When it comes to sore throats in children, it’s important to know how to make them feel better and when it’s time to see a doctor. During winter, children spend more time together indoors at home or school, which gives strep and viruses that lead to sore throats more opportunity to spread.
According to Christi Arnerich, MD, an ear, nose and throat specialist at Stanford Medicine Children’s Health, a sore throat can have many causes, including a strep infection or viral infection. “A sore throat is just a symptom; it doesn’t actually tell you where it originated from. A lot of them are from communicable-type infections that can be picked up in daycare or school, but it also might just be postnasal drip from an old upper respiratory infection,” she explains. “Dryness in the air is also something that can cause a sore throat, especially if your child is a little bit congested and wind up mouth-breathing throughout the night.”
A sore throat can be painful so finding out how badly it hurts is one way to tell if your child needs to see a doctor. Dr. Arnerich says, “The thing to look out for would be, is it a sore throat that they can deal with and maybe it gets better as the day goes on? Or is it one that sticks with them throughout the day to the point that you’re having to change their diet because of how bad it hurts?”
If a child is having a lot of pain or trouble swallowing, there is a good chance that they need medical attention. “If swallowing is declining rapidly to the point that they’re not wanting to take any water, or if they’re beginning to drool to the point that they’re not swallowing their secretions, that’s absolutely a huge red flag.”
Older children may be able to tell you how they feel but with younger children you need to look for other signs that they have a sore throat. Your child may start wanting soft foods like yogurt instead of harder, crispy foods like Cheerios and crackers, or perhaps they are eating less overall. They may also point to their throat or tug at their ears. “Often one of the other symptoms with a very bad bacterial infection would be ear pain. A lot of times they might start grabbing at their ears, as opposed to pointing to their throat” she said. “If they get a bad enough sore throat that their ears are starting to hurt, it definitely warrants being evaluated.”
Children usually recover from sore throats with rest and drinking plenty of fluids. “If you start to see the signs of a cold, using a little bit of humidification or nasal moisturizing, like a saline spray, might decrease the severity of their symptoms. Children over the age of two can use a nasal steroid to see if it can reduce the inflammation,” Dr. Arnerich explains. Finding soothing foods can help too. “If they have a little bit of hot soup or softer food items, that could help them maintain their nutrition and hydration status,” she adds.
When sore throats occur more than six times in a year, or the child doesn’t improve within a week, it may be time for further investigation with a specialist like Dr. Arnerich. “If the pediatrician suspects that there’s some sort of abscess developing back there, so high fever, ear pain, not swallowing, drooling — factors that would seem to echo that there might be that larger infection going on — I get called in,” she said.
Even serious cases can get better with the right care. When in doubt, see your child’s pediatrician. “Nobody wants to see their child in pain. But if it seems like they’re making it through and very gradually getting better, then it will most likely resolve.”
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