Sore throats are common for children, and depending on the cause, they can be fleeting and mild or persistent and severe.

So when is a sore throat considered tonsillitis or “strep throat”? And when should you take your child to a GP or hospital?

Our tonsils are glands at the back of our throat that help fight germs in the mouth, so when a child gets sick with a cold, for example, their tonsils may be the first to feel it. Many sore throats pass within a day or so, but if the pain persists your child may have tonsillitis.

Tonsillitis is an infection of the tonsils which is usually caused by a virus. It can also be caused by bacteria such as Group A Streptococcus. When this occurs, a health professional may call it “strep throat” or “bacterial tonsillitis” and may prescribe antibiotics.

A classic sign of tonsillitis is a yellow or whitish coating on the tonsils or spots. A child with tonsillitis may also have:

  • Swollen lymph nodes in their neck
  • Fever
  • Bad breath
  • Trouble swallowing
  • Other aches and pains, such as a headache, earache or stomach-ache
  • Lethargy
  • Little or no appetite

If you think your child has tonsillitis for the first time, take them to a GP. If your child is having difficulty breathing or drooling, or seems extremely unwell, Epworth emergency physician Jennifer Mines says you should call an ambulance immediately. They may have a dangerous inflammation of the epiglottis (the flap in their throat).

When assessing a sore throat, a doctor will ask about symptoms and examine the mouth. They may also use a swab to gently collect a sample from the tonsils and the back of the throat to look for evidence of a bacterial infection.

If the infection is caused by a virus, your child’s body will usually fight it on its own. You can also help your child get better with the following treatment:

  • Plenty of rest and fluids to drink (icy poles can be soothing)
  • Painkillers such as paracetamol or ibuprofen
  • If your child is struggling with normal foods, try softer foods

If your doctor prescribes antibiotics, make sure your child takes them as directed, and even if your child feels better, it’s important to complete the course. Otherwise the infection may return and your child can infect others.

Dr Mines says both viral and bacterial tonsillitis are spread by respiratory droplets, so coughing, sneezing, kissing, and drooling can transmit it to others.

“Kids might be contagious for 7 to 10 days before they develop tonsillitis and other symptoms of an underlying viral infection”

If your child is finding it hard to swallow, they may be prescribed prednisolone – an anti-inflammatory steroid medication – as well as or instead of antibiotics. This can reduce swelling of the tonsils.

Children should stay home from other activities until their fever is gone and they are able to swallow again.

If a child gets tonsillitis a lot and their tonsils make it difficult to swallow or breathe, a doctor may recommend surgical removal of their tonsils. This procedure, a tonsillectomy, is performed by specialists at Epworth. You can find a specialist here.

For fast emergency treatment, Epworth Richmond's Children’s Emergency Service is available all day, every day.

17 June 2020