Whooping cough in children: What really helps at night
Pediatrics(20/05/2026) A barking cough, shortness of breath, and intense fear: A croup attack often strikes suddenly in the middle of the night. For parents, this is a terrifying experience. The key is to stay calm and take targeted steps to relieve the symptoms.
Typical symptoms of a pseudocroup episode: a barking cough and wheezing sounds when breathing in ©AdobeStock
When children wake up at night with a severe, barking cough, people are quick to call it “croup.” However, there can be various causes behind it.
“The most common cause is a pseudocroup episode, caused by swelling of the mucous membranes due to a usually harmless viral inflammation of the airways,” explains Prof. Dr. Ute Spiekerkötter, Medical Director of the Department of General Pediatrics, Adolescent Medicine and Neonatology at the Medical Center – University of Freiburg.
True croup refers to a severe bacterial infection that spreads to the larynx. This is a form of the infectious disease diphtheria
However, so-called true croup is rare today. The main reason for this is the widespread use of the combined vaccine against diphtheria, which is recommended by the Robert Koch Institute for infants.
If symptoms such as a barking cough, a whistling sound when breathing in, and shortness of breath do occur, it is usually due to a pseudocroup episode.
Pseudocroup
A pseudocroup episode usually has a viral cause; for example, parainfluenza viruses can trigger the symptoms through an upper respiratory tract infection. In most cases, there is a .
Typical symptoms of pseudocroup include:
- severe hoarseness
- dry, barking cough
- wheezing sounds when breathing in
- increasing shortness of breath
“Pseudocroup attacks often occur in the evening or at night. Children between the ages of one and six are particularly affected,” says Spiekerkötter.
Why staying calm is so important in an acute situation
The symptoms of an acute pseudocroup attack can seem dramatic. Frantic gasping for air, a barking cough, and wheezing can quickly trigger panic in both parents and children.
However, most attacks are harmless.
That is precisely why it is important to act calmly. Parents should try to calm their child and provide reassurance.
“By providing cool air and gently holding and comforting the child, the initial symptoms can usually be alleviated. The breathing rate slows down, and the child is able to breathe more easily again,” says Spiekerkötter.
Croup: These steps can provide immediate relief
- Position the child upright. This makes breathing easier
- Cool, moist air can soothe irritated airways. Open a window or go outside for some fresh air
- Above all, it is crucial not to make the situation worse:
The calmer you, as the caregiver, react, the more likely the child is to relax—and with that, their breathing often improves
Important:
If the shortness of breath worsens, persists for a long time, or the child seems very exhausted, seek medical help.
This article was medically reviewed by
Prof. Dr. Ute Spiekerkötter, Medical Director of the Department of General Pediatrics, Adolescent Medicine and Neonatology at the Medical Center – University of Freiburg.
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