Child sore throat: strep or virus, and what to do
Most sore throats in children are viral and come with a cough, a runny nose, or hoarseness. Strep throat usually arrives without a cough, with fever, swollen neck glands, and pain on swallowing. Only a throat swab can tell them apart, and strep needs antibiotics, so a sore throat plus fever and no cough is worth a same-day test.
How long it lasts
Viral sore throats peak on day two or three and clear within a week. Strep pain usually improves within 24 to 48 hours of starting antibiotics.
School and daycare
A viral sore throat is fine at school once your child is fever-free for 24 hours and comfortable. Strep throat means home until 24 hours of antibiotics are in and the fever has gone.
What usually causes sore throat in kids
Scratchy throat alongside congestion and cough. Worst in the morning, eases through the day.
Sudden pain on swallowing, fever, no cough, sometimes stomach ache or headache. Needs antibiotics.
Mouth sores that make eating and drinking hurt, plus spots on hands and feet.
Sore throat as part of a sudden package of fever, aches, and exhaustion.
Strep plus a fine sandpaper rash and a strawberry tongue.
When to call a doctor
- Drooling, or trouble swallowing saliva
- Any trouble breathing, or a muffled "hot potato" voice
- Not drinking enough to keep up, with fewer wet diapers or trips to the bathroom
- A stiff neck, or inability to open the mouth fully
- Fever over 100.4°F for more than three days
- A sore throat with a rash
What helps at home
- Cold fluids, ice pops, and smoothies. Getting fluids in matters more than what they are.
- Warm salt-water gargles for kids old enough to gargle safely.
- Acetaminophen or ibuprofen dosed by weight for pain, which also gets kids drinking again.
- Humidifier overnight and a soft-food day or two.
- If a swab comes back positive for strep, finish the whole course of antibiotics even after the pain stops.
Frequently asked questions
- How do I know if my child has strep throat?
- Strep classically means a sore throat with fever, swollen neck glands, and no cough, and it often comes with a stomach ache in kids. There is no way to be sure without a throat swab, which takes minutes at a clinic.
- How long is strep throat contagious?
- Until 24 hours after the first dose of antibiotics. Without antibiotics a child can stay contagious for two to three weeks, which is why testing matters even when they start to feel better.
- Can my child go to school with a sore throat?
- Yes for an ordinary viral sore throat with no fever. For strep, keep them home until they have had 24 hours of antibiotics and have been fever-free for 24 hours.
- Is strep going around my child's school?
- Strep runs in clusters through a single classroom or grade. Follow your child's school on Ickly and you will see when other parents start logging strep, which is the signal to test early rather than wait.
- What helps a child's sore throat at night?
- A dose of weight-based acetaminophen or ibuprofen before bed, a humidifier, and cold fluids within reach. For kids over one, a spoonful of honey coats the throat and helps them settle.
Is it going around right now?
Parents log sick days at their own schools and daycares on Ickly, so you can see whether sore throat is part of something moving through your child's classroom this week.
See what's going around near youOther symptom guides
General information for parents, not medical advice. Always contact your pediatrician or emergency services if you are worried about your child.