Croup and temperature: what parents should know

Croup is usually linked with a viral upper-airway infection. A child may have a barking cough, a hoarse voice and noisy breathing, with or without a raised temperature. A temperature reading does not show how narrow the upper airway is, so watch for stridor, chest pulling in, unusual sleepiness or difficulty drinking. A common cold can accompany or precede croup. Fever can also have another cause, especially if the child seems increasingly unwell.

Keep your child calm and upright, because crying can make noisy breathing worse. Offer frequent small drinks and check that they are passing urine. Use the fever medicine recommended for your child's age and weight if they are distressed; follow the product directions and do not combine medicines unless a clinician advises it. Avoid steam, smoke and over-the-counter cough remedies that are not intended for young children. A clinician may assess the airway and decide whether treatment such as a nebuliser is needed.

Seek urgent help if breathing is hard, the noisy breath continues while your child is resting, the lips look blue or grey, the child cannot swallow fluids, or they are difficult to wake. Arrange prompt medical advice if the temperature persists, your child is becoming less responsive, or symptoms are worsening rather than easing. Keep watching during sleep and overnight because breathing can change after a child settles.

Ask whether the temperature pattern fits the suspected illness, which breathing signs should trigger urgent help, and how to use any prescribed medicine. Tell the clinician when the barking cough began, the highest reading you observed, how your child is drinking, and whether noisy breathing occurs at rest.