Viral Croup

Croup is an illness that causes a child’s voice box (larynx) and windpipe (trachea) to become irritated and swell. This makes it hard for the child to talk and breathe. It is caused by a virus. It often occurs in children younger than 6 years old. The respiratory distress that croup causes can be scary. But most children fully recover from croup in 5 or 6 days. Viral croup can be spread for the first few days of symptoms.

You child may have had a fever for a day or two. Or he or she may have just had a cold. Croup symptoms occur more often at night. Trouble breathing occurs suddenly, especially trouble taking in a breath. Your child may sit upright and lean forward trying to breathe. He or she may be restless and agitated. Your child may make a musical sound when breathing in. This is called stridor. Other symptoms include a voice that is hoarse and hard to hear, and a barking cough. Children with croup may have a hard time swallowing. They may drool and have trouble eating. Some children get sore throats and ear infections. Croup symptoms will come and go for 5 or 6 days.

In most cases, croup can be safely treated at home. You may be given medicine for your child.

Home care

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

  • Don’t let anyone smoke in your home. 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 are frightened, this will make your child more anxious and make it harder for him or her to breathe.

  • Offer words of comfort such as “It will be OK. 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, you may try having your child 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 inhaling steam or most 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, so the room gets 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 him or her 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 his or her breathing. Check your child’s chest and ability to breathe.

  • Don’t put a finger down your child’s throat or try to make him or her vomit. If your child does vomit, hold his or her head down, then quickly sit your child back up.

  • Don’t give your child cough drops or cough syrup. They will not 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.


The healthcare 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 healthcare 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 warm 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 911right 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 more trouble breathing

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

  • Struggles to catch his or her breath

  • Trouble talking (can't speak or make sounds)

  • Unresponsive or less responsive

  • Wheezing

When to get medical advice

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

  • Fever (see Fever and children, below)

  • New symptoms develop

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

  • Poor chest expansion

  • Pain when swallowing

  • Poor eating or 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 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

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