Croup is a viral infection of the voice box and trachea. It starts as a cold, and proceeds to a hoarse, tight, "barky" cough (sounds like a seal). Symptoms may change from mild to severe several times. The child may have STRIDOR, which is a harsh, raspy noise heard when the child breathes in. Stridor:

• usually only happens when child coughs, or cries
• may become difficult for child to breathe in
• usually HAPPENS AT NIGHT

CALL 911 IF CHILD HAS:

• Severe breathing problems
• Lips are turning blue and dusky
• Child is drooling, spitting, and can’t swallow

• Difficulty breathing when not coughing
• Stridor (see above) not improving after 20 minutes of treatment (see below)

• Stridor during daylight hours
• Sucking in of the skin between the ribs with breathing
• Child can't bend head/neck forward
• Child is less than 1 month old
• Non-stop coughing that doesn’t improve with 1 hour of treatment
• Temperature over 100° F (under the arm) in baby younger than 4 weeks old
• Temperature over 101° F (under the arm) in baby 4-12 weeks old

• Coughing spasms getting worse
• Stridor (see above) attacks happen more than 3 times

• Fever over 104° F
• Child is 1-3 months old, and is having bad coughing spasms

• Stridor is still present after 3 days
• Child is not drinking liquids fairly well
• Child has ear pain

• MIST: run cold mist humidifier in child's bedroom
• FLUID: encourage intake of water, juice
• MEDICINE:

a) Croup is caused by a virus: antibiotics WILL NOT help

b) If over 12 months; DM cough medicine is OK for severe cough

c) Use Tylenol for fever over 102° F

• EXPOSURE: absolutely NO CIGARETTE SMOKE exposure
• WATCH CLOSELY: sleep in same room with child
• Treatment for STRIDOR AND COUGHING ATTACKS: (below)

• Turn shower on hot, close bathroom door
• When the room is foggy, cuddle child on your lap in the steamy room for at least 10 minutes.

• HINT: TRY to appear CALM; it will help your child relax

• If warm mist doesn't help, (it usually does) take child outside
• Breathing cool, night air can ease the stridor.