Sore Throat

Sore throats are a common complaint in children, especially during the late fall and winter months.  They are usually the result of throat inflammation.  The most common causes of sore throats are viral infections, strep infections and infectious mononucleosis.


Viral infections are the single most common cause of sore throats.  Sore throats can be caused by many viruses and are often associated with a runny nose and cough. Fever and redness of the throat may also be present. A viral sore throat last for approximately 3 to 4 days but may last up to 1 week.

Strep infections are the most common bacterial cause of sore throats.  Similar to viral throat infections, strep is often associated with fever and redness of the throat. Additional symptoms of strep may include pus on the tonsils, swollen lymph nodes, headache, stomach ache and rash.  Cough and runny nose are not usually signs of strep.  Strep infections are uncommon in children under age 3 and require in office testing for diagnosis. As strep is a bacterial infection, it requires antibiotics for resolution.

Infectious Mononucleosis  (mono) is one specific viral sore throat which sometimes has different signs and symptoms and often last longer than a classic viral sore throat.  Mono is most common in adolescents.  Similar to viral infections, children with mono often have red swollen throats.  They may also complain of fatigue, upper stomach discomfort and swollen lymph nodes.  Symptoms of mono are often worse in the first 2 weeks, but may linger for 4-6 weeks.  An in office test and/or blood test can diagnose mono, but there is no treatment for mono. 

Symptom management

  • Hydration - It is important to ensure that your child is drinking well, as this reduces the severity of symptoms and the risk of dehydration. In children over 1 year, warm fluids such as tea or chicken broth may help soothe a sore throat. If you have any concerns about whether your child is well hydrated please call our office.
  • Throat Lozenges – in children over age 4, sucking on a hard candy (especially butterscotch) or cough drop may provide comfort
  • Warm Salt Water Gargles (1/4 tsp of salt per glass) may temporarily reduce or relieve sore throats.
  • Soft foods, especially those with a lower acidity, may be easier to swallow with as sore throat.
  • Analgesics – Acetaminophen (Tylenol) or Ibuprofen (Motrin/Advil) may be beneficial for temporary relief of a sore throat.  Acetaminophen may be given every 4 hours and Ibuprofen may be given every 6 hours if needed for comfort.  Consider trying an analgesic if your child is refusing fluids.
  • Antibiotics – antibiotics are only useful for bacterial sore throats, such as those caused by strep infections. If your child is prescribed antibiotics, be sure to use the medication exactly as prescribe.  Additionally, children with bacterial sore throats are contagious until they have been on the medication for 24 hours.


  • Hand washing - Frequent and thorough hand washing can help reduce the risk of any infection, including sore throats.  Encouraging children to limit touching their face, mouth or nose also helps reduce the development and spread of sore throat viruses and strep. 
  • Disinfectants - Frequent cleaning of surfaces with antibacterial and antiviral non-toxic products helps reduce the risk of developing or spreading most illnesses.
  • Avoid sharing drinks and utensils – sore throats may be spread through sharing saliva.  To limit the spread of illness encourage children to avoid sharing drinks, utensils and other items that may result in contamination from another persons saliva.

When to call

Call our office immediately if in addition to a sore throat, your child has excessive drooling or difficulty swallowing, difficulty breathing or is acting very sick.  Also call our office if you’re believe your child may have strep or mono. 

Takeaway message

Most sore throats are caused by viral infections and resolve without specific treatment.  Management of sore throats is geared towards comfort and promoting hydration.

Additional information

  • Information on viral or strep sore throats from the American Academy of Pediatrics.
  • Information on mono from the American Academy of Pediatrics