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
  • 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
  • Cannot even whisper
  • 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)

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Hoarseness

  1. 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.
  2. 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.
  3. 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.
  4. Fever:
    • For fevers above 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.
  5. Humidifier:
    • If the air in your home is dry, use a humidifier. Reason: dry air makes hoarseness worse.
  6. Avoid Tobacco Smoke:
    • Tobacco smoke makes hoarseness and coughing much worse.
  7. What to Expect:
    • Hoarseness from viral laryngitis lasts 1-2 weeks.
  8. 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.
  9. 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

And remember, contact your doctor if your child develops any of the 'Call 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: 04/20/2021

Last Revised: 03/11/2021

Copyright 2000-2021 Schmitt Pediatric Guidelines LLC.