What should you know about croup but no fever?

Croup is linked to swelling around the voice box and upper airway. The typical pattern is a barking cough, hoarse voice, and sometimes a high-pitched noise when breathing in. Fever may be absent, mild, or part of a wider viral illness; its presence or absence does not determine how hard a child is breathing. A blocked nose and cough can also occur with a common cold. If the cough is sudden after choking, or if there is drooling, severe throat pain, or a child looks very unwell, another urgent problem must be considered.

Keep the child comfortable, upright, and as calm as possible. Offer regular fluids and check for wet nappies or usual toilet visits, depending on age. Listen for noisy breathing when the child is settled, not only during crying. Keep smoke away and avoid steam, which can burn skin and does not treat the underlying swelling. Do not start antibiotics or cough remedies without medical advice. Contact a clinician if symptoms are progressing or you are unsure how to judge the breathing.

Get emergency help for stridor at rest, struggling or unusually fast breathing, pulling in at the ribs or neck, pauses in breathing, inability to swallow, drooling, marked sleepiness, or blue, grey, or pale lips. Arrange same-day assessment if the child is drinking much less, passing less urine, becoming tired, or has a cough that is worsening even without fever. A temperature reading should never delay help for visible breathing difficulty.

Tell the clinician when the cough began, whether it is worse overnight, whether noisy breathing happens at rest, and how much the child is drinking. Ask how often to check breathing and which symptoms should send you straight to urgent care.