Why Your Child Has a Recurrent Sore Throat

Sore throats are extremely common in children. While many times the cause of a sore throat is a virus such as the seasonal cold or flu, there are other causes, including allergies, contact to smoke and mouth breathing at night.

Read more below, where Lurie Children’s ear, nose and throat specialists weigh in on when a recurring sore throat should mean a trip to a pediatric ENT specialist.

Families can make an appointment with one of Lurie Children’s ENT specialists by filling out an online Appointment Request Form, contacting 1.800.KIDS DOC (1.800.543.7362) or, for existing Lurie Children's or Town and Country Pediatrics patients, logging in to MyChart to schedule your own new or return appointment for some specialties.

Causes of Recurrent Sore Throats in Children

The average sore throat is most commonly from a viral or bacterial infection. There are a wide range of both viral and bacterial sources. Sore throats that are associated with runny nose or cough are more likely to be viral in origin. If the sore throat is without these symptoms, or you have a high fever, your pediatrician may recommend testing for strep throat, as it’s often treated with antibiotics. Mononucleosis, or “mono,” is also a well-known cause of sore throat that often presents with very large tonsils

In addition to infections, your child may get a sore throat from non-infectious causes. These sore throats tend to be milder in nature (compared to those caused by viral and bacterial infections) and would not require a visit with a pediatric specialist. Causes may include:

• Drainage in the throat from allergies
• Reflux
• Mouth breathing
• Chronic inflammation of the tonsils with tonsil stones

The Frequency of Sore Throats that Makes Them Clinically “Recurrent”

Any sore throat that has never really resolved completely (generally called “chronic”) or has gone away and returned could be considered a “recurrent” sore throat. Most sore throats are treated with observation, supportive care, or antibiotics, if needed.

The specialists like to keep track of how many episodes of tonsillitis, or inflammation of the tonsils causing a sore throat, occur each year to help determine whether the tonsils should be surgically removed. While every patient is different, in general, those conversations start when there are at least three episodes each year for the last three years. Sometimes intervention is considered sooner if there is one year with several infections, or if there are other factors to consider.

When Should My Child See a Pediatric Specialist For a Sore Throat?

Most of the time viral and bacterial infections come and go without complications. Occasionally they can require surgical intervention, for example, if a rare abscess or collection of fluid develops and must be drained. With the more typical or average sore throat, consider seeing a specialist if:

• There have been several episodes in the last 1-3 years
• Other complications from having sore throats, such as difficulty tolerating antibiotics
• Any signs of breathing problems while sleeping

Breathing problems while sleeping are another common reason to have the tonsils and adenoids evaluated and possibly removed. If recurrent sore throats meet a certain number, tonsillectomy (getting the tonsils removed surgically) may be offered to improve quality of life and help avoid antibiotics and missed school or activities.

What to Expect During a Doctor’s Visit for Recurrent Sore Throat Including Tests that Might be Performed?

If the child has a sore throat at the time of the visit, or there are signs of a tonsillitis infection including:

• redness of the throat (posterior pharynx)
• white spots on the back of the throat

Then the surgeon will order a throat culture for strep.

There are generally no other confirmatory tests. A good history and documentation of the frequency of infections is important. Physicians recommend parents keep a diary of tonsillitis/strep infections so it’s easier to gather information on frequency and indication for surgery.

Are There Safe Home Remedies You Suggest for Sore Throat?

• Hot tea and honey are both useful home remedies for sore throat. Do not give honey to children under 12 months of age.
• Keeping your child well-hydrated will also improve the sore throat and may allow your child to recover more quickly.

Is Sore Throat a Symptom of COVID-19?

Sore throat is a symptom that is sometimes seen with COVID-19 infection, and if your child has a new sore throat, you should talk to your pediatrician about whether a COVID-19 test is needed.

Is My Child’s Sore Throat Contagious?

If your child has strep throat or a viral sore throat, he/she may be contagious to others. If your child develops a new sore throat, you should avoid close contacts. Call your pediatrician for recommendations on how long your child should stay home and whether they need to be evaluated.

Lurie Children's Division of Otolaryngology

Lurie Children's Division of Otolaryngology - Head and Neck Surgery provides medical and surgical treatment for children with disorders of the ears, nose and throat (ENT), as well as head and neck tumors. Our physicians treat more children for ENT conditions than any other hospital in Illinois. 

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