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Croup: Is It Serious?

Cause

Croup is a viral infection that causes swelling of your child's vocal cords. It is commonly associated with a cold and fever over 101 degrees. Your child may have a "barking, seal like" cough and a hoarse voice. Croup does not involve your child's lungs.


Expected Course

Croup usually lasts for 5 to 6 days and the cough seems to increase at night. Croup is a mild illness in most children. In mild croup, your child may be hoarse and when coughing, may sound like a dog or seal barking.

Swelling of the vocal cords causes a narrowing of your child's airway. With increased swelling of your child's airway, your child may develop "stridor." Stridor is a sound that is heard when your child takes a breath in.


Description Of Stridor
  • When your child breathes in, you hear a harsh, raspy, vibrating sound.
  • Stridor will be louder when your child is crying, upset, scared, or, coughing.
  • As croup worsens, stridor will be heard when your child is sleeping or at rest.
  • Stridor with retractions (chest wall and rib cage collapsing inward with each breath) is a sign of severe croup and requires immediate treatment in the emergency room.

Treatment Of Croup
If your child develops mild stridor or a barky cough, and is having no difficulty breathing, try the following:


Keep Youself and Your Child Calm!

Most children become scared by the barking cough of croup. This tends to worsen any stridor your child may have. The more upset you are, the more upset your child will be. Staying calm, cool and collected will allow you to help your child.


The Foggy Bathroom

Warm moist air works well to relax the vocal cords and lessen stridor. Run the hot shower with the bathroom door closed. Once the room is fogged up, take your child in there for at least 10 minutes. Try to keep your child calm by cuddling or reading a story.

Fill a humidifier with warm water and have your child breathe deeply from the stream of humidity.

If a humidifier is not available, have your child breathe through a warm, wet washcloth placed loosely over his/her nose and mouth.


What If I Run Out Of Hot Water?

Cold air works as well as humidity to lessen your child's stridor. Dress your child in warm clothes and go for a walk outside in the cold winter air.


Mist And Humidity

Dry air usually makes a cough worse. Keep your child's bedroom humidified. Use a cool air vaporizer if your child's room is warm or a warm air humidifier if the room is cold. Run it 24 hours a day. Remember to clean the vaporizer or humidifier everyday. The room should be moist, but water should not be dripping down the walls.


Warm Fluids For Coughing Spasms

Coughing spasms are often due to sticky mucus caught on the vocal cords. Warm fluids may help relax the vocal cords and loosen up the mucus. Use clear fluids (ones you can see through) such as apple juice, lemonade or herbal tea.


Cough Medicines

Robitussin DM can be used to lessen your child's coughing. Robitussin Pediatric has one-half the dextromethoraphan (cough suppressant) as Adult Robitussin in one teaspoon. The dose of Adult Robitussin is to teaspoon for each 10 pounds of body weight or for Pediatric Robitussin, the dose is to 1 teaspoon for each 10 pounds of body weight. Or example,If your child is 20 pounds, he/she can have to 1 teaspoon of the Adult Robitussin. This dose can be repeated every 4-6 hours as needed for relief of the cough. The maximum single dose of Adult Robitussin is 2 teaspoons or 4 teaspoons of Pediatric Robitussin.

If your child has a fever (over 101 degrees) you may give acetaminophen (Tylenol). Refer to Tylenol dose chart, which are available on our fever sheet in the office or on our Web Page.

What Should I Expect?

Most children settle down with the above treatments and then sleep peacefully through the night. If your child is having any difficulty breathing, call our office immediately.

During the first several nights of croup, you may feel more comfortable sleeping in your child's room. However, once your child is better, return to your normal sleeping arrangements so this does not become a habit.


Will Smoking Effect Croup?

Smoking will make croup worse. Do not let anyone smoke around your child at any time.


Contagiousness

The virus that causes croup is contagious to other children as long as your child has a fever over 101 degrees. Your child can return to school or child care once he/she feels better and the fever is less than 101 degrees for at least 24 hours.


Call Our Office Immediately if:
  • Your child's color around the lips or inside the mouth appears blue.
  • Your child is having trouble breathing.
  • Your child has increased drooling or spitting, or starts having difficulty swallowing.
  • The warm mist fails to improve the stridor in 20 minutes.
  • Your child is acting sick.

Call Our Office Within 24 Hours if:
  • Your child has stridor.
  • Fever (over 101 degrees) with croup lasting more than 3 days.
  • Croup lasting more than 5 days.
  • If you have any concerns or questions.

  1. The pictures below show views of the nose, mouth, throat, upper airway and lower airway (lungs).
  2. The areas labeled "Vocal fold" and "Trachea" (above the lungs) are the areas affected in croup.
  3. In Croup, the trachea becomes swollen and this results in the typical seal bark.
  4. The area marked "Lungs" is the area affected by Asthma.



  1. The pictures to the right show the area involved in croup.
  2. The x-ray on the left shows the narrowing in the trachea, also called the "steeple sign."
  3. The picture on the right shows the narrowed trachea (subglottic area).













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