

  • difficulty breathing
  • fast breathing
  • decreased food intake
  • decreased urination
  • lethargy
  • stridor (squeaky breathing) that occurs constantly, even when at rest
  • inability to swallow
  • blue-tinged skin around the mouth, nose, or fingernails
  • retractions of the chest (when the skin between the ribs presses inward during breathing)

Barking is all well and good when it comes from your family dog or a seal at the beach. But when it comes from your child, it’s likely to set off alarm bells.

Fortunately, most cases of barking cough in young kids are caused by a short-lived bout of croup that can be treated at home.