Sore throats are one of the most common childhood complaints. Understand why kids get sore throats, how to soothe your child’s pain, and when to call your clinician.
Viruses are responsible for most sore throats, which typically resolve in 7–10 days. This includes the common cold, flu, RSV, and hand foot and mouth disease.
Occasionally a sore throat signals a more serious problem. Bacterial infections like strep throat make up 20–30% of throat infections in school-aged children.
Other causes include allergies, post-nasal drip, dry air, mouth breathing, yelling and singing, acid reflux, or mono.
If you believe your child is experiencing a life-threatening medical emergency, please call 911 or go to the nearest emergency room.
Understanding When a Sore Throat Needs Care
It can be hard to decide whether a sore throat is just a passing cold or something that needs a clinician’s attention. Here are some signs to look for to help you confidently care for your child.
Home Care You can usually care for your child at home for the first 3 days when:
Your child has a sore throat but no fever
They are drinking fluids and urinating normally, even if they’re eating less.
Symptoms are mild and accompanied by typical cold signs (nasal congestion or cough).
There’s no vomiting, rash, abdominal pain or stiff neck.
Contact the Clinic Reach out to your Zarminali Pediatrics clinician if you notice any of the following:
Persistent or worsening sore throat that lasts more than 72 hours (3 days).
A sore throat with cold symptoms that doesn't improve after 5 days.
Fever 101 °F or higher.
Children under 3 months with any sore throat or fever of 101.4 or higher.
Additional symptoms such as vomiting, abdominal pain, headache or rash.
White pus on the tonsils or back of the throat.
Swollen glands that are painful to touch or a change in voice that sounds muffled or different.
Immunocompromised children should be seen sooner even with milder symptoms.
Seek Emergency Care Call 911 or go to the ER for:
Trouble breathing or noisy breathing.
Difficulty swallowing.
High fever that doesn’t lower with medication.
Significant voice change (muffled speech).
Refusal to drink liquids or signs of dehydration (dry lips, no tears when crying, fewer wet diapers).
Severe pain or a stiff neck.
Extreme sleepiness or the child is very hard to wake.
Other factors to consider for sore throat
Several factors can influence how we approach a sore throat.
1
Age
Babies and toddlers may not be able to tell you their throat hurts; instead, they refuse feedings or act fussy. Bring infants under 3 months to the clinic with any fever or feeding difficulty.
Children under 3 years rarely get strep throat; they are more likely to have viral infections. Strep is most common in 5–15 year‑olds.
Teens can develop mononucleosis (“mono”) caused by the Epstein–Barr virus. Mono causes sore throat, fever and swollen lymph nodes and lasts longer than a typical cold.
2
Vaccination Status
Vaccines help prevent some causes of severe sore throat. Unvaccinated children who develop a fever or sore throat should be seen promptly because some illnesses can progress quickly.
3
Chronic Conditions and Immune Status
Children taking steroids or those with chronic conditions that suppress immunity should be evaluated sooner for any sore throat. In these children, a mild viral infection can progress more quickly or become complicated.
4
Season and Environment
Viral sore throats peak in winter months but can occur year‑round. Strep throat tends to circulate in late fall through early spring. Allergies and post‑nasal drip can irritate the throat and mimic infection. Look for patterns with exposure to pollen, dust or pet dander. Dry air, smoke or yelling can also cause a scratchy throat without infection.
Home Remedies for Sore Throats
You can do a lot to ease your child’s sore throat at home. The goal is to keep them comfortable while their immune system clears the infection. These strategies are backed by pediatric guidelines.
Hydration Encourage plenty of fluids to loosen any mucus that’s in the throat.
Soothing foods Both warm and cold can soothe a scratchy throat: Think popsicles and slushes, or warm broths and non-caffeinated teas. Offer soft foods like yogurt, applesauce or soups. Avoid salty, spicy or citrus items that can irritate the throat.
Honey (for kids over age 1) A spoonful of honey every few hours coats the throat and may calm coughs that make sore throats worse. Research shows honey works better than over-the-counter cough syrups. Never give honey to infants under 12 months because of botulism risk.
Saline nasal drops or spray Clearing congestion with saline and gentle suction or nose‑blowing can lessen post‑nasal drip and soothe the throat. Salt water in the nasal passages shortens cold symptoms and reduces spread to family members.
Warm salt-water gargles (kids over 8 years) Dissolve salt in warm water for gargling to help bring down swelling.
Pain relief Acetaminophen or ibuprofen can ease throat pain and lower fever. Check doses carefully by age and weight. Don’t give aspirin to children or teens.
What to avoid Skip over‑the‑counter cough medicines, which don’t work any better than honey and come with side effects.
Understanding Your Child’s Sore Throat
Why testing matters
It’s important to know whether your child’s sore throat is viral or bacterial because antibiotics only help bacterial infections. Most viral sore throats improve without medication. For strep throat, antibiotics can speed recovery, reduce contagiousness and prevent complications.
Your pediatrician may perform a rapid strep test, which gives results in about 10–15 minutes. If positive, a 10‑day course of antibiotics is prescribed. Children need to take all ten days of antibiotics — even if they begin to feel better. They remain contagious until they have taken antibiotics for 24 hours. You should replace their toothbrush after 24–48 hours and sterilize drinking utensils to prevent reinfection.
Child Sore Throat FAQ
Why does my child have a sore throat with no other symptoms?
Early in a cold, a sore throat may be the first sign before cough and runny nose appear. Some viruses cause a sore throat without other cold symptoms. Dry air, allergies, shouting or acid reflux can also irritate the throat.
How long should a sore throat last?
Viral sore throats usually improve after 3–5 days and resolve within 7–10 days. If your child’s sore throat lasts longer or doesn’t improve, call your pediatrician.
How do I know if it’s strep throat?
Only a throat swab can confirm strep. Strep throat often comes on suddenly. It may include high fever, stomach aches, painful swallowing, pus on the tonsils, swollen glands and sometimes a sandpaper‑like rash. Cough, runny nose and hoarse voice are unusual in strep. Strep is most common in ages 5–15.
Is a sore throat contagious?
Viral sore throats are contagious for several days before symptoms start and until they resolve. Strep throat remains contagious until 24 hours after starting antibiotics. Teach your child not to share cups or utensils and to wash hands frequently. Sanitize their cups and replace toothbrushes when they start feeling better to avoid reinfection.
Can allergies cause a sore throat?
Yes. Allergies and post‑nasal drip can irritate the throat. Manage nasal congestion with saline spray and allergy medications (if recommended by your clinician).
When can my child return to school or daycare?
Your child can return once they are fever‑free and feel well enough to participate in normal activities. Children treated for strep throat need to have taken an antibiotic for at least 24 hours before going back.
Can I give my child throat lozenges or cough drops?
Lozenges may help older kids (over 6 years) but are a choking hazard for younger children. Medicated sprays and lozenges are generally not helpful and aren’t recommended for young children. Honey works best for kids over 1 year old.
Are there any remedies I should avoid?
Avoid giving honey to infants under 1 year. Never give aspirin to children or teens because of the risk of Reye’s syndrome.
When to call Zarminali Pediatrics
Trust your instincts. If your child’s sore throat worries you, reach out to us. We want to hear from you if you notice any of the following:
Sore throat in a baby under 3 months, or refusal to feed
Sore throat not improving after three days of home care
Difficulty swallowing, drooling or refusing to drink
Sore throat with other symptoms (fever, rash, headache, stomach pain, vomiting, earache or voice change)
