Sore throat in children

Overview

A sore throat is pain, scratchiness, or irritation of the throat that often worsens when you swallow. In children, it is usually caused by a viral infection like a cold or flu, but sometimes a bacterial infection (like strep throat) can be the cause. Most sore throats in children get better on their own within a week.

Yes, sore throat is one of the most common reasons children visit a doctor. Almost every child has at least one sore throat per year.

Sore throats can affect children of any age, but they are especially common in school-aged children (ages 5–15). Younger children (under 3) can also get sore throats, but they may not be able to describe the pain as clearly.

Symptoms

Common symptoms

• Pain or a scratchy feeling in the throat
• Pain when swallowing
• Dry, red throat
• Mild cough
• Runny nose or congestion
• Mild fever

Symptoms in children

• In younger children, you may notice them refusing to eat or drink, drooling more than usual, or being fussier than normal.
• They may cry during feeding or wake up at night with discomfort.
• Older children might say 'my throat hurts' or complain of pain when swallowing.

Symptoms in older adults

• While this article focuses on children, in older adults a sore throat is less common but can be more serious. It may be a sign of a different condition, and medical advice is recommended.

Causes

Main causes

• Viral infections: the most common cause, including cold viruses, flu, and COVID-19.
• Bacterial infections: especially group A streptococcus (strep throat), which requires antibiotic treatment.
• Irritants: such as dry air, smoking, or pollution.
• Other causes: allergies, reflux, or injury to the throat.

Risk factors

• Being in close contact with other children, such as at school or daycare.
• Weakened immune system due to other illness or treatments.
• Living in or traveling to areas with poor air quality.
• Exposure to tobacco smoke.

When to see a doctor

See a doctor urgently if:

• If your child has any of the emergency symptoms listed above (difficulty breathing, drooling, not drinking).
• If your child has a very high fever (over 39°C / 102°F) and looks very unwell.
• If your child is in severe pain and cannot swallow their saliva.

Book a routine appointment if:

• If the sore throat lasts more than 5–7 days.
• If your child has a fever that lasts more than 3 days.
• If you see white patches or pus on the tonsils.
• If your child has had a sore throat many times in a short period.
• If you are worried about a possible strep throat (e.g., red rash, swollen neck glands, fever).

Diagnosis

A doctor will usually diagnose a sore throat by asking about symptoms and looking at your child's throat and neck. They may shine a light in the mouth and gently feel the neck for swollen glands.

Tests that may be done

• Throat swab (rapid strep test): a soft cotton swab is gently rubbed on the back of the throat to check for strep bacteria. Results may come in a few minutes or a few days.
• Throat culture: if the rapid test is negative but the doctor still suspects strep, they may send the swab to a lab. Results take 24–48 hours.
• Blood tests are usually not needed for a sore throat.

What to expect at your appointment

The doctor may ask about your child's fever, drinking, and any other symptoms. They might also check the ears and nose. The examination is quick and not painful, though the throat swab can be briefly uncomfortable. The doctor will then advise on whether treatment is needed.

Treatment

Treatment depends on the cause. Viral sore throats do not need antibiotics and usually get better on their own. Bacterial sore throats (like strep) are treated with antibiotics to cure the infection and prevent complications. Most children recover fully with rest and home care.

Self-care at home

• Ensure your child drinks plenty of fluids (warm water, cool drinks, or ice lollies) to stay hydrated and soothe the throat.
• Offer soft, easy-to-swallow foods like yoghurt, soup, or mashed potatoes.
• Use a cool-mist humidifier in the bedroom to keep the air moist, which can ease throat pain.
• Give your child paracetamol or ibuprofen (age-appropriate, as recommended by your pharmacist or doctor) to reduce pain and fever.
• Encourage plenty of rest and sleep to help the body fight the infection.
• For older children, gargling with warm salty water can help soothe the throat (but do not let them swallow it).

Medical treatments

For bacterial sore throats, a doctor will prescribe a course of antibiotics. It is important to give the full course even if your child feels better after a few days. Pain relief medicines (like those containing paracetamol or ibuprofen) can also be given as needed. Your doctor or pharmacist can advise on the right dose for your child's age and weight. Do not give aspirin to children under 16.

When is surgery considered?

Surgery to remove the tonsils (tonsillectomy) is rarely needed. It may be considered only if a child has very frequent severe sore throats (e.g., 7 or more in one year) or complications such as a peritonsillar abscess. Your doctor will discuss this if appropriate.

Living with this condition

While your child has a sore throat, they may be more tired and irritable. Keep activities low-key, like reading books or watching a movie. Try to keep them comfortable and ensure they drink regularly. Most children feel better within a few days.

Lifestyle tips

• Encourage frequent handwashing to reduce the spread of germs to others.
• Avoid sharing cups, utensils, or toothbrushes with other family members.
• Keep your child home from school or daycare until they have had no fever for 24 hours (without fever-reducing medicine) and feel well enough to return.
• Maintain a healthy sleep routine to support the immune system.

Diet and exercise

There are no specific dietary restrictions, but soft, soothing foods can help. Offer lukewarm liquids, and avoid very acidic or spicy foods that might sting. Once the sore throat improves, your child can resume their normal diet and gentle activities as they feel able.

Mental health and emotional wellbeing

Being sick with a sore throat can make children feel grumpy, tired, or frustrated, especially if they miss school or play. Offer extra comfort and reassurance. Let them know it will pass. If the illness goes on for a long time or affects their mood significantly, speak to your doctor.

Prevention

It is not always possible to prevent a sore throat, but you can reduce the risk by encouraging good hygiene: regular handwashing, covering coughs and sneezes, and not sharing personal items. Avoiding close contact with sick people also helps.

Vaccines

There is no vaccine specifically for most sore throats, but vaccines for flu and COVID-19 can help prevent viral infections that may cause sore throat. The chickenpox vaccine also helps prevent one cause of throat illness (varicella). Talk to your doctor about recommended vaccinations for your child.

Screening programmes

There is no routine screening for sore throat in children. If your child has recurrent sore throats, your doctor may evaluate for underlying causes like allergies or reflux.

Complications

If left untreated

• If a bacterial sore throat (like strep) is not treated, it can sometimes lead to complications such as ear infections, sinusitis, or a peritonsillar abscess (a pocket of pus near the tonsils).
• Rarely, untreated strep throat can lead to rheumatic fever (which can affect the heart) or kidney inflammation (post-streptococcal glomerulonephritis).
• Viral sore throats do not usually cause complications; they resolve on their own.

Long-term outlook

The outlook for children with sore throat is very good. Most recover completely within a week with simple home care. When bacterial infections are treated promptly with antibiotics, the risk of complications is greatly reduced. Your child will soon be back to their usual self.

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