Hoarseness

Is this your child's symptom?

• 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 for Hoarseness

Call 911 Now

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

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 for Hoarseness

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

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

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

Last Reviewed: 05/01/2025

Last Revised: 03/04/2025

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.