Croup is a viral infection of the vocal cords, voice box, and windpipe that lasts five to six days. It results in a tight, low-pitched cough that sounds similar to the barking of a seal. Typically, the child's voice becomes hoarse because the excessive coughing causes the vocal cords to swell.

A condition called stridor, which causes the opening between the vocal cords to narrow, occurs when croup becomes severe. When a child has stridor, breathing becomes difficult, sounds harsh or raspy, and vibrates. Usually stridor only occurs when a child cries or coughs. However, as the disease worsens, it will also appear when relaxed or sleeping.

Croup tends to worsen at night and will affect children under age three more severely than older children. Throughout the course of croup, conditions can change from mild to severe and back several times.

Boys Town Pediatrics recommends the following remedies to care for a child with croup who suddenly develops stridor or tight breathing:

• Warm Mist - Place a warm, wet washcloth loosely over your child's mouth and nose and have him breath. Or, have your child breathe deeply from the stream of humidity from a humidifier (not hot vaporizer).
• Steamy Bathroom - Sit with your child in a steamy bathroom with a hot shower running and the door shut for at least 10 minutes.

Most likely, these treatments will calm your child's cough and help her sleep through the night. However, if the stridor continues after using these methods, call her physician right away. If she turns blue, passes out, or stops breathing, call 911 immediately.

To relieve the discomfort of croup without stridor, Boys Town Pediatrics suggests the following home care remedies:

• Humidifier - Because dry air makes a cough worse, use a humidifier 24 hours a day. If you do not have a humidifier, hang wet sheets or towels.
• Warm Fluids - To relax the vocal cords and loosen mucus which can cause coughing spasms, offer clear warm fluids such as apple juice, lemonade, or herbal tea to children over four months.
• Cough Medicine - Although not as useful as a humidifier or warm fluids, cough drops or syrup can help control coughing. Give children over one year of age, 1/2 to 1 teaspoon of corn syrup as needed. For children over four years of age, cough drops can be given.
• Observation - Because croup can cause breathing to become difficult, it is a dangerous disease and is advised that a parent sleep in the same room as the sick child.
• Avoid Smoke - Never allow smoking around your child, as it can make croup worse.

If the attacks of stridor occur more than three times, a fever lasts more than three days, croup lasts more than 10 days, or you have any other questions or concerns call your child's physician within 24 hours.

If breathing becomes difficult when your child is not coughing, your child begins to drool, spit, or has great difficulty swallowing, warm mist does not clear the stridor within 20 minutes, or your child starts acting very sick, call his or her physician immediately.