Health

Sore throat and strep throat in children: what helps, and when should we get help?

Written by the Kids by Molliora editorial team, based on the sources below. Last updated: 5 November 2026

Short answer

Most sore throats are caused by viruses, often with a cold, and pass on their own within a few days without care (1177); the NHS says usually within a week. A sore throat with a runny nose, cough or hoarseness points to a virus (1177, AAP). Strep throat is a bacterial throat infection, most often group A streptococci, and usually gives pain when swallowing, fever and swollen, tender glands in the neck (1177, AAP). Children may instead complain of a headache, earache or tummy ache (1177). Cold or warm drinks, yoghurt or ice cream and pain relief help (1177). Contact a health centre if your child has had a sore throat and fever for several days without cold symptoms (1177). Get help at once if your child cannot swallow their saliva, is drooling or has difficulty breathing (1177, NHS).

Question	What applies	Source
How long does a sore throat last?	Usually a few days (1177). The NHS says usually within a week; tonsillitis usually 3–4 days. The AAP says a viral sore throat gets better over 7–10 days.	1177, NHS, AAP
Virus or bacteria?	A runny nose, cough and hoarseness point to a virus. Strep usually gives fever and a sore throat without cold symptoms.	1177, AAP
Who gets strep throat?	It is most common in school-age children and teenagers, peaking at age 7–8 (AAP). It is unusual under age three (1177).	AAP, 1177
How is it tested?	A doctor may take a swab from the tonsils for a rapid strep test, with an answer in 5–10 minutes. Not everyone needs a test.	1177, AAP
Antibiotics?	Only for bacterial infection and significant symptoms. In Sweden usually for ten days (1177). Give the whole course, even if your child feels better (AAP).	1177, AAP
Back to school after antibiotics?	Sources differ: at least two days at home (1177); 24 hours after starting (NHS); after two doses 12 hours apart and no fever (AAP). In Sweden, follow 1177.	1177, NHS, AAP
Back to school without antibiotics?	When your child is clearly better, has the energy for a whole day and has been fever-free for a day without fever-reducing medicine.	1177
When is it urgent?	Cannot swallow saliva, drooling, difficulty breathing, or severe pain on one side with difficulty opening the mouth.	1177, NHS

Why does the throat hurt?

Sore throats are very common. Most are caused by viruses, for example with a cold (1177, NHS). Other causes (1177):

Strep throat (tonsillitis): an infection of the tonsils caused by viruses or bacteria. When it is bacterial, it is most often group A streptococci. The tonsils become red, swollen and sore.
Glandular fever: caused by a very common virus. Children usually get mild symptoms, but teenagers and adults can be more ill. Antibiotics do not help.
Scarlet fever: a strep infection with a rash. It mainly affects small children; older children and adults more often get strep throat instead.
Shouting, singing or dry air: straining the vocal cords or very dry air can also make the throat sore. Rest the voice if your child is hoarse.

A note on words: in Swedish, halsfluss means tonsillitis, which can be caused by a virus or by bacteria (1177). In English, strep throat means a throat infection caused by strep bacteria specifically (AAP).

Viral sore throat or strep throat?

Signs of a virus: a runny nose, cough and hoarseness at the same time, often as part of a cold (1177). The AAP also lists red, sticky eyes (pinkeye) as a sign of a virus rather than strep.
Signs of strep: pain when swallowing, often fever, and swollen glands in the neck that feel like tender lumps under the skin (1177). In children over three, the AAP describes a very painful throat, a fever over 38.9 °C, swollen glands and pus on the tonsils.
Children say it differently: they may say they have a headache, pain towards the ears or a tummy ache, and they often show pain by not wanting to eat or drink (1177).
Carrying strep without being ill: many people have strep bacteria in their throat without symptoms, especially young children. They usually do not spread it and do not need treatment (1177).

You cannot be sure from the symptoms alone. If strep is suspected, a doctor looks at the throat and may take a swab (1177, AAP).

