Kids can seem almost invincible. Even after taking tumbles, they can get right back up and keep playing. However, illnesses are a whole other problem, and one of the most common among children and toddlers is strep throat. Studies show that about 15 percent of all cases of sore throat are caused by strep throat. It is most common among kids and teens age 5 to 15, though anyone from any age can contract it. Kids usually average about one strep throat infection every four years in the United States, and the disease is most common during the school year, from late fall to spring. As sore throats are such a common symptom in a wide range of diseases, it can be difficult to truly pinpoint whether your toddler may be suffering from strep throat. Let’s take a look at strep throat, some of its most common signs and symptoms, and tips for treatment and prevention.
What is Strep Throat?
Strep throat, which is medically known as streptococcal pharyngitis, is a bacterial infection in the throat that causes inflammation and soreness. The bacteria responsible for strep throat invades your pharyngeal tissue, which causes your tonsils to swell and irritates the mucus membranes that line the back of your throat. This results in the sore, itchy feeling in your throat that characterizes the illness.
The Causes of Strep Throat
Strep throat is the result of an infection by a bacteria known as Streptococcus. There are several various forms of the bacteria, but the two main types are group A Streptococcus and group B Streptococcus. Group A Streptococcus, which is alternately known as Streptococcus pyogenes, tends to be the main culprit of most cases of strep throat, though it can also cause a variety of other diseases, including toxic shock syndrome, scarlet fever, and skin infections like impetigo and cellulitis. Group B Streptococcus is rarer and can lead to more serious conditions, including blood infections, bacterial pneumonia, and an infection of the membranes surrounding the spinal cord and brain called meningitis. Strep throat bacteria is highly contagious and can easily spread by contact, which is why it’s so common among children in school. Large groups of kids in such close quarters allows the bacteria to spread easily from one person to another. Individuals are most contagious when their symptoms are most severe, usually within the first few days after exposure, but without treatment, you can still spread it to others for up to three weeks. Group A Streptococcus bacteria generally reside in the moist mucus membranes of your nose, throat, and mouth. The bacteria primarily spreads through microscopic water droplets that you create when you sneeze or cough. The bacteria can also spread when you touch a door, phone, keyboard, or other object that may have the bacteria on it. [book_appointment]
Common Signs and Symptoms of Strep Throat
Symptoms of strep throat in kids and toddlers can occur within the first five days of initial exposure. These symptoms can vary from person to person and can exhibit themselves differently based on age. Your child may not exhibit any symptoms at all. A sore, itchy throat that comes on suddenly is the main symptom in all cases of strep throat. Along with a sore throat, common symptoms of strep throat in adults and teens include:
A high fever
Red or white patches on the throat and tonsils
Swollen, inflamed tonsils or throat
Swollen tender lymph nodes around the neck
General aches, pains, and stiffness in the joints and muscles
Kids between the ages of 1 and 3 may have symptoms that include:
Irritability and general discomfort
Swollen lymph nodes in the neck
Nasal discharge that may appear thick or bloody
Loss of appetite, nausea, or other complaints of a stomach ache
Kids under the age of 1 may have a lower grade fever accompanied by:
General fussiness and irritability
Yellow or green nasal discharge
A sudden decrease in appetite
Refusal to drink or nurse, which is a common sign of painful swallowing
A red rash on the legs, arms, and torso
Potential Complications of Strep Throat
When left untreated, strep throat may potentially lead to complications that may pose more serious problems to your toddler’s health. Some common complications include:
Scarlet fever – Scarlet fever is actually an allergic reaction that your child may have to the strep bacteria. It often results in a rash that is red, pimply, and rough to the touch. While scarlet fever is not more dangerous than strep throat, it may cause your toddler to feel sicker and be more irritable.
Rheumatic fever – In rare cases of strep throat, the bacteria will enter your toddler’s blood stream and travel to the heart, where it can take root in the heart valves and form a small mass. That mass can interfere with normal heart functions, making it difficult for your child to breathe and causing chest pains and persistent fevers.
Glomerulonephritis – This condition describes inflammation of the kidneys and occurs when the antibodies designed to protect the body from strep mistakenly attack healthy kidney cells. This causes the kidneys to temporarily fail and is noted by blood in the urine.
Strep throat may also progress to ear or sinus infections.
