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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. Wrap your child in warm clothing or blankets if the weather is chilly.

    • Don't let people smoke in your home. Smoke can make your child's cough worse.

    • Sleep in the same room as your child so you are quickly available if the croup gets worse during the night

  • A fever of  100°F ( 37.7°C) to  101°F ( 38.3°C) is common in a child with croup:

    • Follow your healthcare provider's advice on treating your child's fever.

    • Before giving your child any medicine, read the label. Make sure you are giving the right dose for their age and weight. Never give a child adult medicines.

    • Use over-the-counter (OTC) medicines such as ibuprofen or acetaminophen to reduce your child’s fever, if advised by the provider. But never give ibuprofen to children younger than 6 months old.

    • Don't give OTC cough and cold medicines to a child younger than 6 years old unless directed by the provider.

    • Don’t give aspirin to a child younger than age 19 unless directed by the provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder. It most often affects the brain and the liver.

Follow-up care

  • Make a follow-up appointment as directed.

  • Talk with your child's healthcare provider about vaccinations. Babies should have their first dose of the Hib vaccine at 2 months old.

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

Call 911

Call 911 right away if your child:

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

  • Has stridor when resting

  • Has a hard time swallowing, or is drooling

  • Has trouble breathing

  • Has a severe cough

  • Has pale or blue-colored skin around the fingernails, mouth, or nose

  • Struggles to catch their breath

  • Can't speak or make sounds

  • Has trouble waking up or loses consciousness

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) 

  • Feeling tired or lack of energy (fatigue)

  • Can't handle fluids

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

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

  • Sluggishness or vomiting

  • Your child doesn't get better within 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 of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. 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.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel OK using a rectal thermometer, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

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

A baby under 3 months old:

  • First, ask your child’s healthcare 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

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

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher

  • 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

© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.