Baby and Child Health

It’s frustrating as a parent to watch your child suffer with a sore throat. Here are the main things you should know.

What causes sore throat in children?

The most common cause of sore throats in children are infections which can be caused by viruses most commonly and sometimes bacteria

So should my child get antibiotics just in case?

Most infections causing sore throats – even those caused by bacterial infections – are ‘self limiting’ which means they will get better in their own with supportive care which can be given at home such as giving pain relief and oral fluids.

Giving antibiotics as a routine is not advised in most healthy children – they may cause side effects including diarrhoea and vomiting as well as risking antibiotic resistance in the future.

Some exceptions are:

• In countries where a disease known as rheumatic fever is common doctors may use different protocols to assess and give antibiotics
• If your child has signs of scarlet fever or had exposure to a child with scarlet fever (see below)
• Outbreaks of severe invasive group A streptococcal disease in children may change antibiotic prescribing practices

When should I seek medical help when my child has a sore throat?

It is rare for a throat infection to cause a serious illness such as sepsis. The most important thing to say is that you know your child best. One of the most important aspects to consider is how your child is behaving – if they are consistently not responding to cues as they normally would or just ‘not right’ then get them seen urgently.

Having said this children can be often be unsettled at times with a sore throat and sometimes more so with fever – but if they also tend to perk up this is reassuring and in keeping with normal illness patterns.

Other factors which would need medical review are:

• Fever for 5 days or more
• Insufficient fluid intake
• Reduced passing urine – for example not passing urine all day or a small amount in one sitting
• Signs of, or exposure to scarlet fever, a highly contagious infection requiring antibiotics to limit spread and complications

Excellent detailed advice on assessing and treating unwell children with fever is given on the NHS website here

What can I do to help my child with sore throat?

• Give them fluids little and often, even if it involves syringing in small amounts such as 5ml every 5 minutes. In some circumstances this may well be how they will tolerate fluids. Don’t be too upset if they are not having much my way of food for a couple of days as long as they are keeping well hydrated (eg with apple juice diluted 50:50 with water). This is key to avoid a hospital admission due to dehydration
• If they complain of regular pain it is reasonable to give them regular analgesia for a whole day – pick one of Ibuprofen or Paracetamol rather than using both. You can use the other medication for breakthrough pain if needed
• If your child is really struggling with the pain, and especially if they also have issues with or tonsillitis a numbing throat spray such as benzydamine (trade name difflam) may be very helpful to increase fluid intake – ask your doctor or pharmacist if it would be useful to prescribe this
• There is some evidence that honey provides some symptom relief for upper respiratory tract infection in children over 1 year of age (particularly cough). This can be used in combination with ginger as a complementary therapy (although there isn’t clear evidence that it is helpful).