Sore throat in children

Key points about sore throat in children

  • Sore throats are common and most children will get better by themselves within a week.
  • However it's important for all Māori or Pasifika children and adults (aged 3–35 years) to have a throat swab or be treated for possible strep throat. This is to avoid some rare but serious long-term heart or kidney problems.
  • A sore throat, with or without other respiratory symptoms, such as a cough, fever, or runny nose, could also be a COVID infection. Test for COVID-19 and stay home until well.
Māori wahine holding tamariki
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DO

  • test for COVID
  • give pain relief such as paracetamol or ibuprofen 
  • check with a pharmacist if a throat spray or medicated lozenges are ok for your child
  • drink warm liquids, eg, honey and lemon (for tamariki aged 1 year and over)
  • eat cool or soft foods
  • give an ice block or suck ice (if old enough)
  • rest and drink plenty of fluids
  • see a nurse or GP for a throat swab or antibiotics if you or your child are Māori or Pasifika aged 3 to 35 years
  • allow older children to gargle with warm salt water (1 teaspoon of salt per glass of water).

DON’T

  • don’t expect antibiotics as these will not help most sore throats, unless your child is high risk as above
  • don’t give lozenges to young children as they might choke
  • don’t send your child back to day care, kindy or school until they are well. 
Girl with sore throat holding her neck

Image credit: Canva

Antibiotics are only needed if your child:

  • is at high risk for rheumatic fever
  • has a bacterial infection and tests positive for strep throat, or they have a severe sore throat, such as with scarlet fever. 

When should I see my healthcare provider?

For any of the following:

  • if you or your child are Māori, or Pasifika aged 3 to 35 years
  • babies under 6 months
  • a sore throat and a very high temperature, or feeling hot and shivery
  • a weakened immune system, eg, because of diabetes or chemotherapy
  • severe pain at the back of the throat
  • not able to drink much, or has a very dry mouth, or no pee (urine/mimi) for more than 8 hours
  • symptoms that aren’t improving after 48 hours
  • development of a rash
  • fever of 38°C or above for more than 5 days
  • symptoms getting worse or if you are worried
  • they often get sore throats
  • increased snoring or periods of stopping breathing when asleep.

When should I seek urgent help?

Call 111 and ask for an ambulance or go to the nearest hospital if your child:

  • has difficulty breathing, eg, is struggling for breath or making a grunting noise with each breath
  • has difficulty swallowing their own saliva – drooling can indicate this
  • is confused or drowsy 
  • has any other symptoms that appear life-threatening.

  • The most common cause of a sore throat is a viral infection.
  • A strep throat infection (Group A streptococcus bacteria) is a less common but important cause. 

Other conditions that can cause a sore throat are:

  • Ask your child to cover their mouth and nose when they sneeze or cough.
  • Don’t share eating utensils or toothbrushes.
  • Try to create space between your children when they sleep.
  • Keep your home warm and dry. 

Remember:

Māori and Pasifika children are most at risk of developing rheumatic fever and should see a doctor or nurse if they show ANY signs of a sore throat.

A sore throat with or without fever or other symptoms can be a sign of COVID-19 infection. You may need to test over several days before being sure this isn’t COVID.

Video: Rheumatic fever informative video

This video may take a few moments to load.

(Stop Sore Throats Hurting Hearts, NZ, 2016)

Video: Rheumatic fever

Rheumatic fever is a serious illness that affects the valves of the heart. It mainly affects children (aged 5-19 years) after a group A streptococcal (GAS) infection (which usually causes a sore throat). Hear more from Dr Nigel Wilson, Paediatric Cardiologist. This video may take a few moments to load.


(Morningside Productions Ltd, NZ, 2012)

Sore throat in children(external link) KidsHealth NZ
Rheumatic fever prevention programme(external link) Ministry of Health, NZ

Resources

References

  1. Sore throat(external link) Auckland Regional HealthPathways, NZ, 2020
  2. Sore throat (external link) Ministry of Health, NZ

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Janine Bycroft, GP

Last reviewed:

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