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
 
- If NOT, try one of these: 
 - Croup
 - Nose Allergy (Hay Fever)
 
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
 Call Doctor or Seek Care Now
  |  
  Contact Doctor Within 24 Hours
 Contact Doctor During Office Hours
  |  
  Self Care at Home
  |  
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.
Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.
Reviewed: 5/1/2025 Updated: 3/4/2025

