Viral Croup

Home care

Croup can sound frightening. But in many cases, the tips below can help ease your child’s breathing:

• Don’t let anyone smoke in your home or around your child. Smoke can make your child's cough worse.

• Keep your child’s head raised. Prop an older child up in bed with extra pillows. Never use pillows with an infant younger than 12 months old.

• Stay calm. If your child sees that you're frightened, they'll get more anxious. This will make it harder for them to breathe.

• Offer words of comfort such as “It will be okay. I’m right here with you.”

• Sing your child’s favorite bedtime song.

• Offer a back rub or hold your child.

• Offer a favorite toy.

If the above tips don’t help your child’s breathing, try having them breathe in steam from a shower or cool, moist night air. According to the American Academy of Pediatrics and the American Academy of Family Physicians, no studies prove that breathing in steam or moist air helps a child’s breathing. But other medical experts still support this method. Here’s what to do:

• Turn on the hot water in your bathroom shower.

• Keep the door closed. This will get the room steamy.

• Sit with your child in the steam for 15 or 20 minutes. Don’t leave your child alone.

• If your child wakes up at night, you can take them outdoors to breathe in cool night air. Wrap your child in warm clothing or blankets if the weather is chilly.

General care

• Sleep in the same room with your child, if possible, to watch their breathing. Check your child’s chest and ability to breathe.

• Don’t give your child cough drops or cough syrup. They won't help the swelling. They may also make it harder to cough up any secretions.

• Make sure your child drinks plenty of clear fluids, such as water or diluted apple juice. Warm liquids may be more soothing.

Medicines

The health care provider may prescribe a medicine to reduce swelling, make breathing easier, and treat fever. Follow all instructions for giving this medicine to your child.

Follow-up care

Follow up with your child’s health care provider, or as advised.

Special note to parents

Viral croup is contagious for the first few days of symptoms. Wash your hands with soap and clean, running water before and after caring for your child. Limit your child’s contact with other people. This is to help prevent the spread of infection.

When to call 911

Call 911 right away if your child: 

• Makes a whistling sound (stridor) that becomes louder with each breath.

• Has stridor when resting.

• Has a hard time swallowing their saliva, or drools.

• Has more trouble breathing.

• Has a blue, purple, gray, or dusky color around the fingernails, mouth, or nose.

• Struggles to catch their breath.

• Has trouble talking (can't speak or make sounds).

• Is unresponsive or less responsive.

• Is wheezing.

When to get medical advice

Contact your child's health care provider right away if any of these occur:

• Fever (see "Fever and children" below)

• New symptoms occur

• Cough or other symptoms don't get better or get worse

• Poor chest expansion

• Pain when swallowing

• Poor eating or a decrease in appetite

• Your child doesn't get better in a week

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years old, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The health care provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel okay using a rectal thermometer, ask the provider what type to use instead. When you talk with any provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

• First, ask your child’s provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Contact the health care provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4°F (38°C) or higher in baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older