Croup, Cough & Stridor

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Diagnostic Findings of Croupy Cough

  • There is a distinctive cough that occurs with infections of the voice box (larynx)
  • The cough is tight, metallic, and like a barking seal
  • The voice is usually hoarse

Diagnostic Findings of Stridor

  • A harsh, raspy, vibrating sound is heard when your child breathes in
  • Breathing in becomes very difficult
  • Stridor only occurs with severe croup
  • Stridor is usually only present with crying or coughing
  • As the disease becomes worse, stridor also occurs when a child is sleeping or relaxed


Croup is a viral infection of the vocal cords. It is usually part of a cold. The hoarseness is due to swelling of the vocal cords. Stridor occurs as the opening between the cords becomes more narrow.

Expected Course

Croup usually lasts for 5 to 6 days and generally gets worse at night. During this time, it can change from mild to severe many times. The worst symptoms are seen in children under 3 years of age.

First Aid For Attacks of Stridor With Croup

If your child suddenly develops stridor or tight breathing, do the following:

Inhalation of Warm Mist

Warm, moist air seems to work best to relax the vocal cords and break the stridor. The simplest way to provide this is to have your child breathe through a warm, wet washcloth placed loosely over his nose and mouth. Another good way, if you have a humidifier (not a hot vaporizer), is to fill it with warm water and have your child breathe deeply from the stream of humidity.

The Foggy Bathroom

In the meantime, have the hot shower running with the bathroom door closed. Once the room is all fogged up, take him in there for at least 10 minutes. Try to allay fears by cuddling your child.

Results of First Aid

Most children settle down with the above treatments and then sleep peacefully through the night.

NOTE: If the stridor continues in your child, call our office IMMEDIATELY. If your child turns blue, passes out, or stops breathing, call the rescue squad (911).

Home Care For A Croupy Cough


Dry air usually makes coughs worse. Keep the child’s room humidified. Use a cool mist humidifier if you have one. Run it 24 hours daily. Otherwise, hang wet sheets or towels in your child’s room.

Warm Fluids for Coughing Spasms

Coughing spasms are often due to sticky mucus caught on the vocal cords. Warm, clear fluids, such as apple juice, lemonade, or tea, may help relax the vocal cords and loosen the mucus.

Cough Medicines

Medicines are less helpful than either mist or swallowing clear fluids. Older children can be given cough drops for the cough, and younger children can be given some corn syrup. If your child has a fever (over 102°F [38.9°C]), you may give him acetaminophen.

Close Observation

While your child is croupy, sleep in the same room with him. Croup can be a dangerous disease. By all means, don’t let anyone smoke around your child; smoke can make croup worse.


The viruses that cause croup are quite contagious until the fever is gone or at least until 3 days into the illness. Since spread of this infection can’t be prevented, your child can return to school or child care once he feels better.

Call our office immediately and begin First Aid for stridor if:

  • Breathing becomes difficult
  • Your child develops drooling, spitting, or great difficulty in swallowing
  • Your child develops retractions (tugging in) between the ribs
  • The lips turn bluish or dusky
  • Your child can’t sleep because of the croup
  • The warm mist fails to clear up the stridor in f20 minutes
  • You feel your child is getting worse

Within 24 hours if:

  • The coughing spasms are getting worse
  • The attacks of stridor occur more than three times
  • Your child is not drinking much
  • A fever (over 104°F [40°C]) occurs
  • You have other concerns or questions