Sore Throat

Symptom Definition

  • 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 captured by the Drinking Fluids, Decreased guideline.
  • Cause: most sore throats are part of a cold. Of severe sore throats, about 20% are caused by the Strep bacteria. Only these need an antibiotic.

See More Appropriate Topic

  • If sore throat is mild and the main symptom is croup, hoarseness or a cough. (Note: these symptoms are rarely seen with Strep). (See Croup or Cough)

Call 911 Now (your child may need an ambulance) 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 (night or day) If

  • Your child looks or acts very sick
  • Difficulty breathing, but not severe
  • New drooling (can’t swallow fluids) or having great difficulty swallowing
  • Fever > 104°F (40°C) or stiff neck
  • Signs of dehydration (very dry mouth, no tears with crying and no urine for > 8 hours)

Call Your Doctor Within 24 Hours (between 9 and 4) If

  • You think your child needs an office visit or throat culture
  • Sore throat pain is severe
  • Rash that’s widespread
  • Earache or sinus pain/pressure
  • Fever has lasted > 3 days
  • Age < 1 year old
  • Recent exposure to Strep
  • Sores present on the skin
  • Sore throat is the main symptom and persists > 24 hours
  • Sore throat with viral syndrome is present > 3 days

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

Parent Care at Home If

  • Probable viral throat infection and you don’t think your child needs to be seen

Home Care Advice for Sore Throats

  1. 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.
  2. 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
  3. Pain Medicine: Give acetaminophen or ibuprofen for severe throat discomfort or fever > 102°F (39°C).
  4. Soft Diet: Cold drinks and milk shakes are especially good. (Reason: Swollen tonsils can make some foods hard to swallow.)
  5. 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.
  6. Expected Course: Sore throats with viral illnesses usually last 3 or 4 days.
  7. Call Your Doctor If
    • Sore throat is the main symptom AND lasts > 24 hours
    • Mild sore throat with a viral syndrome lasts > 3 days
    • Fever lasts > 3 days
    • Your child becomes worse or develops any of the “Call Your Doctor Now” symptoms