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Acute sore throat is most common in those aged 5-24 years, but it can affect anyone. It is usually caused by a viral or bacterial infection. Sore throat is a self-limiting condition, with symptoms clearing up within 3 days in 40% of people and within 1 week in 85% of people.1
Non-infectious causes may include physical irritation from gastro-oesophageal reflux disease (GORD) or chronic cigarette smoke, or an allergy such as hay fever.1
Common causes of sore throat in children
Tonsillitis(usually viral, can also be bacterial)
The tonsils are small glands either side of the throat.3 They may become inflamed (red and swollen) due to an infection and may have pus-filled spots or white patches on them.1,4,5 Other symptoms could include a sore throat, problems swallowing, headache, nausea, vomiting, stomach pain and a high temperature (38°C or above).1,4 Babies may also drool more than usual5
Viral tonsillitis is often associated with a cold or flu4
Bacterial tonsillitis may be caused by various bacteria, including Group A Streptococcus bacteria, which results in strep throat.6 Strep throat is more common in 5-15 year olds;1 it is less likely in those under the age of 3.5
Hand, foot and mouth(viral)
This starts with a sore throat, fever and not wanting to eat. The second stage involves the appearance of mouth ulcers and raised spots on the hands, feet and sometimes the thighs and bottom.5,7 It often occurs in the late summer and autumn; children younger than 4 years are most commonly affected.1 Hand, foot and mouth disease is contagious and children should be kept away from school or nursery while they are unwell.7
Common cold(viral)
It is common for children to have 8 or more colds a year. A dry, sore throat may be noticeable a day or 2 before the cold starts.2 The child may also have a runny or stuffy nose, cough or earache.1,3
Tonsillitis(usually viral, can also be bacterial)
The tonsils are small glands either side of the throat.3 They may become inflamed (red and swollen) due to an infection and may have pus-filled spots or white patches on them.1,4,5 Other symptoms could include a sore throat, problems swallowing, headache, nausea, vomiting, stomach pain and a high temperature (38°C or above).1,4 Babies may also drool more than usual5
Viral tonsillitis is often associated with a cold or flu4
Bacterial tonsillitis may be caused by various bacteria, including Group A Streptococcus bacteria, which results in strep throat.6 Strep throat is more common in 5-15 year olds;1 it is less likely in those under the age of 3.5
Hand, foot and mouth(viral)
This starts with a sore throat, fever and not wanting to eat. The second stage involves the appearance of mouth ulcers and raised spots on the hands, feet and sometimes the thighs and bottom.5,7 It often occurs in the late summer and autumn; children younger than 4 years are most commonly affected.1 Hand, foot and mouth disease is contagious and children should be kept away from school or nursery while they are unwell.7
Common cold(viral)
It is common for children to have 8 or more colds a year. A dry, sore throat may be noticeable a day or 2 before the cold starts.2 The child may also have a runny or stuffy nose, cough or earache.1,3
Tonsillitis(usually viral, can also be bacterial)
The tonsils are small glands either side of the throat.3 They may become inflamed (red and swollen) due to an infection and may have pus-filled spots or white patches on them.1,4,5 Other symptoms could include a sore throat, problems swallowing, headache, nausea, vomiting, stomach pain and a high temperature (38°C or above).1,4 Babies may also drool more than usual5
Viral tonsillitis is often associated with a cold or flu4
Bacterial tonsillitis may be caused by various bacteria, including Group A Streptococcus bacteria, which results in strep throat.6 Strep throat is more common in 5-15 year olds;1 it is less likely in those under the age of 3.5
As you have seen in the video, it may not be easy to identify what causes a young child to be upset. Those unable to talk or communicate in a comprehensible manner will rely on adults to assess and manage their pain. Even children who are able to speak may find it difficult to explain exactly what the problem is.
Viral and bacterial infections may be associated with symptoms such as a sore throat, which could be the cause of a child's distress.
Even though viral infections are common and therefore may be the most likely cause of their child’s sore throat, parents and caregivers may still be concerned that it could be a sign of something more serious, and some may feel helpless, especially when they struggle to comfort their child. It is important that you show empathy during your conversations. Combined with the right support, reassurance and advice, they will feel more empowered to make appropriate choices when looking after their unwell child.
You can reassure them that viral sore throats usually clear up on their own, without the need for antibiotics,3 and they can support their child at home through implementing appropriate self-care measures.
Self-care to support children with sore throats
Keep them hydrated by encouraging plenty of fluids1,3,5 (breast milk, infant formula or other age-appropriate drinks)
Let them rest4,6,8
Offer cool, soft foods8 (only for babies who are weaning or those eating solid foods)
Avoid irritants8 (e.g. do not smoke near them)
When to refer young children
Advise parents and caregivers to keep an eye on their child and seek medical advice if:2,3
The child has a sore throat for more than 4 days with a high temperature and is generally unwell
The child seems dehydrated (e.g. has sunken eyes, seems drowsy and has not passed urine for 12 hours)
Urgent advice should be sought if the child: has severe symptoms; is getting worse quickly; is unable to swallow; has difficulty breathing or stridor (a high-pitched sound when breathing)1,2,8
Sore throat
