Unfortunately sore throats are quite common, especially in children, and can occur for several reasons including viral or bacterial infections. One of the main viral infections which causes a sore throat is the common cold with it being responsible for a quarter of all sore throats. Other viruses which less commonly cause a sore throat in children are the flu viruses, the herpes simplex virus, the Epstein Barr virus (glandular fever), and the Adenovirus. Bacterial infections only account for a third of sore throats in children and are mostly due to streptococcal infections. Babies and children are particularly likely to suffer from sore throats as their bodies haven’t yet had time to build up resistance to the infections which commonly cause this nasty symptom.
There are some reasons which are not related to infection that may also cause the symptoms of a sore throat.These include but are not limited to;
• Gasto-Oesophageal Reflux disease (see https://wonderbaba.ie/2015/01/31/reflux-a-wonderbaba-guide/)
• Hay fever ( see https://wonderbaba.ie/2015/05/03/hay-fever-and-children/ )
• Stevens – Johnson syndrome (rare reaction to medication)
• Blood disorders
• Treatments for illnesses such as cancer
• Kawasaki Disease ( a rare condition which causes other symptoms also)
When your child has a sore throat they may also have swollen tonsils (tonsillitis), swollen glands in their neck and discomfort swallowing. Tonsillitis describes the inflammation of the tonsils and is mostly due to viral infections but can also be from a bacterial ones. I will talk a little more about tonsillitis towards the end of this article.
If an infection is the cause of your child’s sore throat they may also be suffering from symptoms such as a high temperature, runny nose, headache, aches and pains and lethargy. Here is the link to my blog about fever : https://wonderbaba.ie/2015/01/12/temperatures-what-they-are-and-how-to-treat-them/
Clues your baby or child has a sore throat:
• As babies can’t speak to explain how they are feeling they may be crying more often than normal.
• They may refuse bottles completely or take less milk than normal. Breastfed babies may refuse to feed or fuss at the breast.
• They may act hungry, start to feed and then push the breast or bottle away.
• They may have one or all of the symptoms mentioned above such as high temperature, headache etc and this may cause irritability and poor form.
How to treat a sore throat:
– This is the biggest challenge with a baby or toddler suffering from a sore throat so I would say try to feed little and often. Some babies who are weaned will still eat some solids so you can add boiled cooled water to their meals to increase daily fluid intake. Some babies won’t eat at all but will take a few oz’s of milk every few hours. Ice lollies are a good option for children old enough! You can give dioralyte sachets to children over one year to sip on to prevent dehydration but always use it in line with the manufaturers guidelines. Have a read of my dehydration blog to know what to look for and to know when you should see the doctor – http://www.wonderbaba.ie/2015/04/23/a-wonderbaba-guide-to-dehydration/
• Avoid giving milk or food which is too hot as heat can irritate sore throats, so even though your baby may normally like a warm bottle it might be worth trying a room temperature one or cooler food.
• Keep foods soft and easy to swallow.
• If the cause of a sore throat is reflux or hayfever it is worth talking to the doctor to ensure these conditions are under control to prevent sore throats.
• Pain killers – Paracetamol (calpol or paralink) or Ibuprofen (nurofen) can be used when appropriate to relieve pain and fever. It is useful to time a feed about 30-60mins after giving the medicine so that they are more likely to take the feed as they will have relief from the pain. Both of these medicines should be used in line with the manufacturers guidelines and recommended doses can be found on their packets but don’t hesitate to contact me using the details below if you are unsure at all about what dose to give. I would generally recommend trying paracetamol first and if that doesn’t work within a couple of hours you can also give Ibuprofen for added pain relief.
• Antibiotics – These are only useful in the case of bacterial infection and will have zero effect on viral throat infections. Your doctor will be able to distinguish between a viral infection and bacterial infection when examining your child’s throat. I’m sure you’ve heard it plenty of times before but I really can’t emphasise the importance of avoiding antibiotics when they are not necessary as using them for viral infections etc will just cause your little one to build up resistance to the antibiotic which might mean it won’t work when they next get a bacterial infection and really need it.
• Ensure the whole family are practising good hand hygiene – no easy task with toddlers and children around!! This will help to prevent any infection from spreading to other family members.
- Difflam Spray – This is an anti-inflammatory spray which can be used for children of all ages. It should be sprayed directly onto the throat area at a dose of one puff per 4kg body weight up to a maximum of four puffs every 2-3 hours. It is just for short term use and can be quite tricky to use for a baby but if you have a willing toddler it may well provide some much needed pain relief!
• Your baby or child is too sore to take fluids and you are worried about dehydration
• You are unsure of the cause of your babies distress, high temperature or illness and want to get them assessed for a sore throat.
• Their voice is affected.
• They develop wheeze or difficult breathing or swallowing.
• The sore throat is recurrent or lasts for longer than a week. You may need to go to the doctor sooner depending on your babies ability to take fluids. If at all concerned about dehydration or a persistent high temperature which does not respond to Paracetamol or Ibuprofen please to get your baby checked over.
This is a common cause of sore throats and is when the two small glands at the top of your childs throat become infected, its again usually viral but can occasionally be bacterial. The irony is tonsils become infected when protecting your childs body from infection…that means that they actually act as a barrier to infection and when one occurs they isolate it and stop it spreading to the rest of the body. The older a child gets the less they need their tonsils as their bodies are more able to fight infection off itself and so the tonsils shrink in size. Occasionally tonsils can become a problem by the severity of which they swell becoming severe or the frequency of it occurring becoming too often. This is when the doctor will consider the risks and benefits of removing them. The doctor can differentiate between viral and bacterial tonsillitis by the presence of pus filled spots. In this case antibiotic treatment is required, other than that the treatment is the same as with other sore throats as described above.
I often tell my customers that sore throat and ear infections are two of the most common ailments I come across in the pharmacy which cause babies to go off their food and drink. These symptoms can generally cause your baby to be fussy and irritable and it’s always worth remembering they are a possibility if you are left wondering what happened to your happy calm little angel! More often than not there is no treatment other than pain relief needed but if you can’t get your baby to take enough fluids or you cannot get a fever under control it is certainly worth the trip to the GP to ensure there is no bacterial infection present or other issue causing the symptoms.
I hope you have found this article helpful and if you have any questions at all please don’t hesitate to contact me by sending a private message to the WonderBaba facebook page (www.facebook.com/wonderbabacare) or by calling me (Sheena) at Milltown totalhealth Pharmacy in Dublin 6 on 012600262. I’m always happy to help!