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 Pacific Peoples 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 Pacific Peoples 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) Health New Zealand | Te Whatu Ora

Resources

References

  1. Sore throat(external link) Auckland Regional HealthPathways, NZ, 2020
  2. Sore throat (external link) Health New Zealand | Te Whatu Ora

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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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