Sore throats are common and most children will get better by themselves within a week.
However it's important for all Māori or Pasifika children and adults (aged 3–35 years) to have a throat swab or be treated for possible strep throat. This is to avoid some rare but serious long-term heart or kidney problems.
COVID-19 pandemic
A sore throat, with or without other respiratory symptoms, such as a cough, fever, or runny nose, could also be a COVID infection. Test for COVID-19 and stay home until well or sure this isn’t COVID.
How to care for a sore throat yourself
DO
test for COVID
give pain relief such as paracetamol or ibuprofen
check with a pharmacist if a throat spray or medicated lozenges are ok for your child
drink warm liquids, eg, honey and lemon (for tamariki aged 1 year and over)
eat cool or soft foods
give an ice block or suck ice (if old enough)
rest and drink plenty of fluids
see a nurse or GP for a throat swab or antibiotics if you or your child are Māori or Pasifika aged 3 to 35 years
allow older children to gargle with warm salt water (1 teaspoon of salt per glass of water).
DON’T
don’t expect antibiotics as these will not help most sore throats, unless your child is high risk as above
don’t give lozenges to young children as they might choke
don’t send your child back to day care, kindy or school until they are well.
Image credit: Canva
Antibiotics are only needed if your child:
When to see a doctor or nurse
For any of the following:
if you or your child are Māori, or Pasifika aged 3 to 35 years
babies under 6 months
a sore throat and a very high temperature, or feeling hot and shivery
a weakened immune system, eg, because of diabetes or chemotherapy
severe pain at the back of the throat
not able to drink much, or has a very dry mouth, or no pee (urine/mimi) for more than 8 hours
symptoms that aren’t improving after 48 hours
development of a rash
fever of 38°C or above for more than 5 days
symptoms getting worse or if you are worried
they often get sore throats
increased snoring or periods of stopping breathing when asleep.
Call 111 and ask for an ambulance or go to the nearest hospital if your child:
has difficulty breathing, eg, is struggling for breath or making a grunting noise with each breath
has difficulty swallowing their own saliva – drooling can indicate this
is confused or drowsy
has any other symptoms that appear life-threatening.
Causes of a sore throat
The most common cause of a sore throat is a viral infection.
A strep throat infection (Group A streptococcus bacteria) is a less common but important cause.
Other conditions that can cause a sore throat are:
How to prevent or reduce sore throats spreading
Ask your child to cover their mouth and nose when they sneeze or cough.
Don’t share eating utensils or toothbrushes.
Try to create space between your children when they sleep.
Keep your home warm and dry.
Remember:
Māori and Pasifika children are most at risk of developing rheumatic fever and should see a doctor or nurse if they show ANY signs of a sore throat.
A sore throat with or without fever or other symptoms can be a sign of COVID-19 infection. You may need to test over several days before being sure this isn’t COVID.
Need more info?
Sore throat in children KidsHealth NZ Rheumatic fever prevention programme Ministry of Health, NZ
References
Sore throat Auckland Regional HealthPathways, NZ, 2020
Sore throat Ministry of Health, NZ
Resources
Support Phone Healthline for free on 0800 611 116 any time of the day or night for advice on any health issue, no matter how small. In an emergency, phone 111 for an ambulance.
Back to top
Credits: Health Navigator Editorial team. Reviewed By: Dr Janine Bycroft, GP
Last reviewed: 29 Jul 2022
Page last updated: 03 Aug 2022
Information for healthcare providers on sore throat – children
The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.
The following information on sore throat is taken from Auckland Regional HealthPathways, NZ, accessed February 2021:
Red flags
signs of peritonsillar cellulitis or abscess (quinsy) development
swelling causing acute upper airways obstruction
dehydration due to swallowing difficulty.
Practice point
Be vigilant to prevent rheumatic fever
Be especially vigilant of GAS sore throat in people at high risk of rheumatic fever, particularly Māori and Pacific patients aged 3 to 35 years.
Red flags for a potential GAS throat infection are:
Temperature > 38 degrees Celsius
No cough or coryza (which may suggest a viral cause)
Swollen anterior cervical lymph nodes
Tonsillar swelling or exudate
A guide for GAS sore throat management Heart Foundation, NZ, 2019
Management of recurrent treated GAS sore throats Heart Foundation, NZ, 2019Guide for household sore throat management Heart Foundation, NZ, 2019
Clinical guidelines and resources
Sore throat Auckland Regional HealthPathways, NZ, 2020 Navigating uncertainty – managing respiratory tract infections BPAC, NZ, 2019Management of recurrent group A streptococcal (GAS) positive sore throats in children and adolescents at high risk of rheumatic fever Ministry of Health, NZ & Heart Foundation, NZ, 2019 NZ guidelines for rheumatic fever – group A streptococcal sore throat management guidelines 2019 update Heart Foundation, NZ, 2019 Summary of key changes in the group A streptococcal sore throat management guideline 2019 update Heart Foundation, NZ, 2019 Sore throat algorithm Heart Foundation, NZ, 2019 Antimicrobial stewardship using pharmacy data NZ Medical Journal, 2016 Guide for household sore throat management Heart Foundation, NZ, 2019 Rheumatic fever in Māori – what can we do better? BPAC, NZ, 2011 Sick and tired of being tired and sick – laboratory investigation of glandular fever BPAC, NZ, 2012 Rheumatic fever awareness campaign Health Promotion Agency, NZ, 2014–2017
Regional HealthPathways NZ
Access to the following regional pathways is localised for each region and access is limited to health providers. If you do not know the login details, contact your DHB or PHO for more information:
Sore throats can break a heart
Rheumatic fever is a preventable condition that starts with a sore throat, but if left untreated it can end in heart surgery or death. Remember the key to prevention is to get your child’s sore throat checked.
VIDEO (Northland District Health Board, NZ, 2013)
Rheumatic fever informative video
VIDEO (Stop Sore Throats Hurting Hearts, NZ, 2016)
Rheumatic fever
Rheumatic fever is a serious illness that affects the valves of the heart. It mainly affects children (aged 5-19 years) after a group A streptococcal (GAS) infection (which usually causes a sore throat). Hear more from Dr Nigel Wilson, Paediatric Cardiologist. VIDEO (Morningside Productions Ltd, NZ, 2012)