Discharge Instructions for Croup

Your child has been diagnosed with croup. This is usually caused by a viral infection of the upper airways and voice box (larynx). You may have noticed that your child had a rough, barking cough. This is one of the most common signs of croup. You may also have noticed a wheezing and rattling sound (stridor) when your child took a breath. Your child may be given a medicine that eases swollen airways. Here are instructions for caring for your child at home.

Home care

  • Cool or moist air can help your child breathe easier:

    • Use a cool-air humidifier or vaporizer. Turn it on next to your child’s bed during and after an attack.

    • During an attack, have your child sit up and breathe in the humidified air.

    • Take your child into the bathroom, close the door, and steam up the room by running hot water through the shower. Hold your child to reduce the chance that he or she may get too close to the hot water and get burned.

    • Take your child outside to breathe in the cool night air. Make sure to wrap your child in warm clothing or blankets if the weather is chilly.

  • A fever of 100°F (37.7°C) to 101°F (38.3°C) is common in a child with croup. Use over-the-counter (OTC) medicines such as ibuprofen or acetaminophen to reduce your child’s fever. Don’t give aspirin to a child with a fever. Generally, ibuprofen is not recommended for infants younger than 6 months. The correct dose for these medicines depends on your child's weight. Also, don’t give OTC cough and cold medicines to children younger than 6 years old unless the healthcare provider tells you to do so.

Follow-up care

  • Make a follow-up appointment as directed.

  • Be sure your child finishes all medicines prescribed by the doctor.

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 his or her saliva or drools

  • Has increased difficulty breathing

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

  • Struggles to catch his or her breath

  • Can't speak or make sounds

When to call your child's healthcare provider

Call your child's healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below) 

  • Increased trouble breathing

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

  • Trouble relaxing or sleeping after 20 minutes of steam or cool outdoor air

  • Trouble being wakened

  • Pale skin, sluggishness, or vomiting

  • Your child doesn't get better within a week

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.