Congratulations! You made it through the first month of the year! I’m hoping you have gotten through as unscathed by illness as my family thankfully has (knock on the biggest piece of wood).
If you or your family has been sick, don’t worry, there is always something going around. And it is always important to talk to your kiddos about the importance of washing their hands correctly, and with soap (who here needs to do a soap smell-check every time their child “washes” their hands?) to stop the spread of germs. There’s also never a bad time to remind your kiddos to cough and sneeze into their “wing,” and to not put their fingers in their mouths. (Anyone else with an avid thumb-sucker? My daughter sucks not one but both of her thumbs. Cringe.)
One of the most frequent calls I get as a pediatric office nurse is about kids with a sore throat. 
Sore throats come in many different shapes and sizes and are certainly not one-size-fits-all. There are a range of causes for sore throats, from cold viruses to the Strep A bacteria, to allergies, to dry air, to too much screaming, yelling, talking, and laughing.
The biggest thing most medical care providers are concerned about with a sore throat is strep. Strep throat is something to be concerned about because, if left untreated, it can lead to something called Rheumatic Fever. Thankfully, if diagnosed, strep is relatively easy to treat with antibiotics and your child should be feeling better within 24 hours of starting antibiotics.
Strep throat has five main symptoms often associated with it.
If your child has strep, they may exhibit only one, a combination of, or possibly all of these symptoms:
- A significant sore throat that hurts all day. (With a virus, the sore throat tends to wax and wane, often being worse first thing in the morning and at night)
- Fever
- Headache
- Stomach ache, nausea, or vomiting
- Rash- fine and red, that often starts in the armpits or groin, and feels a bit like sandpaper. (Have you heard of Scarlet Fever? This is it.)
If your child has the following symptoms, your kid’s sore throat is less likely to be caused by strep throat and is more likely caused by a virus (which is much more common):
- Cough
- Hoarseness
- Runny nose
- Conjunctivitis or eye discharge
- Diarrhea
Now, if your kid has a sore throat but you aren’t sure if it’s strep or something else, you may want to call your healthcare provider and set up an office visit. 
What does that sore throat office visit look like?
Typically you will get taken back to an examining room by a nurse who will take your child’s vital signs. They may or may not then swab your child’s throat (the MD, NP, PA, etc. may also do this later in the visit).
What does swabbing the throat look like? Getting your throat swabbed is not a pleasant experience, especially if it already hurts! Your medical care provider basically takes a long “fuzzy Q-tip” and stick it way in the back of your child’s throat. This will unfortunately often make the child gag. In the office I work in, we often will offer children a fruit popsicle afterward (shhhh! Don’t tell the other kids!)
Once the sample is collected (basically saliva and cells from the throat), it can be tested using a Rapid Strep Test there in the office. This test is usually somewhere between 90-95% accurate. For those children that show symptoms of strep throat but test negative on the rapid test, we then send their sample to the hospital lab to grow out a culture. Infrequently, we do get positives back from the culture that showed negative in the office rapid test.
Culturing a sample typically takes a few days. Once the positive strep diagnosis has been confirmed, your child will likely be prescribed a course of antibiotics. Thankfully, children tend to feel much better after being on antibiotics for 24 hours. At the 24 hour mark, they are also cleared to go back to school or childcare.
What if your child has strep and it isn’t diagnosed right away? The good news is you have around ten days to diagnose and treat strep before you risk any possible long-term lasting side effects from the illness.
At home strategies for helping soothe your kid’s sore throat, no matter what the cause:
-Warm tea with honey (please note, honey should not be given to infants under one year of age)
-Fruit juice popsicle
-Over the counter pain relievers, such as acetaminophen
-Cool mist humidifier
-Pineapple juice
-Gargling with warm salt water (Recipe: dissolve ¼-½ teaspoon table salt in an 8oz glass of warm water)
Having a sore throat, or just feeling under the weather in general, often leads to kids having a decreased appetite and sometimes a reluctance to eat or drink.
If your child is sick and does not want to eat, this is okay!
The biggest thing medical care providers care about is that the child is still drinking and peeing regularly. A child could go many days without eating and we are okay with that as long as they are continuing to hydrate. If your child does have a sore throat, you may have to experiment and see what feels best for them to eat and drink, as well as what temperature foods feel best (warm or cool tend to be the safest to try).
Do you have sore throat soothing tips that work for you and your family? I would love to hear them!
*Please note, the information contained in this post is not a substitute for medical advice but is intended to give you a better idea of symptoms to look out for and how to manage a sore throat. Anytime you or your child(ren) are sick, please contact your healthcare provider. Most offices offer around the clock phone services, even after hours and on weekends and holidays.
