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Hoarseness

Definition

  • Hoarse voice is raspy and deeper than usual
  • If hoarseness is severe, the child can do little more than whisper
  • Cough is often present

Causes

  • Laryngitis is the medical name for a hoarse voice. Caused by an infection or irritation of the larynx (voice box) and vocal cords.
  • In children, most hoarseness is caused by a virus. It's usually part of a cold. The onset is slow.
  • The laryngitis viruses cause Croup in younger children.
  • Less often it can be caused by an allergen, such as pollen. Watery eyes and runny nose may also occur. The onset is sudden.
  • Overuse of vocal cords (shouting, yelling or loud singing) can also be a cause.

When To Call

Call 911 Now

  • Severe trouble breathing (struggling for each breath, can barely speak)
  • You think your child has a life-threatening emergency

Go to ER Now

  • Can't swallow any fluids and new onset drooling

Call Doctor or Seek Care Now

  • Trouble breathing, but not severe
  • Cannot even whisper
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Age less than 2 months old
  • Fever lasts more than 3 days
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Allergy symptoms (such as runny nose and itchy eyes) also present
  • Hoarseness lasts more than 2 weeks
  • You have other questions or concerns

Self Care at Home

  • Hoarse voice from a common cold
  • Hoarse voice from overuse (shouting or singing)

Care Advice

What You Should Know:

  • Most hoarseness is part of a common cold.
  • It means the vocal cords are irritated and swollen.
  • Here is some care advice that should help.

Warm Liquids:

  • Age greater than 1 year. Can sip warm fluids such as chicken broth or apple juice.
  • Age greater than 6 years. Can also suck on cough drops or hard candy. Butterscotch seems to help.
  • Age greater than 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.

Rest the Voice:

  • Avoid yelling and screaming. Reason: it causes vocal cord strain.
  • Have your child try to talk as little as possible. He or she can also write notes for a few days.
  • Also, avoid clearing the throat. Reason: it can make hoarseness worse.

Fever:

  • For fevers higher than 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: lower fevers help fight infections.
  • For all fevers: keep your child well-hydrated. Give lots of cold fluids.

Humidifier:

  • If the air in your home is dry, use a humidifier. Reason: dry air makes hoarseness worse.

Avoid Tobacco Smoke:

  • Tobacco smoke makes hoarseness and coughing much worse.

What to Expect:

  • Hoarseness from viral laryngitis lasts 1-2 weeks.

Return to School:

  • Your child does not need to miss any school for a hoarse voice.
  • Your child can go back to school after the fever is gone.

Call Your Doctor If:

  • Trouble breathing or swallowing occurs
  • Hoarseness lasts more than 2 weeks
  • You think your child needs to be seen
  • Your child becomes worse

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Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
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