Patient education: Strep throat in children (The Basics)

What is strep throat? — 

This is an infection caused by bacteria that causes a sore throat. However, most sore throats are caused by a virus, and are not strep throat.

About 3 out of every 10 children with a sore throat actually have strep throat. It is most common in school-age children.

How can I tell if my child has strep throat? — 

It is hard to tell the difference between strep throat and a sore throat caused by a virus. But there are some clues you can look for.

Teens and children older than 3 years who have strep throat often have throat pain that starts quickly. They might also have other symptoms, like:

●Fever (temperature higher than 100.4°F, or 38°C)

●Swollen glands in the neck

●Headache

●Belly pain, nausea, or vomiting

You might also be able to see redness on the roof of the child's mouth, or white patches in the back of their throat (figure 1). Children older than 5 years who have strep throat do not usually have a cough, runny nose, or itchy or red eyes.

Strep throat is uncommon in very young children, but if they do get it, it can cause a runny or stuffy nose, plus a slight fever. Babies with strep throat might act fussy and not want to eat.

Is there a test for strep throat? — 

Yes. If you think your child might have strep throat, a doctor or nurse can easily check for it. They can run a swab (Q-Tip) along the back of the child's throat, and test it for the bacteria that cause strep throat.

Does my child need antibiotics? — 

If the test shows your child has strep throat, then yes, they need antibiotics. Most people with strep throat get better without antibiotics, but doctors and nurses often prescribe them anyway. That's because antibiotics can prevent problems that strep throat can sometimes cause. Plus, antibiotics can reduce the symptoms of strep throat and keep it from spreading to other people.

How can I help my child feel better? — 

Make sure your child takes all their antibiotics as instructed, even if they start to feel better. There are also other ways to help relieve symptoms:

●Soothing foods and drinks – Give your child things that are easy to swallow, like tea or soup, or popsicles to suck on. They might not feel like eating or drinking, but it's important they get enough liquids. Offer different warm and cold drinks to try.

●Medicines – Acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) can help with throat pain. The right dose depends on your child's weight, so ask their doctor how much to give.

Do not give aspirin or medicines that contain aspirin to children younger than 18 years. In children, aspirin can cause a serious problem called Reye syndrome. Do not give children throat sprays or cough drops, either. These contain medicine, but they are no better at relieving throat pain than hard candies. Plus, throat sprays can cause an allergic reaction.

●Add moisture to the air – You can use a cool mist humidifier to keep the air from getting too dry. If you don't have a humidifier, you can sit with your child in a closed bathroom with a warm shower running a few times a day.

●Avoid smoke – Do not smoke around your child or let others smoke near them. Being around smoke can irritate the throat. Plus, it's dangerous to the child's health.

●Other treatments – For children who are older than 4 to 5 years, sucking on hard candies or a lollipop might help. For children older than 6 to 8 years, gargling with salt water might help.

When can my child go back to school? — 

They should be taking antibiotics before going back to school. This is to avoid spreading the infection to others.

Children can go back to school after a full day of antibiotics. If your child starts taking antibiotics by 5:00 PM, they will probably no longer be contagious by the next morning. If your child is feeling better and no longer has a fever, the doctor might say they can return to school the next morning.

How can I keep my child from getting strep throat again? — 

Wash your child's hands often with soap and water. This is one of the best ways to prevent the spread of infection. You can use an alcohol rub instead, but make sure it gets everywhere on your child's hands.

Teach your child about other ways to avoid spreading germs, like not touching their face after being around a sick person.

When should I call the doctor? — 

Call for an ambulance (in the US and Canada, call 9-1-1) or take your child to the emergency department if they:

●Have trouble breathing or swallowing

●Are drooling much more than usual

●Hae a stiff or swollen neck

●Have signs of severe fluid loss, such as:

•Your child does not urinate for 24 hours.

•Your child's soft spot is sunken.

•Your child's eyes are sunken.

Call your child's doctor or nurse for advice if your child:

●Has very bad pain in their throat, and cannot eat or drink anything

●Cannot open their mouth all the way

●Has not had anything to drink in many hours, and has one or more of the following:

•Your child is not as alert as usual, is very sleepy, or is much less active.

•Your child is crying all the time.

•Your infant has not had a wet diaper for over 8 hours.

•Your older child has not urinated for over 12 hours.

•Your child's skin is cool.

●Develops a red rash or peeling skin

●Develops joint pain within 1 month of having strep throat

●Has red or brown urine

●Still has symptoms after finishing all the antibiotics

More on this topic

Patient education: Strep throat in adults (The Basics)
Patient education: Sore throat in children (The Basics)
Patient education: Scarlet fever (The Basics)
Patient education: Tests for strep throat (The Basics)

Patient education: Sore throat in children (Beyond the Basics)