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Instructions

• Instructions for new users

Call 911 Now If:

• Severe difficulty breathing (struggling for each breath, unable to speak or cry because of difficulty breathing, continuous severe stridor)
• Child has passed out or has bluish lips
• Croup started suddenly after taking a medicine or allergic food
• Child is drooling, spitting or having great difficulty swallowing (EXCEPTION: drooling due to teething)

First Aid Advice for Stridor (or for any difficulty breathing or severe coughing)

Inhale warm mist in a foggy bathroom with the shower running, from a wet washcloth held near the face, or from a humidifier (add warm water) for 20 minutes.

If that fails, inhale cool air from breathing near an open refrigerator or taking outside for a few minutes.

Call Your Doctor Now If:

• Your child looks or acts very sick
• Child choked on a small object that could be caught in the throat
• Difficulty breathing (age < 1 year old) not relieved by cleaning the nose
• Difficulty breathing (age > 1 year old) present when not coughing
• Ribs are pulling in with each breath (retractions)
• Stridor (harsh noise with breathing in) is present or has occurred today
• Child can't bend the neck forward
• Fever > 104°F (40°C) at any age
• Age < 12 weeks with fever > 100.4°F (38°C) rectally
• Severe chest pain

Call Your Doctor Within 24 Hours If:

• You think your child needs to be seen
• Continuous (nonstop) cough
• Age < 1 month (EXCEPTION: coughs a few times)
• Age 1 to 3 months with a cough for > 3 days
• Earache is also present
• Fever present > 3 days

Call Your Doctor During Weekday Hours If:

• You have other questions or concerns
• Croup is a recurrent problem
• Barky cough present > 10 days

Home Care (Read "Call Your Doctor…" first):

Humidifier

If the air is dry, run a humidifier in the bedroom. (Reason: dry air makes croup worse).

Coughing Spasms

For coughing spasms, give warm fluids to relax the airway (warm apple juice). (Avoid if < 4 months old).

Cough Medicine for Mild Coughs

These are less helpful than warm mist. After age 1 year, use corn syrup 2 to 5 ml whenever needed as a homemade cough medicine. It can thin the secretions and loosen the cough.

After age 4, use cough drops or hard candy. Remember, coughing up mucus is very important for protecting the lungs from pneumonia.

Cough Suppressant for Severe Coughs

Use dextromethorphan (DM) which is present in most cough syrups. Do not use under 1 year old.

Fever Medicine

For fever > 102°F (39°C), give acetaminophen (e.g. Tylenol) or ibuprofen.

Observation During Sleep

Sleep in the same room with your child for a few nights. (Reason: croup can suddenly become severe at night).

Avoid Tobacco Smoke

Active or passive smoking makes coughs much worse.

Contagiousness

Your child can return to day care or school after the fever is gone and your child feels well enough to participate in normal activities. For practical purposes, the spread of croup and colds cannot be prevented.

Expected Course

Croup usually lasts 5 to 6 days and becomes worse at night.

Call Your Doctor If:

• Stridor (harsh raspy sound) occurs
• The croup lasts > 10 days
• Your child becomes worse or develops any of the "Call Your Doctor…" symptoms