Pharyngitis in infants

Overview

Pharyngitis is an infection that causes swelling and pain in the back of the throat (pharynx). In infants (babies under 1 year old), it often makes them fussy, uncomfortable, and can affect feeding.

Yes, pharyngitis is one of the most common infections in infants and young children.

Pharyngitis most often affects infants and toddlers under 2 years old, especially those in daycare or around older siblings.

Symptoms

Common symptoms

• Fussiness or crying more than usual
• Difficulty feeding or refusing to eat
• Drooling more than normal
• Fever (temperature above 100.4°F or 38°C)
• Cough or runny nose

Symptoms in children

• Complaints of a sore throat (in older toddlers who can talk)
• Red, swollen tonsils with white patches
• Swollen glands in the neck
• Headache or stomach ache

Symptoms in older adults

• Mild sore throat without much fever
• Hoarseness
• Dry cough

Causes

Main causes

• Viruses such as cold viruses, flu, or adenovirus (most common)
• Bacteria like group A Streptococcus (strep throat, less common in infants under 2)
• Irritants like smoke or very dry air (can make symptoms worse)

Risk factors

• Exposure to other sick children (e.g., at daycare or in the family)
• Weakened immune system (e.g., from another illness or as a newborn)
• Season - more common in late fall and winter

When to see a doctor

See a doctor urgently if:

• If your baby has trouble breathing or swallowing
• If they have a fever over 102°F (39°C) that does not come down with fever medicine
• If they show signs of dehydration (very few wet diapers, sleepy, dry mouth)

Book a routine appointment if:

• If the sore throat or fever lasts more than 3 days
• If your baby seems very uncomfortable and you are worried
• If there is a rash or swollen lymph nodes

Diagnosis

The doctor will ask about symptoms, examine the baby's throat, ears, and neck, and listen to their breathing.

Tests that may be done

• Throat swab (using a cotton swab to collect a sample from the back of the throat) - mostly done in older children, not always in infants
• Rapid strep test to check for bacteria (if suspected)
• Blood tests are rarely needed

What to expect at your appointment

The exam is quick. A throat swab may be done if the doctor thinks it might be bacterial. The clinic may call you with results in a few days.

Treatment

Treatment depends on the cause. Viral pharyngitis goes away on its own. Bacterial pharyngitis is treated with antibiotics. Never give aspirin to a child under 16.

Self-care at home

• Encourage your baby to drink extra fluids (breast milk, formula, or water if over 6 months)
• Use a cool-mist humidifier in the room to soothe the throat
• Offer soft, cool foods like yogurt or applesauce if your baby is eating solids
• Give fever reducers suitable for infants (paracetamol or ibuprofen) as directed by your doctor

Medical treatments

If tests show a bacterial infection (like strep throat), the doctor will prescribe a course of antibiotics to be given exactly as instructed, even if the baby seems better. Make sure your baby finishes all the medicine.

When is surgery considered?

Surgery (like tonsillectomy) is rarely needed for pharyngitis in infants. It might be considered in older children with very frequent, severe infections, but not as a first step.

Living with this condition

While your baby has pharyngitis, offer comfort, extra cuddles, and plenty of rest. Keep them home from daycare to avoid spreading the infection.

Lifestyle tips

• Wash hands frequently to prevent the infection from spreading to others
• Do not smoke near the baby, as smoke can irritate the throat
• Keep the baby's environment clean, especially toys and pacifiers

Diet and exercise

Offer breast milk or formula more often to keep your baby hydrated. If they are eating solids, choose soft, non-irritating foods like mashed bananas or porridge. Avoid citrus juices or spicy foods until the throat feels better. No special exercise needed – rest is best.

Mental health and emotional wellbeing

Caring for a sick, fussy baby can be stressful and exhausting. It's normal to feel worried or tired. Take breaks when you can, and ask family for help. Remember that this is temporary.

Prevention

You cannot always prevent pharyngitis, but good hygiene can reduce the risk. Wash your hands and your baby’s hands often. Keep your baby away from people who are sick.

Vaccines

Some vaccines, like the flu vaccine (after 6 months) and routine childhood vaccines, can help prevent infections that sometimes lead to pharyngitis. Ask your doctor about the recommended vaccination schedule.

Screening programmes

There is no routine screening for pharyngitis. Your doctor will only test if your baby has symptoms that suggest a bacterial infection.

Complications

If left untreated

• Dehydration from not drinking enough fluids
• Ear infection (otitis media)
• Rarely, untreated strep throat can lead to rheumatic fever (which can damage the heart) or kidney inflammation

Long-term outlook

With proper care, almost all babies recover fully from pharyngitis without long-term problems. Viral cases resolve on their own, and bacterial infections get better with antibiotics. The outlook is excellent.

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