How can you soothe a child’s sore throat?

In children, sore throats are typically caused by viral infections such as colds or the flu (influenza). These infections are the most common. Bacterial infections, including those caused by streptococcus A (strep A) are less common.

Other infections or factors may also be involved [2]:

• certain infections, such as COVID-19, whooping cough and measles;
• bacterial pharyngitis;
• allergies (dust, pollen, mites);
• a dry or irritated throat;
• irritants in the air (smoke, dry air, fine particles).

A sore throat can be accompanied by several other common symptoms, such as: [3]

• a burning, itchy or scratchy sensation at the back of the throat;
• pain or difficulty swallowing;
• fever;
• hoarseness;
• bad breath;
• cough, runny nose or sneezing.

However, some symptoms require closer monitoring. Their presence requires prompt consultation with a healthcare professional, or even a visit to the emergency room.

Prompt consultation with a doctor is recommended if the child has any of the following symptoms [4]:

• persistent fever (above 38.5°C) for longer than 48 hours;
• severe sore throat that does not improve despite home remedies;
• refusal to eat or drink due to the pain;
• sore throat accompanied by a rash or swollen glands;
• a white abscess in the throat;
• deterioration in overall health.

A visit to the emergency room is required if the child has any of the following symptoms:

• rectal temperature above 38°C in a child under 3 months old;
• severe difficulty breathing or swallowing;
• unusual paleness or bluish lips and fingers;
• signs of dehydration: dry mouth, lack of tears, decreased urination.

In most cases, sore throats are caused by viruses. A child’s immune system can fight off the infection in a few days to a week. Treatment, therefore, consists mainly of alleviating the pain [5].

Here are some effective ways to do this:

• Make sure they drink small quantities often. Choose cold, mild, non-irritating liquids. Citrus juices should be avoided.
• Offer soft foods like purées or frozen foods, such as frozen yogurt. 

If needed, give them pain relief medication, making sure to follow the dosage instructions based on their weight:

• Option one (child more than 3 months old): acetaminophen
• Option two (child more than 6 months old): ibuprofen

About honey

Honey can help sooth sore throats in children over one year of age. However, it is contraindicated for children under one year of age, even in small quantities or in recipes. Both pasteurized and unpasteurized honey can cause a serious form of food poisoning known as infant botulism [6].

Unlike viral infections, bacterial infections – which account for about 20% of sore throats in children – require both pain relief medication and antibiotics to eliminate the bacteria responsible.

Group A streptococcus is the most common cause of bacterial infection resulting in sore throats in children aged 5 to 15 years. This infection is less common in children under the age of three. It lasts around seven days, with or without antibiotics. However, untreated streptococcus A infections can lead to serious complications such as:

• an abscess on the tonsils;
• acute rheumatic fever;
• kidney inflammation.

Conversely, it is contraindicated to prescribe antibiotics if there is no bacterial infection. Unnecessary use of antibiotics promotes the development of antibiotic-resistant bacteria. The challenge, therefore, lies in quickly distinguishing a viral infection from a bacterial infection.

The best way to do this is to confirm the presence of strep A with a throat swab.

The rapid strep A test (Strepto Direct) is a simple, fast test and does not require a medical prescription. A preliminary positive result, obtained in a few minutes, confirms the presence of strep A. An antibiotic can then be prescribed on the spot by Biron [8].

A negative rapid test result, however, does not completely rule out the presence of strep A. In this case, the sample must be analyzed in the lab to confirm the result, by one of the following methods:

• bacterial culture (results available up to 48 hours later);
• bacterial DNA amplification (PCR) (results available in less than 24 hours).

Sore throats are common in children. In 80% of cases, they are caused by common viral infections such as colds or the flu (influenza). These infections resolve on their own in a few days, without complications.

In 20% of cases, sore throats are caused by a group A streptococcal bacterial infection. This infection is more severe and, if left untreated, can lead to serious complications.

Although some symptoms can help guide the diagnosis, the most reliable way of distinguishing a bacterial infection from a viral infection remains the rapid strep A test, confirmed as needed by lab analysis.

Lastly, parents should always pay close attention to the symptoms and promptly consult a healthcare professional when their child’s condition requires it.