I Think My Child Has Strep Throat: What Should I Do?

Your child was their usual, active self yesterday, staying busy and feeling fine. But today, they’ve somehow woken up with a sore throat that’s so red, raw, and painful they can barely swallow. They’re miserable, and you want to help them feel better ASAP. 

Throat pain is one of the most frequent reasons for same-day sick visits at The Center for Advanced Pediatrics in Darien and Norwalk, Connecticut; it’s also a top reason for walk-in visits to our Urgi-Kids urgent care clinic in Norwalk. Often, the culprit is strep throat. 

When your child has a sore throat

When your child has a sore throat, you want to know whether it’s mildly scratchy, painfully tender, or somewhere in between. Just as symptom severity can vary, not all sore throats are the same — in fact, they’re categorized into three types based on which part of the throat (pharynx) is swollen, red, and sore: 

• Pharyngitis affects the area between the mouth and the esophagus (pharynx) 
• Tonsillitis affects the lymphoid tissues at the back of the mouth (tonsils)
• Laryngitis affects the voice box, making voice projection difficult (larynx)

Most kids who develop a sore throat have pharyngitis, or a combination of pharyngitis and tonsillitis. This scratchy or burning discomfort can make your child’s throat feel raw, tender, and irritated — especially when they eat, drink, or talk. 

Most sore throats are a sign of illness

Most sore throats are a sign of illness and are caused by a viral infection, such as the common cold, influenza (flu), mononucleosis (mono), or COVID-19. A sore throat is also the primary symptom of strep throat, one of the most common bacterial infections among children. 

When a sore throat comes from a virus like the common cold, you can expect your child’s pain to improve gradually until it resolves, usually in about a week. When it stems from strep throat, however, you can expect their pain to persist until antibiotic treatment begins. 

Signs indicating likely strep throat

If strep is the first thing that comes to mind when your child complains of throat pain, we understand: Strep is a common contagious illness among kids aged five to 15, and up to 35% of kids who visit the doctor for a sore throat test positive for strep. 

So, which symptoms point to likely strep, and which don’t? 

Typical strep symptoms

Strep symptoms appear two to five days after a child contracts group A streptococcus (GAS) bacteria from respiratory droplets, surface contact, or direct contact with someone who has active strep. Typical symptoms include at least two of the following:  

• Sudden, severe throat pain that persists
• A sudden fever that peaks on day two
• Tender, swollen lymph nodes in the neck
• A visibly red throat and inflamed tonsils   
• White patches at the back of the throat
• Tiny red spots on the roof of the mouth 

Some kids — particularly younger children — experience abdominal pain, vomiting, or headaches when they have strep throat. Strep is rare in babies and toddlers. 

Signs that a sore throat is viral

With strep throat, there are no additional respiratory symptoms. If your child has a cough, runny nose, congestion, or sneezing with their sore throat, they’re more likely to have a viral infection. Viral symptoms also tend to come on more gradually compared to strep. 

Next steps when you suspect strep

The only way to know if your child has strep — and obtain the antibiotic treatment they need to kill the infection, get better, and prevent complications — is to see our team ASAP for a rapid strep test and throat culture.

Rapid strep testing vs. strep culture

A rapid strep test detects antigens from GAS bacteria, providing results in minutes. These results are 95-98% accurate, but there’s still a minor chance of getting a false positive or a false negative. 

For this reason, we always perform a throat culture at the same time. These results, which are 100% accurate, take a day or two to receive.

When your child is diagnosed with strep

If your child tests positive for strep, we prescribe antibiotics (usually amoxicillin). They should take the entire course as directed, even if they start feeling better before they’ve finished the medicine, or the infection can return. At-home care includes: 

• Pain relief as needed (acetaminophen or ibuprofen)
• Plenty of water and other liquids to maintain hydration
• A soft food diet as tolerated, until throat pain eases
• Cold treats, like popsicles, to soothe their sore throat

To prevent spreading the infection to others, keep your child home from school, daycare, and playdates until they’re fever-free and have been taking antibiotics for at least 24 hours. Once they’ve been on antibiotics for 24-48 hours, replace their toothbrush to prevent reinfection. 

Prompt walk-in care for sore throats 

Think your child may have strep? Get in touch with our team at The Center for Advanced Pediatrics today: Contact your nearest office in Norwalk or Darien, Connecticut, to book a same-day sick visit, or stop by our walk-in Urgi-Kids urgent care clinic in Norwalk during normal business hours.