Dr Phil Kieran: How can I tell if my son's sore throat needs medical attention?

"When young children have a sore throat, it can be challenging to judge if it is improving or worsening and whether to consult a doctor."

My 10-year-old often complains about having a sore throat. How can I tell if it’s strep throat that requires medical attention or a normal sore throat that will clear up on its own?

Sore throats are very common and can be caused by a wide range of issues, from seasonal allergies that cause us to breathe more through our mouths at night to acid reflux, overuse of the voice (such as singing or shouting), or, more commonly, upper respiratory tract viruses.

When young children have a sore throat, it can be challenging to judge if it is improving or worsening and whether to consult a doctor. Add to this a child who reports a sore throat frequently, and it is easy to become worried that you will either fall into over-medicalising a normal experience, potentially exposing your child to more antibiotics than they need, or dismissing an illness that ends up being more serious.

Finding this balance with my own children is tough, so I have great sympathy for parents who don’t have GP training and experience to rely on.

Generally, you will need to see a doctor for a throat bacterial infection which is not getting better. This would be what most people refer to as strep throat or tonsillitis. A bacterial infection typically develops over a few days and worsens progressively.

The child will likely have a high temperature and pain on swallowing. You may notice little lumps in the neck area, which are enlarged lymph nodes (swollen glands), and can be sore to the touch. If you can look into the throat, you might see that the tonsils have a white or yellow coating or white-ish spots. If any of these symptoms are present, I recommend seeing your GP.

By contrast, if the soreness in the throat doesn’t seem particularly bad or if your child doesn’t seem to notice it when they are having fun, it is less likely to be a bacterial infection. If they have a sore throat, a runny nose, and a cough all at the same time, it is far more likely that a virus is the cause of their sore throat.

From a practical point of view, if your child has a sore throat but is otherwise well, I would be inclined to adopt a wait-and-see approach. If everything settles down over the next few days, there’s usually nothing to worry about. However, if the pain gets worse progressively or they develop a fever, or if they seem generally quite unwell and off form, it is reasonable to go to the doctor and get reviewed.

I always encourage parents to trust their gut. If you think your child is unwell, ensure they get medical attention. And if you believe they are alright, keep an eye on things over a few days.

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