8 Causes of Baby's Hoarse Voice, Treatment And Home Remedies

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Hoarse voice in babies can be due to various reasons ranging from overuse of vocal cords to viral infections. Hoarseness is a condition that makes the voice sound breathy, raspy, rough, or strained. The common cold is the most common cause of hoarseness in babies (1). Babies who cry a lot may also experience hoarseness due to overuse of vocal cords.

Although some people may use dysphonia and hoarseness interchangeably, these are different conditions. Dysphonia involves issues with voice production, resulting in poor voice quality and affecting communication skills. In comparison, hoarseness is a rough voice (2).

Read on to know the causes, treatment, and prevention of hoarse voices in babies.

What Causes A Hoarse Voice In Babies?

Dr. Paul Patterson, a board-certified pediatrician and expert in developmental and behavioral pediatrics from Bethesda, Maryland, says, “Everyone has differences in vocal qualities, and some voices may naturally be more hoarse than others, not necessarily indicating a problem. There are also various reasons for a hoarse vocal quality in babies. Crying and screaming during times of distress can cause some hoarseness but typically is present only for two to three days.”

According to a report from the American Academy of Pediatrics, most cases of hoarseness in children are harmless, can be reversed, and tend to resolve on their own (3). The most common cause of hoarseness is cold. Sometimes, it could be cold, runny eyes, and cough in babies (4). However, hoarseness could also be due to many other reasons, such as:

1. Laryngomalacia: Babies with laryngomalacia have noisy breathing because of a soft, floppy voice box. This occurs because the tissue above their Vocal cordsⁱThe two bands of elastic muscle tissue in your voice box that vibrate to produce your voice. is softer than normal, which can partially block their airway. This condition is usually not dangerous and gets better by around 18-20 months of age (5). In some case reports, respiratory stridor is noted as the first symptom (6).
2. Upper respiratory tract infections: Several viral and a couple of bacterial infections can result in laryngitis (an inflamed LarynxⁱThe voice box in your throat that contains your vocal cords and helps you speak, breathe, and protect your airway when swallowing. ) The inflammation leads to swelling of the vocal cords that lie within the larynx, and this causes a hoarse voice (7).
   The parainfluenza virus is another virus that can cause a hoarse voice, barking cough, and a specific symptom called stridor (8). This collection of symptoms with an increased body temperature, mild fever, and runny nose is called croup (9). Stridor is an audible, high-pitched, inspiratory whistling noise caused by an inflamed larynx, trachea, and upper bronchus. Once you hear stridor, it is important that your baby is seen by a pediatrician (10). Croup can range from mild to severe and may require inpatient observation and treatment depending on its severity. Other such conditions that could lead to a hoarse voice are laryngitis (swelling of the larynx) and pharyngitis (swelling of the pharynx) (11) (12).
3. Excessive crying: Colicky babies tend to cry more than the others, and strain their larynx, which may lead to a hoarse voice.

4. Vocal nodule: Overuse of the vocal cords can lead to nodules and swelling on the edge of the vocal cords(13). These nodules and swelling are benign but can cause chronic hoarseness. Older infants and toddlers experiment with their voice, and often these experiments are noisy. The hoarseness in this case tends to be worse in the evenings after a day of heavy use.
5. Laryngopharyngeal reflux: Frequent acid reflux to the larynx can irritate the vocal cords nodules (14). Babies with gastroesophageal reflux can have a hoarse voice. However, unlike in vocal cord nodules, the hoarseness from laryngopharyngeal or silent reflux in babies tends to be worse in the morning.
6. Spasmodic croup/allergies: An allergy can cause excess secretion of mucus in the airway from the nose to the BronchiolesⁱThe tiny branches of airways in your lungs that carry air to and from the air sacs. . In some children, a condition called spasmodic croup occurs. In this case, it is postulated that due to allergens, and not infections, the upper airway becomes inflamed, causing recurrent hoarseness and stridor (15).
7. Vocal cord lesions: Vocal cord lesions can be benign like PapillomasⁱSmall, wart-like, benign or non-cancerous growths. caused by human papilloma virus, which leads to stridor and hoarseness. This may require surgical removal by an ENT physician. PolypsⁱSoft, swollen growths that can form in various parts of the body. can also grow on the vocal cord tissue leading to hoarseness (16).
8. Irritants: Smoke from automobiles and cigarettes can also cause vocal cord irritation (17). Chemicals and air pollution can also exhibit the same finding of hoarseness.

In rare cases, a baby may be born with abnormalities in the airway that can cause hoarseness.

Did you know?

The congenital laryngeal web is a rare laryngeal lesion that can cause recurrent stridor and persistent hoarseness in infants (18).

When To See A Doctor?

Dr. Patterson adds, “The key is listening for a persistent hoarse vocal quality when it is lasting longer than a week and may be accompanied with behaviors that cause muscular tension (for example, excessive amount and time of screaming and crying or snoring at night time). Check in with a pediatrician if a child has an illness or fever or is acting differently accompanying the hoarse voice.”

It is good to see a doctor if, along with hoarseness, the baby (14) (19):

• Has a weak voice that does not seem to get better, or the voice stays hoarse for several weeks.
• Makes no sound while crying or makes a sharp, abnormal sound while crying.
• Has a sore throat that lasts a long time.
• Coughs continuously, and it does not seem to get better.

• Has trouble while breathing and makes wheezing sounds while breathing.
• Loses their appetite or has a problem while swallowing.

Besides these, hoarseness with a baby sore throat that lasts a long time is another condition when prompt medical examination is necessary.

