Sore throat in children

A sore throat is a common childhood problem. Usually, a sore throat gets better on its own after a few days, but sometimes it may require treatment with an antibiotic.

Maori and Pacific Island children are at high risk of developing rheumatic fever and should see a doctor or nurse if they show any sign of sore throat.

What causes a sore throat?

A sore throat is a common symptom of a number of illnesses ranging from the common cold to glandular fever. When bacteria or viruses infect the tissues at the back and sides of the throat, the body tries to fight the infection, which can cause the glands in the neck to swell and become tender.

Sore throat caused by a virus

  • Viral infections are the most common cause of sore throat (90%). 
  • An example of a viral sore throat is one which you get when you have a cold
  • Because the common cold is caused by a virus, this type of sore throat cannot be treated with antibiotics.

Sore throat caused by bacteria

  • Bacterial infections are the cause of about 1 in 10 sore throats (10%).
  • Infection with a bacteria called Streptococcus is the most common cause of bacterial sore throats. This is often known as strep throat.
  • Strep throat needs to be treated with an antibiotic to reduce the risk of heart or kidney problems.

What are the symptoms of a sore throat?

The main symptom of a sore throat is pain, discomfort or a raw feeling in the throat. This is usually worse when swallowing.

If a sore throat is caused by a cold, your child may also have a cough, red eyes and a runny nose (usually not seen with strep throat).

Children with strep throat may have:

  • a fever (greater than 38.5 degrees Celsius)
  • swollen tonsils, sometimes with white patches
  • swollen or tender glands in their neck
  • headache
  • stomach pain.

When to see a doctor

Maori and Pacific Island children are at high risk of developing rheumatic fever and should see a doctor if they show any signs of sore throat. 

  • Rheumatic fever is caused by untreated strep throat and can cause heart damage for life.
  • If you’re in the Northland, Auckland, Lakes, Waikato, Bay of Plenty, Gisborne/East Coast, Hawke’s Bay, Porirua or Hutt Valley areas and your child is Māori or Pacific, aged 4 to 19 years and has a sore throat, they can have it checked at a free sore throat clinic

For everyone else, you should see your GP or nurse if your child:

  • has symptoms that are not improving after 48 hours
  • is not drinking much or shows signs of dehydration (very dry mouth, no tears with crying and no wee for more than 8 hours)
  • has great difficulty swallowing
  • has swollen glands (feel for tender lumps in the neck) that are getting bigger
  • has any other symptoms you are concerned about.

Diagnosis and treatment

  • If strep throat is suspected, your GP or nurse will take a throat swab to be tested.
  • If strep throat is diagnosed, your doctor will prescribe an antibiotic, such as penicillin or amoxicillin.
  • Your child must finish the full course of antibiotics to make sure the strep throat does not cause rheumatic fever.
  • Children with strep throat need to be taking an antibiotic for 24 hours before they can return to school or daycare.

Looking after a child with a sore throat

  • Most sore throats are just part of a cold.
  • It is best to keep your child at home until any fever is gone and your child feels well enough to participate in normal activities.
  • Reassure your child and keep them warm and comfy.
  • Provide them with warm fluids to drink, such as chicken broth or apple juice.
  • A teaspoon of honey can provide some relief for younger children over 1 year of age (honey is not recommended for children under 1 year of age).
  • Older children may find relief by sucking on non-medicated lozenges (medicated lozenges are not suitable for children).
  • Children over the age of 8 years can gargle warm water with a little salt added.
  • Pain medicine, such as paracetamol or ibuprofen (in syrup form for young children), can be given in appropriate doses for severe throat discomfort or fever.

Learn more 

More than 3300 visits to free sore throat clinics NZ Government Press Release, 10 July 2014
It starts with a sore throat East Bays Courier, Auckland, 7 August 13
NZ children get better start to life  NZ Government Press Release, 8 July 2013
Budget 2013: Additional $21.3m to fight rheumatic fever  NZ Government Press Release, 21 May 2013
Rheumatic fever prevention programme NZ Ministry of Health, 2014
Sore throat in children KidsHealth NZ, 2014

Credits: Editorial team.