Your child’s croupy cough will most likely disappear within a few days, though some continue to cough for up to seven days. Croup often disappears as quickly as it started. Sometimes the harsh barky cough is followed by a loose cough and runny nose or by an ear infection. Though croup can recur, children usually outgrow croup symptoms by age ten. Some do not outgrow croup until they are teenagers.

The virus that causes croup is contagious. It is spread when your child coughs and breathes. For other family members, especially adults, this same virus can cause simple cold-like symptoms such as hoarseness, cough, sore throat, and a runny nose.

What can I do to make my child more comfortable?

If your child has a fever or a sore throat, give acetaminophen (Tempra™ or Tylenol™) or ibuprofen (Advil™ or Motrin™). Doses are recommended on the side of the bottle, or you can ask a health care professional. Never give your child more than 5 doses of acetaminophen or more than 4 doses of ibuprofen in a 24 hour period.

If you open your child’s bedroom window a bit to let the cold air in, remember to dress your child warmly. Don’t worry - neither you nor your child will get sick from breathing cold air. Encourage cold fluids such as juice, a slushy, or a Popsicle™. Children with croup usually have a sore throat, and this may help soothe it.

If your child starts to make easily-heard croupy sounds, and is not ‘blue in the face’ or very restless with trouble breathing, try these home treatments.

In cold weather, bundle your child in warm clothes and go outside together to breathe colder air for five to 10 minutes.
In warm weather, make sure that your child is warmly dressed, then open the freezer door and allow her to breathe the cold air.
Most importantly, if your child is upset, comfort and speak calmly and in quiet tones. This will help more than anything to reduce breathing problems.

How can I monitor my child to be sure she is okay?

Croup is a noisy disease. You can check on your child by always staying within hearing range. Every once in a while, watch and listen to your child breathing without a shirt or blanket covering the chest. This way, you will be able to tell if your child is having difficulty breathing and needs to be checked by a doctor.

Listen for a crowing sound while your child is breathing in. If you hear this sound note whether you hear it all the time, even when she is calm, or only when she is upset and crying.
Look to see whether your child’s chest wall or the notch just below the Adam’s apple is sucking or caving in.
See if your child is able to calm down, or if she remains upset and restless even when you try to calm her.
Making sure that you have enough light to see well, look at the colouring of your child’s lips and face. Check for a bluish-grey colour.

Should I seek medical care immediately?

After exposing your child to cold air, seek medical care right away if:

your child makes a steady, continuing and easily heard crowing sound with breathing
your child’s chest wall sucks or caves in with each breath
your child’s croupy symptoms continue to make her very upset or restless.

Remember to dress both you and your child warmly when getting ready to go to the emergency department or your doctor’s office. If it is not too cold, roll down your car window a bit. Breathing cold air improves children’s croupy symptoms, and your child will most likely be quite a bit better when you arrive at your destination.

When is it an emergency?

The following severe symptoms are an emergency.

Your child’s face is bluish-grey in colour for more than a few seconds; or
Your child becomes unusually sleepy or glassy-eyed while making croupy sounds; or
Your child is really stressed, is struggling to breathe, and you can not calm her within a few minutes.

If your child has very severe symptoms, get help as fast as possible. If there is ambulance service in your area, it is safest to call 911 rather than driving to the nearest hospital yourself. Ambulance paramedics can start treatment for your child immediately. If you live in an area without ambulance service or it will take a long time to reach you, drive your child to the nearest hospital emergency department.

What medical treatment improves croup?

Since a virus causes croup, antibiotics do not help. Neither do antihistamines and decongestants (over-the-counter cold medications). Mist therapy has been used for many years, but has never actually been shown to help improve croup symptoms.

The most effective treatment for croup is the medication dexamethasone. This is a kind of corticosteroid. Usually, only one dose given by mouth is necessary. This medication, which is very safe, helps to reduce breathing troubles. Your child will be less likely to need to stay in hospital or return for medical care. The medicine starts to work within two or three hours, and lasts for a couple of days.

Another effective treatment is an adrenaline (epinephrine) breathing mask, which works within minutes but lasts less than two hours. This is usually used only for children with more severe symptoms.

Should my child come home or stay in the hospital?

Most children with croup have mild symptoms, so it is safe for your child to get better at home. About one child with croup in 25 (4 per cent) needs to be kept in hospital for a few days until breathing improves. Children who must stay in the hospital will be watched.

If breathing becomes really difficult, more adrenaline masks will be given.

Of those children who stay in hospital, one in every 100 (1 per cent) have so much trouble that they must have a special tube put down their windpipe to help them breathe. If this is necessary, your child would be transferred to an Intensive Care Unit (ICU). Even the most severely affected children almost always get completely better within one or two weeks, without any complications.

Can I prevent my child from getting croup?

Just as it is difficult to prevent your child from getting a cold, the same is true for croup. However, good hand washing helps to stop the spread of the virus that causes croup.

Croup Advice for parents

Croup
Advice for parents