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My child seems to have a sore throat – he's uncomfortable swallowing and his cry sounds scratchy. Could it be caused by an infection?
It's possible. Your child may have a sore throat caused by any one of a number of illnesses, such as a cold or flu virus. Measles, chickenpox, and croup can also cause a sore throat. In fact, the most frequent cause of a sore throat is a viral infection. If the doctor diagnoses tonsillitis, it means that the bumpy tissue on either side of the back of your child's throat is infected with a virus or bacteria.
The most common bacterial culprit is streptococcus (strep), but this is unusual in babies and toddlers. Another bacterial infection that can cause a sore throat is whooping cough.
Irritants in the air – secondhand tobacco smoke, cat or dog dander, dust, and pollen from ragweed, grass, and trees – can also bother a child's throat and trigger the cold-like symptoms known as allergic rhinitis, or hay fever.
Even dry heat can make it hard for your child to swallow if he tends to sleep with his mouth open. If this is the case, his mouth will be dry when he wakes up, but he'll feel fine as soon as he's had something to drink.
There are other reasons why your child might have difficulty swallowing. If he has lesions in his mouth from gingivostomatitis (which can also cause a sore throat) or hand, foot, and mouth disease, for example, they can keep him pretty miserable. So might thrush or teething – could a new tooth be making its way out?
Should I take my child to the doctor?
If your child has sores in her mouth, you'll want to have the doctor take a look at them. And because bacterial infections can spread and damage other parts of your child's body if left untreated, it's important to have the doctor look at your child's throat if you think it's anything more than dry or mildly irritated.
Also bring your child to the doctor right away if:
- her throat looks infected (bright red, swollen, or flecked with pus)
- you think she can't swallow easily or open wide
- her breathing is labored
- she has a loss of appetite, signs of dehydration, excessive drooling, a stiff neck, or over-the-top crankiness
If you decide that your child's sore throat is mild enough that it doesn't warrant a trip to the doctor, still give him a call if it lasts longer than a week.
Head to the doctor if your child is younger than 3 months and is running a fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher. If he's at least 3 months old, ask his doctor about any fever. She may want to see him if he's between 3 and 6 months old and he has sore throat symptoms and his fever gets to 101 degrees F (38.3 degrees C), or if he's over 6 months and it reaches 103 degrees F (39.4 degrees C).
Is a sore throat ever an emergency?
Very rarely. The only throat condition that's truly an emergency is epiglottitis, which is now extremely rare thanks to the Hib vaccine. An infection of the flap of throat tissue that prevents food and liquids from going down the windpipe, epiglottitis makes it hard to breathe as well as to swallow.
A child with epiglottitis quickly turns feverish (with a temperature above 101 degrees F), develops raspy breathing, and often drools. If your child has these symptoms, call the doctor immediately. If your child's having trouble breathing, call 911.
If you suspect epiglottitis:
- keep your child sitting up
- don't try to examine his throat
- don't offer him food or drink, as it could make breathing more difficult
If the doctor thinks it might be epiglottitis, you'll need to take your child directly to the emergency room for treatment.
If my child has an infection, how will it be treated?
For most viral infections, no treatment is available or necessary. Your child's immune system can generally overcome a virus within a week. She'll benefit from plenty of rest and fluids.
If your child's doctor suspects a bacterial infection, he'll take a sample of cells from her throat. This quick test is easier to endure than a shot. The doctor swabs the back of the throat – gag! – and it's over.
Most doctors will run a rapid strep test that provides results within 10 minutes. If the test is negative, the sample will usually be sent for a more accurate one- to two-day culture, to double-check the results.
If it turns out that your child does have a bacterial infection (like strep), the doctor will prescribe an antibiotic. Follow the instructions to the letter for giving your child her medication. Don't slack off – if you stop giving the antibiotic too soon, the bacteria can rally and reemerge quickly in a more severe form.
If your child develops an aggressive infection, you may have to bring her to the hospital for several days to receive drugs or fluids intravenously.
How contagious is a sore throat?
Bacterial and viral infections are very contagious. Wash your child's hands frequently and, if he's old enough to be eating solids, make sure nobody shares eating utensils, cups, or toothbrushes with him. Wash your own hands often, too, especially after diaper changes.
Your child's doctor will let you know how soon your child can go back to daycare, but in general you'll need to keep him home until he's feeling better and – if it's a bacterial infection – he's been on his antibiotic for at least 24 hours.
How can I ease the pain of my child's sore throat?
If your child's old enough to be eating solids, warm beverages – tea or broth, for example – can be soothing. (Skip the honey in the tea until your baby is at least a year old, though. Honey may contain botulism spores that can grow in a baby's immature intestinal tract.) Children older than 12 months might also enjoy a little apple juice or an ice pop. Avoid citrus juices, though, as these can make your child's throat feel worse.
Keep in mind that it's important to keep your child from becoming dehydrated, so even though it may hurt to swallow, she'll need plenty of fluids, especially if she's running a fever. For young babies, that means breast milk or formula. If it's hard for your baby to swallow, try giving her smaller amounts to drink more frequently than usual.
If your child's really uncomfortable, ask the doctor whether you can give her a pain reliever such as infant acetaminophen or, if she's 6 months or older, ibuprofen. Never give a child aspirin, which is associated with a rare but serious condition called Reye's syndrome.
Try a cool mist vaporizer or humidifier in your child's bedroom to moisten the air and soothe her throat. Be sure to keep the filters clean, or they can add germs to the air.