The sore throat checklist: What parents need to know - Harvard Health

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Sore throats happen to children all the time — and most of the time, they are nothing to worry about. Sometimes, though, parents do need to worry. Here's what parents should know about sore throats.

Signs that a sore throat could be an emergency

First and most important, here's when a sore throat could be a sign of a real emergency:

  • When your child has any trouble breathing. The sore throat could be a sign of a swelling or blockage in the respiratory system.
  • When your child is having trouble swallowing, especially if they are drooling. This also could be a sign of dangerous swelling or blockage.
  • When your child has a high fever that won't go down, or unusual sleepiness. A temperature of 102° F or higher that won't go down with acetaminophen or ibuprofen, or unusual sleepiness, could be a sign of a serious infection.
  • When your child has severe, unrelenting pain. That kind of pain, anywhere, warrants immediate attention.

If any of those happen, you should take your child to the nearest emergency room.

More common reasons for sore throats in children

Luckily, such emergencies are rare. Sore throats can be caused by many things, including:

  • Viral infections. It's most likely a virus if along with the sore throat your child has a runny nose and cough, perhaps with body aches, fever, an upset stomach, or diarrhea. Many different viruses can cause these symptoms, including the one that causes COVID-19. If your child has these symptoms, you should call your doctor about COVID testing, even if you don't think they have been exposed. These days, even just a sore throat alone could be COVID. If your child has a sore throat that doesn't go away easily with something to drink and some distraction, check in with your doctor.
  • Allergies. Sore throats often come along with allergies, especially when stuffy noses lead to mouth breathing, which leads to a dry mouth. It can be hard to tell the difference between allergies and a virus. If the sore throat is mild and accompanied by a stuffy nose, sneezing, and some itchy eyes, chances are it's allergies. If you aren't sure, check with your doctor.
  • Bacterial infections, such as strep throat. It's more likely to be a bacterial infection if there is fever and there's no runny nose or cough. Sometimes children with strep throat will also have a headache, stomachache, and a sandpapery rash, as well as a voice that sounds like they are holding a hot potato in their mouth.
  • Irritants that are inhaled or swallowed. Exposure to irritants in the air, like air pollution, can cause a sore throat — as can swallowing anything that irritates the throat, like acids. Be sure to keep all dangerous things out of your child's reach. Call your doctor or a Poison Center (800-222-1222) if you think your child has gotten into anything.
  • Gastroesophageal reflux. When acid comes up from the stomach, it can lead to a sore throat. If your child has problems with stomachaches and/or heartburn along with the sore throat, that may be the cause. Talk to your doctor about this.

Preventing sore throats

To help prevent the infections that can cause sore throats, it's always a good idea to

  • wash your hands regularly (or use hand sanitizer if soap and water isn't available)
  • avoid touching your face
  • wipe down public surfaces before touching them
  • do your best to stay away from sick people.
In areas where COVID-19 infections are prevalent, wearing a mask can make a real difference — as can being vaccinated if you are eligible.

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