A sore throat is a pain, scratchiness or irritation of the throat that often worsens when your child swallows. It may come out of the blue if they’re fighting a viral or bacterial infection, and they may also experience cold symptoms like a runny or blocked nose, sneezing, a fever, coughing, headache, and they may complain of pain on swallowing. You might be able to feel the glands in their neck are enlarged and these can feel quite tender to touch. If you look in the back of their throat, you might see one or both tonsils are large and red, causing the gap between them to reduce, and you may notice some white spots on the tonsils.
The most common cause of a sore throat is a viral infection such as a cold or flu. Other causes can be due to bacterial tonsilitis, pharyngitis, swollen neck glands, sore throat in the aftermath of an infection, from swallowing something that has scratched, like crisps or a foreign object, or from breathing through the mouth when sleeping. It can also become sore from screaming or forceful vomiting.
It usually takes between 7 and 10 days for your child to clear any infection and a sore throat to resolve. It should be getting better during that time. If it lasts any longer, it’s worth speaking to a doctor.
The most important thing with any infection and fever is to keep drinking, but this can be hard with children, especially if swallowing is uncomfortable. Using a straw may encourage them, and sucking on ice cubes can also be a good way to maintain fluids and keep the area soothed. In children the best way to manage a sore throat is to give them regular painkillers such as paracetamol or ibuprofen, and these will also help settle a fever. You can also give them warm honey and lemon drink, to soothe the throat. Honey should not be given to children less than 1 year old as there is a risk of botulinum toxin. If your child is older, then they may be able to gargle with warm salt water to clear any pus that tastes bad. Difflam spray can be bought from the pharmacist to help with the pain of a sore throat. Children over 6 years old can have Strepsils, which are sore throat lozenges to help soothe their symptoms. If the sore throat is suspected to be caused by bacteria, antibiotics may be prescribed by their doctor.
If they are open-mouthed breathing or having other difficulty breathing, or they are drooling, you should seek urgent medical attention via the emergency department. If you notice very enlarged tonsils or white spots at the back of the throat, you should contact your doctor, and they can assess whether this is a bacterial tonsilitis that may improve with antibiotics. If their fever is not going down with paracetamol and ibuprofen, they are struggling to drink enough fluids and they are passing very little urine, they may be at risk of dehydration and you should contact their doctor urgently. In addition, their doctor will want to know if their sore throat has not resolved within 7 days or is getting worse.