Youth Throat

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Sore throats in children are very common, and parents are almost always worried about strep throat. But more sore throats are caused by viruses or even post-nasal drip from allergies. On this week’s On Call for All Kids , Rachel Dawkins, M.D. , medical director of the Pediatric and Adolescent Medicine Clinics at Johns Hopkins All Children’s Hospital, helps parents tell the difference between a sore throat and strep.
It is an infection in the throat and of the tonsils caused by bacteria called group A streptococcus. Group A strep lives in the nose and throat and can be spread by respiratory droplets (coughing and sneezing). Kids can get sick with the bacteria if they breathe in those droplets, touch something that is contaminated then touch their mouth or nose, or drink from the same glass as a sick person.
Strep can also cause skin infection. This is known as impetigo.
Interestingly, some kids can be asymptomatic carriers of strep bacteria. They may test positive for strep but if they don’t have symptoms of severe illness, they should not be treated.
Strep throat is usually mild. Throat pain and fever WITHOUT cough are the most common signs. Red, swollen tonsils with white patches might be present and there might be red dots on the roof of the mouth. Kids may also present with headache or belly pain. Scarlet fever has a particular rash on the body that is common.
Cough, runny nose, pink eye, or hoarseness/laryngitis are not common with strep throat. So when a child comes in with a runny nose, cough and sore throat this is almost always due to a viral cause and should not be treated with antibiotics.
First of all, your doctor should test for strep throat. You cannot look in a throat and determine if a child has strep. A good history and a quick swab will give your doctor good information. A throat culture might be done to pick up bacteria a rapid test might have missed.
For those kids with a positive test, antibiotics will help treat the infection.
For kids with a negative test, supportive care is all that is needed. Acetaminophen or ibuprofen can help with pain. Eating cold foods such as popsicles or gargling with salt water may help symptoms. In kids older than a year, they can use honey to relieve cough. Make sure to avoid any other cough or cold medicine in children less than 4 and talk to your pediatrician about any over-the-counter medication.
On Call for All Kids is a weekly series featuring Johns Hopkins All Children's Hospital experts. Visit HopkinsAllChildrens.org/Stories each Monday for the latest report. You also can explore more advice from Rachel Dawkins, M.D., or download our free Pocket Doc app, which features a symptom checker, parenting advice and other tools for staying in touch with us.
At the start of the pandemic, how stress, anxiety and fear have been generated in families during the COVID-19 pandemic had not been studied in great detail. Early research had suggested that children — observing how their parents reacted to various aspects of the pandemic — may have reacted in a similar manner. Looking for answers, Diana Kalpakian, Ph.D., joined Melissa Faith, Ph.D., and colleagues and conducted a study in May 2020, early in the pandemic. The results of their research were recently published.
Posted on Sep 26, 2022 in General News
Rachel Dawkins, M.D., shares some things parents should think about as they’re preparing for the season, and how to help kids stay calm if there is a hurricane.
Posted on Aug 16, 2022 in General News
The newborn period is a time like no other, and something that should be a celebration for you and your loved ones. Keeping your baby safe during this time is of utmost importance. Shannon Glenn-Otto, M.D., a general pediatrician at Johns Hopkins All Children’s Hospital shares some useful guidance for first-time parents when it comes to visitors.
Posted on Oct 14, 2022 in General News
With uncertainty until the final hours as to where Hurricane Ian, a massive category 4 storm, would make landfall, teams of dedicated professionals at Johns Hopkins All Children’s Hospital locked down and prepared for the worst, while continuing to provide a high level of care to patients. While the hospital was spared from the worst of the storm, its mission to care for sick children was tested in an extraordinary way. This video shares that experience. 
Posted on Oct 12, 2022 in General News
Johns Hopkins All Children’s Hospital has developed an Augmentative and Alternative Communication (AAC) preschool language class. This program gives children ages 2-6, who cannot be introduced to a public school setting due to health or other concerns, a chance to learn to communicate through AAC devices within a specialized class or social setting. This helps them learn to interact with teachers and other children and build relationships through structured play, music, art and other motivating activities.
Posted on Oct 06, 2022 in General News
Johns Hopkins All Children’s Hospital plans to reopen its Outpatient Care location in Fort Myers on Monday, Oct. 10.
© 2022 Johns Hopkins All Children’s Hospital. All rights reserved


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