Health Information

Symptoms

• Voice (or cry) is raspy and deeper than usual
• Cough and throat clearing is often present
• Runny nose and watery eyes may also occur
• Allergic symptoms often have a sudden onset.

Causes

• Reaction to an inhaled substance (called an allergen). Most often, this is a pollen.
• Grass, trees, weeds and molds are the most common pollens.
• Allergens can also be from cats, dogs, horses, rabbits and other animals.
• Dust, chemicals, or pollutants can also cause a raspy voice. This is from irritation of the vocal cords, not an allergic reaction.

Prevention - How to Reduce the Pollen Your Child Breathes:

• Pollen is carried in the air.
• Keep windows closed in the home, at least in your child’s bedroom.
• Keep windows closed in car. Turn the air conditioner on recirculate.
• Avoid window fans or attic fans. They pull in pollen.
• Try to stay indoors on windy days. Reason: The pollen count is much higher when it’s dry and windy.
• Avoid playing with the outdoor dog. Reason: Pollen collects in the fur.
• Pollen Count: You can get your daily pollen count from www.pollen.com. Just type in your zip code.

Care Advice

1. Overview:
   • Pollen allergies are very common. They occur in about 15% of children.
   • Symptoms can be controlled by giving allergy medicines. Use either a short-acting (Benadryl) or long-acting (Zyrtec).
   • Since pollen allergies recur each year, learn to control the symptoms.
   • Here is some care advice that should help.
2. Allergy Medicines Short-Acting:
   • Allergy medicines are called antihistamines.
   • They help control all allergic symptoms.
   • Benadryl or Chlorpheniramine (CTM) products are helpful. No prescription is needed. They need to be given every 6 to 8 hours.
   • The key to control is to give allergy meds every day during pollen season.
3. Allergy Medicines Long-Acting:
   • Cetirizine (Zyrtec) or Loratadine (Claritin) are long-acting allergy medicines. No prescription is needed.
   • Advantage: Causes less sedation than older allergy meds such as Benadryl and CTM. They are long-acting and last up to 24 hours.
   • AGE 2- 6 years old, give 2.5 mg (2.5 ml or 1/2 teaspoon) of liquid syrup. Use once daily in the morning.
   • AGE 6-12 years old, give 5 mg chewable tablet once daily in morning.
   • AGE: 12 years and older, give 10 mg tablet once daily in morning.
   • Downside: Doesn’t control allergy symptoms as well as older allergy medicines. Also, sometimes will have breakthrough symptoms before 24 hours. If that happens, you can give a single dose of Benadryl or CTM.
   • Cost: Ask the pharmacist for a store brand. Reason: Costs less than the brand names.
4. Warm Liquids:
   • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice.
   • Age over 6 years. Can also suck on cough drops or hard candy. Butterscotch seems to help.
   • Age over 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.
5. Rest the Voice:
   • Avoid yelling and screaming. (Reason: 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: Can make hoarseness worse.)
6. Avoid Tobacco Smoke:
   • Tobacco smoke makes hoarseness and coughs much worse.
7. Wash Pollen Off Body:
   • Remove pollen from the hair and skin with shampoo and a shower. This is really important before bedtime.
8. What to Expect:
   • Hoarseness from an allergic substance that can be avoided should go away in hours. Examples are a reaction to pets, a barn, raking leaves or air pollution.
   • Hoarseness during pollen season can last 4-8 weeks. It may return whenever you don’t give the allergy medicine. It can flare-up whenever the pollen count goes high.
9. Return to School:
   • Your child does not need to miss any school for allergies.

Call Your Doctor If

• Trouble breathing or swallowing occurs
• Hoarseness is not better in 2 days after starting allergy medicine
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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