Sore and Strep Throats in Kids

Female pediatrician looking in young girl's mouth

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When a child has a sore throat, the first thing that most parents think of is strep throat. Although strep is a common childhood infection, it is important to keep in mind that there are a lot of other things that can cause your child to have a sore throat. These include viral infections of your child's throat, colds, allergies that can cause a sore throat secondary to post-nasal drip, and even reflux.

Causes of a Child's Sore Throat

It can help to uncover what might be causing your child's sore throat if you first understand some of the medical terms related to sore throats, including:

  • Tonsillitis: An inflammation or infection of the tonsils, which can be caused by strep and many viral infections. So while strep throat is a form of tonsillitis, so is mono and other viral infections.
  • Pharyngitis: An inflammation or infection of the pharynx, the area of the mouth near the tonsils. While most people use the terms tonsillitis and pharyngitis to mean the same thing, with pharyngitis, the inflammation isn't limited to the tonsils. Like tonsillitis, both strep and viruses can cause pharyngitis.
  • Post-Nasal Drip: Drainage down the back of your throat from a cold, sinus infection, or allergies and which can cause a sore throat without tonsillitis or pharyngitis.


Recognizing any other symptoms that your child has can also help you determine what might be causing your child's sore throat.

For example, with strep throat, children will often have classic symptoms that can include:

  • Fever
  • Sore throat (pain on swallowing)
  • Red tonsils that might have a thick white exudate (pus) on them
  • Swollen lymph nodes (glands) that can be tender
  • The sandpaper-like rash of scarlet fever
  • Headache, abdominal pain, nausea, vomiting

On the other hand, children who have a virus that is causing their sore throat will often have a cough, diarrhea, pink eye, mouth ulcers, a hoarse voice or a runny nose.

Symptoms That Indicate Mono

Besides strep, colds, and allergies, infectious mononucleosis — or mono — is the other condition that can have classic symptoms. These mono symptoms can include:

  • A sore throat, which is often described as the worst sore throat the child has ever had
  • A high fever
  • Enlarged lymph nodes or glands in the neck, armpit, or groin
  • Malaise and fatigue (not feeling well and feeling tired)
  • Anorexia (loss of appetite)
  • Muscle aches
  • A rash, especially if your child was taking antibiotics, like ampicillin or amoxicillin
  • Headache
  • Nausea
  • Abdominal pain

Irritation, reflux, and other infections can also less commonly cause children to have sore throats.

What to Do When Your Child Has a Sore Throat

Recognizing what might be causing your child's sore throat can be difficult, even after a doctor's visit, which is why your pediatrician will often do a strep test when your child complains of a sore throat. This is especially important when you consider that strep throat is one of the few causes of a sore throat that you can treat with antibiotics.

Most other infections will not be helped by antibiotics or need other types of treatments altogether, such as antihistamines for allergies or acid reducers for reflux.

Symptomatic Sore Throat Treatments

Ideally, your pediatrician will be able to treat the underlying cause of your child's sore throat, whether it is strep throat, sinusitis, or allergies. Unfortunately, especially when your child has a viral infection, such as mono, the sore throat will have to get better on its own.

There are often some things that you can do until then to help your child feel better, though, including:

  • Giving your child a pain reliever, such as acetaminophen (Tylenol) or ibuprofen (Motrin).
  • Encouraging your child to drink cool drinks, eat popsicles, and avoid acidic drinks (orange juice, lemonade, etc.), which can irritate a sore throat.
  • Offering hard candy, throat lozenges, or lollipops for older kids (remember that these are a choking hazard for younger toddlers and preschool-age children, though).
  • Encouraging your child to gargle with warm salt water (most kids don't like to do this, though).
  • Using a sore throat spray, such as Chloraseptic Sore Throat Spray for Kids, which can be given to kids as young as age two years (most kids don't like to use throat sprays either).
  • Asking your pediatrician about a prescription of Benadryl, Maalox, and viscous lidocaine, a mixture that can be used as a "swish and spit" in your child's mouth to help ease more severe throat pain.

By Vincent Iannelli, MD
Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.