The doctor will diagnose the underlying cause of hoarseness by inspecting the baby’s throat. If needed, additional tests such as a laryngoscopyⁱA medical procedure to look at the larynx using a special scope. , MRI scan, or biopsyⁱA medical test where a small piece of tissue is removed and examined under a microscope to check for disease. may be performed (20). Blood and sputum tests may be needed for diagnosing infections. Once the diagnosis is confirmed, the doctor will prescribe the necessary course of treatment.

Research finds

Studies are ongoing to trace all the bacteria, proteins, genes, and immune system cells in the normal larynx. This understanding might help better diagnose and treat laryngitis, a common cause of hoarse voices in babies (14).

How Is Hoarse Voice In Babies Treated?

The treatment of hoarse voice depends on its cause, duration of hoarseness, the baby’s age, and health history at large, which the doctor is likely to ask you during a consultation. Depending on the symptoms and health in general, you might be sent to an ENT specialist (otolaryngologist).

An otolaryngologist will view the vocal folds to get a proper understanding of the probable cause of hoarseness. Treatment is suggested once a confirmed diagnosis is made (2). However, the use of antibiotics for treating hoarseness is not recommended (21).

Hoarseness of voice can be highly irritating for the baby. You may alleviate the discomfort, before or during the treatment, with the use of natural remedies. But as you plan to do so, check with your doctor about the efficacy and safety of the remedy.

Things to know

The doctor might prescribe anti-allergy medicines if your baby’s hoarse voice is due to an allergy. These medicines can make the mucus on the vocal cords dry and sticky. Keeping the babies hydrated can thin the mucus and reduce discomfort (22).

Home Care For Hoarse Voice

Here is what you can do to prevent or reduce the hoarseness of a baby’s voice (2) (7):

1. Keep the baby hydrated: Increase the number of breastfeeding sessions or give more water to sip frequently if the baby is older than six months.
2. Use a cool-mist humidifier: A humidifier pumps water vapor into the ambient air so that it does not dry the throat and airways. The use of humidifiers during throat problems may prevent drying up of the vocal cords. Only use a cool-mist humidifier and not a steam/hot-mist humidifier, which increases the risk of burns.
3. Avoid allergens and irritants: If you know the baby has allergies, keep them away from potential allergens, such as pollen, pet fur, pet dander, strong fragrances, and dust. Babies and toddlers should be kept away from pollution, too. Do not let anyone in the home smoke, and avoid going to places where the baby will be exposed to tobacco smoke.
4. Control colic and restrict vocal cord overuse: If the baby cries a lot, then try swaddling and relaxing them with a lullaby. Older toddlers may be taught to speak softly until the vocal cord gets better. You can offer incentives to the toddler for being silent. You may also try to keep the toddler occupied with games that require silent play.
5. Maintain good hygiene and vaccinate: Babies and toddlers should wash hands after outdoor play. Keep the baby’s surroundings clean. If someone has a cold in the family, then they must keep away from the baby. Vaccinating the baby and the family is also essential to avoid infections such as influenza.

Quick tip

When a humidifier isn’t available, you can use small water bowls or damp towels on radiators to moisten the indoor air. Moist air makes breathing easier for babies (22).

Infographic: Causes And Management Of Hoarse Voice In Babies

If it sounds like your baby is straining to speak and there is hoarseness, what could be the reasons and how can you help them? Check out this infographic for a quick read of:

• Causes of hoarse voice
• Home care measures

Illustration: Momjunction Design Team

Illustration: Causes of Baby’s Hoarse Voice Treatment And Home Remedies

Image: Dall·E/MomJunction Design Team

Is laryngitis a concern for a 7-month-old? Watch this informative video to understand how to recognize and manage laryngitis in infants effectively.

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Reviewer Expert Author Editor Fact Checker

Dr. Garima Garg SethMD

Dr. Garima Garg Seth is a well-known pediatrician in Gurgaon, having more than 19 years of experience in this field. She has completed her education from topmost organizations in India, including AIIMS, New Delhi; Sir Ganga Ram Hospital, New Delhi; and CMC Vellore.

Read full bio of Dr. Garima Garg Seth

• 
  Paul PattersonMD, PhD, FAAP Dr. Paul Patterson is the chief medical officer and co-founder at Pathfinder Health. A board-certified pediatrician and expert in Developmental and Behavioral Pediatrics, Dr. Patterson received his MD from Uniformed Services University of the Health Sciences. He is also a licensed professional engineer with a PhD in Electrical Engineering from The George Washington University.
  
  Dr. Paul Patterson is the chief medical officer and co-founder at Pathfinder Health. A board-certified pediatrician and expert in Developmental and Behavioral Pediatrics, Dr. Patterson received his MD from Uniformed Services University of the Health Sciences. He is also a licensed professional engineer with a PhD in Electrical Engineering from The George Washington University.

Rohit GarooBSc, MBA

Rohit Garoo is a writer-turned-editor with over 9 years of experience in content writing, editing, and content marketing. He did his bachelors in Science at St. Xavier's College, Hyderabad, and masters in Business Administration at Osmania University.

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Dr. Ritika ShahBDS, CLC

Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College.

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Vidya TadapatriMSc (Biotechnology)

Vidya did her post-graduation in Biotechnology from Osmania University, Hyderabad. Her interest in scientific research and writing made her pursue a career in writing, in which she now has over five years of experience. She has done certified biotechnology-related training programs under renowned organizations such as Centre For Cellular & Molecular Biology and Department of Biotechnology.

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