Sore throat

What is a sore throat?

A sore throat is not a disease, but rather a symptom of many common illnesses in children. The pain is caused by an infection accompanied by inflammation of the throat. A sore throat is often the result of tonsillitis (infection of the tonsils) or pharyngitis (infection of the back of the throat).

Most often, a virus such as the common cold, the flu, or mononucleosis is involved. Other upper respiratory tract infections (sinusitis, ear infections, bronchitis, etc.) can also lead to a sore throat.

Sometimes, a sore throat is due to a bacterial infection. It is usually a streptococcal infection, as in the case of scarlet fever.

Sore throats can come with a variety of symptoms, depending on what’s causing them:

• Difficulty swallowing
• Tender or swollen lymph nodes
• Fever
• Stomachache or headache
• Nausea and vomiting
• Red or swollen tonsils
• White, greyish, or yellow secretions on the tonsils

Sore throats are usually not serious, but depending on the cause, they can lead to complications. These occur mainly in cases of streptococcal infection or mononucleosis. However, complications are rare.

Treatment

Most sore throats are caused by a virus and require no medical treatment, as they will resolve on their own in a week or less.

However, in cases of infectious mononucleosis (caused by a virus), treatment with corticosteroids is necessary when enlarged tonsils interfere with breathing.

Care and practical advice

• To relieve pain and fever, give your child acetaminophen (Tylenol^® or Tempra^®) or ibuprofen (Advil^®, Motrin^®, etc.) as indicated and in the doses recommended for your child’s weight and age. Don’t give ibuprofen to babies under 6 months, and never give aspirin (acetylsalicylic acid, or ASA) to a child or teen.
• Give your child plenty of liquids such as water or juice. However, avoid citrus juices (orange, lemon, grapefruit), as these can irritate the throat. You can also offer them soft, soothing foods such as ice cream or yogurt.
• You can give your child a spoonful of honey before bedtime. Some studies suggest that honey may help sooth a sore throat. However, you should never give honey to children under 1 year old, as there is a risk of infantile botulism, a rare but potentially serious illness.
• If your child is 4 or older, you can give them sugar-free hard candies and lozenges containing honey, herbs, or pectinto soothe their sore throat.
• If they’re old enough to gargle without choking, let them to do so a few times a day with 2.5 mL (½ tsp) of salt diluted in a glass of lukewarm water.
• Encourage quiet activities. Your child doesn’t have to stay in bed all day, but they do need to rest.

Bacterial sore throat

If symptoms point to a sore throat of bacterial origin, the doctor may consider antibiotics.

For more information, consult our fact sheet on throat infections.

Prevention

Since a sore throat is most often caused by a cold or flu, follow the guidelines to prevent these infections.

• Wash your hands with soap after coming into contact with an infected person or touching an object they handled. Wash your child’s hands often. Teach them to do it themselves as soon as possible, especially after they cough, sneeze, or blow their nose.
• Teach your child to cough or sneeze into a tissue or into the crook of their elbow rather than into their hand.
• Clean toys, faucets, and door handles thoroughly, preferably with an alcohol-based cleaner.
• Avoid sharing food, utensils, glasses, or cups.
• Avoid contact with people who have a cold or the flu as much as possible.

When should you consult a doctor?

• Doesn’t play as usual, is lethargic or sleepy
• Is unable to swallow anything, including liquids
• Shows signs of dehydration (e.g., urinates less than twice a day)
• Has a rash
• Has trouble breathing
• Has a high fever (39 to 40 °C) that does not go down even with adequate medication, or has a fever that lasts more than 3 days
• Is taking antibiotics to treat a streptococcal infection, but doesn’t improve after one to two days of treatment

If your child suffers from recurrent sore throats (more than five a year), let your doctor know.

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician Research and copywriting:The Naître et grandir team Updated: August 2024

Photo: GettyImages/Tatiana Foxy