What soothes at home

Keep drinking, even if swallowing hurts. Both cold and warm drinks can soothe (1177). Watch for signs of drinking too little, such as weeing less than usual or dark, strong-smelling wee (NHS).
Cold, soft food: yoghurt or ice cream often feels good (1177, NHS).
Throat lozenges: they do not reduce the swelling but can soothe. Sugar-free ones are best for teeth (1177). Do not give young children anything small and hard to suck, because of the risk of choking (NHS).
Pain relief: over-the-counter medicine with paracetamol or an anti-inflammatory such as ibuprofen can ease the pain (1177, NHS). Some lozenges and mouth sprays with medicine are not suitable for children, so ask a pharmacist (1177). Read more in our fever guide.
Take it easy: rest does not have to mean staying in bed, but avoid physical exercise while there is an infection in the body (1177). Avoid smoky places (NHS).
Salt-water gargling (sources differ): the NHS says children should not gargle with salt water, while the AAP says gargling with warm salt water may relieve some throat pain. For younger children, skip it.

Strep throat: treatment and spread

Antibiotics if needed: antibiotics are not given if the doctor judges that the infection is mild or caused by a virus. They are given for significant symptoms caused by bacteria, usually for ten days (1177). Give the whole course as prescribed, even when your child feels better (AAP).
How it spreads: through close contact, such as hands and kisses, and through the air when someone coughs or sneezes (1177). Symptoms often start one to two days after infection (1177); the AAP says two to five days.
Toothbrush and towels: after starting antibiotics, boil your child's toothbrush after each use for three to four days, and clean dummies and toys that go in the mouth (1177). Do not share toothbrushes or towels (1177).
It can come back: getting strep throat again within a month is fairly common, and a different antibiotic is often used then (1177). If several people at home keep getting strep, the doctor may want to check everyone in the household (1177).
Taking out the tonsils: this is only considered for children who get strep throat often, for example three to five times in one or two years, when certain antibiotics have not helped (1177). The AAP also says it is recommended only for the most severely affected children.
Back to school: sources differ. 1177 says your child stops being contagious about two days after starting antibiotics, so stay home at least two days. The NHS says 24 hours after starting antibiotics; the AAP says after two doses 12 hours apart and no fever. In Sweden, follow 1177. Read more in our guide on sick days and school.

Complications are rare

Complications after strep throat are unusual (1177). The most common is a peritonsillar abscess (quinsy), a collection of pus behind the tonsil, usually on one side of the throat (1177). Signs (1177):

the fever comes back after a couple of fever-free days
your child is tired and listless
it is hard to open the mouth
swallowing and breathing get harder

Ear infection, rheumatic fever and kidney inflammation can occur after strep throat, but are rare (1177).

Try this week

Stock the freezer with ice lollies or ice cream and keep yoghurt in the fridge during the cold season, for days when swallowing hurts (1177).
Give each person at home their own toothbrush mug and towel, and replace or boil the toothbrush after strep throat as advised (1177).
Check what pain relief you have at home and the right dose for your child, before anyone is ill.

When to get help

Most children with a sore throat during a cold do not need care (1177). Call 1177 for advice on symptoms and where to seek care.

Contact a health centre if your child (1177):

has had a sore throat for a couple of weeks
keeps getting sore throats
has a sore throat and swelling on the outside of the neck

Contact a health centre or out-of-hours clinic as soon as possible if your child (1177):

has had a sore throat and fever for several days, but no cold symptoms such as a runny nose, cough or blocked nose
has a sore throat, fever and a fine, bumpy rash

Seek care at once at a health centre or out-of-hours clinic, or at A&E if they are closed, if your child (1177):

cannot swallow their saliva, has a fever and has difficulty breathing
has severe pain on one side of the throat and difficulty opening the mouth

These can be signs of a more serious infection, such as epiglottitis or an abscess (1177). Call the emergency number, 112, at once if your child has difficulty breathing or cannot swallow, is drooling, makes a high-pitched sound when breathing in, or has severe symptoms that are quickly getting worse (NHS, which gives 999 for the UK).