Diagnosing Strep Throat in Toddlers
As prominent as sore throats are in strep infections, they can be potentially misleading. Most sore throats are actually caused by viral infections. If your child exhibits sore throat along with symptoms of the common cold, like coughing, sniffling, or a runny nose, they probably have a viral infection, which should go away on its own without the need for treatment. The only true way to know if your toddler is suffering from strep throat is to get a professional diagnosis from your pediatrician. Diagnosis is generally made with a physical exam. Make sure you have your toddler’s medical history on hand. From there, your pediatrician will likely test using a throat culture. This involves rubbing a cotton swab to collect fluid samples from the back of your child’s throat. While this is not painful, it may cause some gagging. The sample is then tested to detect any presence of group A Streptococcus. Most pediatricians will use a rapid strep test, which returns results within minutes. However, rapid strep tests cannot detect all instances of strep. Even if your toddler tests negative via the rapid strep tests, your pediatrician will send the samples to a lab to create a throat culture. While these results will take longer (usually about 48 hours), a throat culture can indicate all forms of the bacteria and provide more definitive results.
Treatment for Strep Throat in Toddlers
Thankfully, strep throat can be easily treated with a course of antibiotics, usually amoxicillin and penicillin. The antibiotics should relieve symptoms and reduce your toddler’s discomfort almost instantly. Antibiotics will also significantly reduce chances of your toddler spreading the infection to others. In kids, strep throat is not contagious anymore once they have been on antibiotics for 24 hours. However, make sure that your little one does take their entire course of antibiotics. Even if your child’s symptoms have improved does not mean that the bacteria has been completely eliminated from their system. Stopping early can lead to a relapse of symptoms, causing a worse infection and potentially leading to more serious complications. Not administering the full course of antibiotics for strep throat also increases the risk of creating “super bacteria’ that are resistant to common antibiotics, forcing your pediatrician to prescribe more powerful medication that could be difficult for your toddler to manage.
Taking Care of Your Toddler at Home
The best thing you can do to make your child comfortable and speed up recovery is to make sure that they stay at home. Once you know for sure that your child has strep throat, keep them at home for at least 24 hours after they are first given antibiotics or for a few days until their symptoms subside. This also keeps them from spreading strep bacteria to others. Provide plenty of cold water, juice, or popsicles to soothe your toddler’s throat while keeping them hydrated. Warm liquids like soup or chamomile tea can also reduce their discomfort and pain. If your toddler is old enough to gargle, mix a half teaspoon of salt in a cup of water and have them gargle the mixture to relieve discomfort and potentially remove bacteria from their throat. Over-the-counter pain relievers can also help your little one better stave off the soreness. Stick with acetaminophen or ibuprofen (the latter should only be used if your child is 6 months or older). Never give your kids aspirin. Studies show that aspirin can increase the risk of Reye’s syndrome, a rare condition that causes swelling in the brain and liver, potentially leading to death. Consider running a cool-mist humidifier in your toddler’s room while they sleep. This can help to reduce pain and ease their breathing. Make sure you keep the humidifier clean. A dirty humidifier may just spread more germs and bacteria into the air.
Preventing Strep Throat in Toddlers
Preventing strep throat can be difficult, especially considering most toddler’s immune systems are just developing. Most people, kids and adults (including pregnant women, carry strep bacteria without developing symptoms, making it impossible to truly predict the illness or avoid exposure. One good thing you can do to at least reduce the risk of strep throat is to teach your little one how to properly wash their hands. Make sure they wash their hands frequently, particularly before they eat a meal and after they come back from daycare, the playground, or other outing. Furthermore, make sure your toddler does not share their toys, utensils, drinks, and other objects while they are sick. You should also replace your child’s toothbrush once the infection has passed. Although your toddler will now have some immunity to the strep bacteria, they can still get re-infected. [book_appointment]
When to Call Your Pediatrician
You should call your pediatrician whenever you suspect your little one has strep throat, but you should also consult your pediatrician if you notice symptoms like:
A fever of 101.5 degrees Fahrenheit
A red rash
Difficulty swallowing or breathing
Swollen joints or a rash up to three weeks after the initial strep infection (these may point to scarlet fever or rheumatic fever)
You should also consult your doctor if your child’s symptoms do not improve 48 hours after taking the antibiotics. If you think that your kids may be suffering from strep throat, consult your healthcare professional or an urgent care center immediately.
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mayoclinic.org. Strep Throat. Accessed on September 3, 2020. https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338
cdc.gov. Strep Throat: All You Need to Know. Accessed on September 3, 2020. https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html
Medline Plus. Strep Throat. Accessed on February 14, 2021. https://medlineplus.gov/ency/article/000639.htm