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

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

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)

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 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

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC. Date Updated: Mar 31 2025 13:37 Version 0.1

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February 12, 2026
There are cases of measles in NC, and we are aware of exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. 2 doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!
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