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Sore throats are quite common in all children and may occur several times a year. Sore throats can be either bacterial or viral infections and it's not always clear which. We'll break it down for you.
What causes a sore throat?
Generally there are two types of infections that cause a sore throat:1) A viral infection. Viral infections go away by themselves and don't require antibiotics. Children with sore throats due to a virus can be managed at home and do not necessarily even require a doctor visit.2) A bacterial infection. Strep throat is a bacterial infection, and it's caused by a type of bacteria called Streptococcus. Bacterial infections should be managed with an antibiotic such as Amoxicillin. If strep throat isn't managed with an antibiotic, the infection may worsen and spread, and even cause other problems such as rheumatic fever or kidney problems.
How do I know if it's strep throat?
Check the symptoms.Strep throat generally causes a fever and a sore throat which is red with swelling. It does NOT generally cause a runny nose & congestion - so if your child has those symptoms, it is more likely to be a general virus than strep. Kids with strep may also have a headache and a bellyache or occasionally vomiting, so it isn't always clear cut.Do a strep test.If your child is over 3 years old, you or your doctor can perform a throat swab test to confirm whether your child has strep throat. In the test a cotton swab is rubbed against the back of your child's throat and tonsils. Historically, this was and is still usually performed by a pediatrician during an in-person sick visit, but with a concierge pediatrician like Blueberry Medical, you can do this yourself at home and get prescriptions without going in for an in-person visit. If you're interested in how this works, see the article on how we do our at-home strep diagnosis. In general though, there are 2 types of strep tests you'll see:1) 5-minute rapid strep test - The rapid test can be done in under 5 minutes either at home or at the doctors office. The rapid tests today will catch about 70-90% of strep infections. If it shows positive, your child is diagnosed with strep, but if it shows negative, there is still a chance that the test simply missed it.2) Cultured strep test - This is for when the rapid strep test shows negative, but other signs point to strep and your doctor wants to be especially sure. Strep culture tests are run in a lab and take 24 - 48 hours, but they are close to 95% accurate. Most doctors offices don't have a lab on-site that can perform the culture, so they send the cotton swab to a lab.
When is a sore throat an emergency?
It should be treated as an emergency if your child:
- Has a muffled-sounding voice.
- Has a stiff neck or difficulty opening the mouth.
- Is having trouble breathing.
- Is drooling much more than usual.
Treating a Sore Throat at Home
There are a few things you can do to help relieve the pain:
- Liquid foods and drinks: try a fruit smoothie or soup. A popsicle is usually a winner as well.
- Acetaminophen (Tylenol) or Ibuprofen (Motrin, Advil) can help with the pain. Make sure you're giving the correct dose for your child's size.
- A hard candy or lozenge may help if the child is older.
- Honey is a great natural soother and can be given to kids over 1 year.

Liquid foods like smoothies are a great way to get some calories into your child while easing the throat. Image source.
When can my child go back to daycare or school?
If your child had a fever, he or she should stay home for at least 24 hours after the fever has gone away. If the cause is strep throat, your child should be on antibiotics and fever free for 24 hours.
How can I stop this from happening again?
The best ways to avoid infection are to teach your kids to wash their hands frequently and to keep their hands away from their face.
