Sore throat and tonsillitis

Pharyngitis and tonsillitis are infections in the throat that cause it to be sore. If the tonsils are primarily involved, it is called tonsillitis and if the throat is primarily involved it is called pharyngitis. Your child's throat may feel dry, itchy, scratchy or painful.

The tonsils are small round pieces of tissue at the back of the throat. The tonsils are a part of the body's defensive lymphatic system. They help fight germs that cause infection and prevent you from getting sick. When tonsils are doing their job of fighting viruses and bacteria, they increase in size, become inflamed and red, and can feel painful.

Signs and symptoms of a sore throat

• Your child may say their throat or neck is sore.
• Your child may say it hurts when swallowing, drinking or eating.
• Your child may have a hoarse voice.
• Younger children may refuse to eat or drink, take smaller amounts than usual, or cry when feeding and swallowing.

Some children may have other symptoms including:

• fever, cough and runny nose
  
• nausea and stomach (tummy) pain
• their throat may be redder than normal, possibly with pus. There can be more redness with both viral and bacterial throat infections.

Causes of a sore throat

• Illnesses like a cold or the flu can cause a sore throat.
  
• Sometimes sore throats can be caused when children sleep with their mouths open and wake up with a dry mouth and sore throat.
• Children with post-nasal drip may get sore throats from clearing their throats or coughing at night.
• Certain viruses can cause sores in the mouth or throat, resulting in a sore throat.
• Sore throats can be caused by a bacterial infection, most commonly by strep throat (a family of bacteria called streptococcus). In this family, Group A Streptococcus (GAS) is the most common bacteria and can cause complications in other parts of the body.

​Caring for your child at home

• If your child is having trouble swallowing, give soft foods that are easy to swallow.
  
• Give plenty of liquids.
  
• If your child is more than one year old, try giving pasteurized honey to soothe the throat and help with the cough (infants less than one year should not be given any honey).
  
• Older children can try gargling with warm salt water.
  

​Sore throats caused by sleeping with the mouth open

• Offer your child something to drink if their throat is sore.
• Use a humidifier at night to put more moisture in the air. This may help prevent sore throats.

If this happens often or if it is associated with snoring, breathing difficulty or excessive daytime sleepiness, discuss it with your health-care provider.

​Sore throats caused by post-nasal drip

• Rinsing the nasal passages with a saline solution can help to lessen throat clearing or coughing.

Sore throats caused by viruses

If your child has a sore throat caused by a virus, you can:

• give your child acetaminophen or ibuprofen to treat pain and fever. Follow the instructions on the label.
• use a liquid preparation or rectal suppositories instead if your child’s throat is too sore to swallow pills.

​Sore throats caused by a virus should go away in about seven days. Antibiotics will not help sore throats caused by viruses.

Sore throats caused by strep throat

Most strep throat (an infection caused by GAS) cases get better in three to seven days without antibiotics. Antibiotic treatment reduces the risk of other people becoming infected and reduces the risk of developing a serious condition called rheumatic fever.

Sore throat caused by tonsillitis

Tonsillitis may cause the tonsils to become enlarged, leading to difficulty swallowing, transient breathing difficulty or snoring at night. These symptoms improve as the tonsillitis gets better. Enlarged tonsils may be caused by a strep infection.

Persistently enlarged tonsils and/or adenoids may cause your child to have obstructive sleep apnea (OSA). This is when your child goes through long pauses between breaths while sleeping and can occur when your child's tonsils have become large enough to block your child's air passage. If you are concerned that your child may have OSA, discuss this with their health-care provider.

​Treatments that will not help a sore throat

Treatments that should not be used to help sore throat include:

• over-the-counter throat sprays. There is no evidence that over-the-counter sprays help with a sore throat. Some throat sprays may contain ingredients (Benzocaine) that may cause an allergic reaction or other problems.
• throat lozenges or hard candies. These remedies are a choking hazard for young children.
• any leftover medicine from family or friends. Leftover medicine may not be the right medicine or the right dose. You could harm your child without intending to.
• Antibiotics will not help cure a sore throat caused by a virus.

​Prevent a sore throat

Wash your hands​ and your child’s hands often. This will help to stop the spread of germs and lower the chances of getting a sore throat caused by infection or virus.

​Complications of a sore throat

Sore throats that are caused by viruses, throat clearing, dryness or irritants rarely have any long-term complications. These types of sore throats do not need antibiotics and tend to resolve on their own.

Untreated throat infections caused by GAS can lead to rheumatic fever.

Make an appointment with your child's doctor if:

• Your child has been in contact with someone with strep throat, or your child has had strep throat in the past.
• Your child has a sore throat that lasts longer than a few days.

Go to the nearest Emergency Department or call 911 if:

• Your child is having trouble breathing.
• Your child is drooling or having a lot of trouble swallowing.
• Your child is acting very sick.
• Your child is having trouble moving their neck.