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When Your Child Has Pharyngitis or Tonsillitis 

Your child’s throat feels sore. This is likely because of redness and swelling (inflammation) of the throat. Two areas of the throat are most often affected. These are the pharynx and tonsils. Inflammation of the pharynx (pharyngitis) and inflammation of the tonsils (tonsillitis) are very common in children. This sheet tells you what you can do to ease your child’s throat pain.

Front view of face with open mouth comparing oral cavity and tonsils with inflamed throat and enlarged tonsils.

What causes pharyngitis or tonsillitis?

Most commonly, pharyngitis and tonsillitis are caused by a viral or bacterial infection.

What are the symptoms of pharyngitis or tonsillitis?

The main symptom of both conditions is a sore throat. Your child may also have a fever, redness or swelling of the throat, and trouble swallowing. You may feel lumps in the neck.

How is pharyngitis or tonsillitis diagnosed?

The healthcare provider will look at your child’s throat. The healthcare provider might wipe (swab) your child’s throat. This swab will be tested for the bacteria that causes an infection called strep throat. If needed, a blood test can be done to check for a viral infection such as mononucleosis.

How is pharyngitis or tonsillitis treated?

If your child’s sore throat is caused by a bacterial infection, the healthcare provider may prescribe antibiotics. Otherwise, you can treat your child’s sore throat at home. To do this:

  • Give your child acetaminophen or ibuprofen to ease the pain. Don't use ibuprofen in children younger than 6 months of age or in children who are dehydrated or vomiting all of the time. Ask your child's healthcare provider about how much and when to give the medicine.

  • Don’t give your child aspirin to relieve a fever. Using aspirin to treat a fever in children could cause a serious condition called Reye syndrome.

  • Give your child cool liquids to drink.

  • Have your child gargle with warm saltwater if it helps relieve pain.

  • Try an over-the-counter throat numbing spray.

Always talk with your child's healthcare provider before giving your child any over-the-counter medicines, especially if it's the first time your child will be taking the medicine.

What are the long-term concerns?

If your child has frequent sore throats, take him or her to see a healthcare provider. Removing the tonsils may help relieve your child’s recurring problems.

When to call your child's healthcare provider

Call your child’s healthcare provider right away if your otherwise healthy child has any of the following:

  • Fever (see Fever and children, below)

  • Sore throat pain that persists for 2 to 3 days

  • Sore throat with fever, headache, stomachache, or rash

  • Trouble turning or straightening the head

Call 911

If your child has any of these symptoms, call 911 right away:

  • Problems swallowing or drooling

  • Trouble breathing or needing to lean forward to breathe

  • Problems opening mouth fully

  • Trouble speaking

  • Skin that is blue, purple, or gray in color

  • Loss of consciousness or problems waking

  • Feeling faint or dizzy

  • Shortness of breath with a fast heartbeat

Fever and children

Use a digital thermometer to check your child’s temperature. Don't use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel OK using a rectal temperature, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

Below are guidelines to know if your child has a fever. Your child's healthcare provider may give you different numbers for your child.

A baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

A child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher

  • Fever that lasts more than 24 hours in a child under 2 years old

  • Fever that lasts for 3 days in a child age 2 or older

© 2000-2020 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.