Until this moment, you’ve probably only heard hoarse voices coming from older children or full-grown adults. You know the sound — that deep, grating rasp that comes during a particularly nasty sinus infection or after shouting to talk to friends all night at a loud concert.
Now you’re hearing differently. How could such a hoarse and raspy voice emerge from the throat of your warm and cuddly baby?
It’s surprising and a bit concerning to hear your baby’s usual sweet coos replaced by a hoarse voice. But try not to panic because there are plenty of reasons that your baby may have a hoarse voice and most of them are pretty easy to deal with.
First, it’s important to understand the way voice works to understand why baby hoarse voices happen.
The mechanics of voice
Place your fingers lightly against the front of your throat and sing a song. Feel something vibrating? That’s the exhaled air moving out of your lungs, into your larynx and through your vocal cords or folds.
As the air passes through the narrow opening (glottis) between the almost-closed vocal folds, the air vibrates and voice is produced. Hoarseness happens when the vocal folds do not vibrate normally.
So what can affect the normal operation of vocal folds? There are a few things, and identifying which one is at play can help you treat the cause.
Timing can help you diagnose hoarseness. If your baby sounds hoarse after extended bouts of crying, you can blame the crying. Ditto for a cold or cough: a post-nasal drip and phlegm can affect those vocal folds and lead to hoarseness.
Here are some reasons why hoarseness could happen and how to manage them:
Most likely, you can put it down to your baby overexercising their vocal cords. Think back to the last sports event or loud concert you attended. How did your voice sound after all the cheering or shouting you did? Similarly, a hoarse baby is most likely hoarse from over-use.
Of course you’ll want to comfort your baby when they’re crying excessively, but it’s not always easy to eliminate the reason for those tears.
Do your best to calm the crying, offer plenty of breastfeeding time or a pacifier, and give your little one a chance to rest their vocal cords and the hoarse voice should clear up.
Viruses like those that cause croup will need to run their course. Ditto for a cold. But you can offer relief by clearing out the nasal passages using sprays, saline solutions, and a nasal aspirator. A cool-mist vaporizer or humidifier can be especially helpful for croup.
Ask your doctor about other possible treatments if the illness or the hoarse voice persists for more than a few days.
Some infections lead to a buildup of mucus and can accompany runny or stuffy nose. The extra secretions can drain into the throat and may affect the vocal folds. Allergies lead to the same problem.
If your little one is ill, talk to your doctor about possible treatments for the illness. If allergies are the cause it may require extra cleaning or changes to reduce the dust, dander, or other allergens in your home.
Note that hoarseness alone would be an unlikely sign of GERD. You would see other indications, such as feeding difficulties, spitting up, vomiting, crying with feeds, or poor weight gain.
This can sometimes be treated by giving smaller, more frequent feedings. Try holding your baby upright after a feeding and burping them often. In more severe cases, medications or even surgery may be needed.
Vocal cord nodules
Vocal cord nodules or cysts might be considered in an infant with a persistent hoarse voice — particularly if the hoarseness is present from birth.
These may be congenital, where the baby is born with something affecting their vocal cords, or caused by something that grows over time, like a cyst or hemangioma.
Recurrent respiratory papillomatosis (RRP)
This rare condition causes recurrent benign wart-like growths on the surface of the vocal folds or around them. Your medical team will decide if these needed to be treated with surgery.
Tumors can be serious. Hoarseness that persists or comes with significant breathing problems or feeding difficulties should be addressed quickly.
Injuries can also cause hoarseness. Caustic acids or poisons that are swallowed, breathing or feeding tube placement, and bodily trauma (like being in a car accident) can damage the tissue.
If you suspect your baby has ingested something they shouldn’t have, seek emergency care immediately.
Sometimes, an infant is born with a deformity of the larynx (voice box) that houses the vocal folds. In other cases, the laryngeal nerve responsible for moving the vocal folds is damaged.
Again, discussing your baby’s hoarse voice with your pediatrician can help identify any issues and create a treatment plan if needed.
Life can seem like a juggling act on fast when you’re trying to balance child care, family life, work, and the ins and outs of life. So keeping track of your baby’s hoarseness can be tricky.
If you feel that the hoarseness has been present for several days up to a week and isn’t improving, then reach out to your pediatrician. If you aren’t sure of the cause of the hoarseness or your baby is a newborn don’t wait that long.
Hoarseness is a symptom that something is wrong. By treating the underlying cause of hoarseness, you should soon be listening to happy gurgling.
Whatever the cause, keep in mind the following tips that can help your baby:
- Protect your baby from exposure to smoke from cigarettes and other pollutants that may cause irritation.
- Keep your baby hydrated by offering frequent breastfeeding or bottles.
- Consider using a humidifier to maintain moisture in the air or sit with your baby in a closed bathroom with a hot shower running so that they can breathe in the steam.
It may be just a hoarse voice, but given the underlying causes, your baby may not feel in top shape. When you give them the extra love and care they’re craving, remember that you may need some too!