The Campaign For Children's
Children's Hospital and Regional Medical Center
HomeOur ServicesChild Health & SafetyFor Health Professionals
Health & Safety InformationChild Health AdviceClasses & EventsNewsletters
Skip to main content.

Sore Throat

Description / Symptoms

Pain, discomfort or raw feeling of the throat, especially when swallowing. Children less than 2 years of age usually don’t know how to complain about a sore throat.

A young child who refuses previously enjoyed foods or begins to cry during feedings may have a sore throat. Their symptoms are usually better covered using the dehydration (drinking fluids, decreased) guideline.

Cause

Most sore throats are part of a cold. In fact, a sore throat is often the first symptom. Of persistent sore throats, about 20% are caused by the Strep bacteria. Only these need an antibiotic.

See More Appropriate Topic (instead of this one)

  • If sore throat is mild and the main symptom is croup (because croupy cough is rarely seen with strep), see Croup
  • If sore throat is mild and the main symptom is cough (because cough is rarely seen with strep), see Cough

When to Call Your Doctor for Sore Throat

Call 911 Now If:

Severe difficulty breathing (struggling for each breath, making grunting noises with each breath, unable to speak or cry because of difficulty breathing).

Call Your Doctor Now If:

  • Your child looks or acts very sick
  • Difficulty breathing, but not severe
  • Great difficulty swallowing fluids or saliva
  • Stiff neck
  • Fever > 105°F (40.6°C)
  • Signs of dehydration (very dry mouth, no tears with crying and no urine for > 8 hours)
  • Purple spots or dots on skin

Call Your Doctor Within 24 Hours If:

  • You think your child needs an office visit or throat culture
  • Sore throat pain is severe and not improved 2 hours after taking ibuprofen
  • Pink rash that's widespread
  • Earache or sinus pain/pressure
  • Fever has lasted > 3 days
  • Age < 2 years old
  • Exposure to Strep within last 7 days
  • Sores present on the skin
  • Sore throat is the main symptom and persists > 48 hours

Call Your Doctor During Weekday Hours If:

  • Sore throat with cold/cough symptoms is present > 5 days
  • You have other questions or concerns

Home Care (Read "Call Your Doctor…" first):

Reassurance

Most sore throats are just part of a cold. The presence of a cough, hoarseness or nasal symptoms points to a cold as the cause of your child's sore throat.

Local Pain Relief

  • Children over age 1 can sip warm chicken broth or apple juice
  • Children over age 4 can suck on hard candy (e.g. butterscotch) or lollipops
  • Children over age 6 can also gargle warm water with a little table salt or liquid antacid added

Pain Medicine

Give acetaminophen (e.g. Tylenol) or ibuprofen for severe throat discomfort or fever > 102°F (39°C).

Soft Diet

Cold drinks and milk shakes are especially good. (Reason: Swollen tonsils can make some foods hard to swallow).

Contagiousness

Your child can return to day care or school after the fever is gone and your child feels well enough to participate in normal activities. Children with Strep throat also need to be taking an oral antibiotic for 24 hours before they can return.

Expected Course

Sore throats with viral illnesses usually last 4 or 5 days.

Call Your Doctor If:

  • Sore throat is the only symptom AND lasts > 48 hours
  • Sore throat with a cold lasts > 5 days
  • Fever lasts > 3 days
  • Your child becomes worse or develops any of the "Call Your Doctor…" symptoms

Parent Care for Pediatric Symptoms. Copyright 2000-2006.