A Blog from Your Kaiser Permanente Pediatricians in Northern California

boy with strep throat

Does My Kid Have Strep Throat? 6 Things to Understand

I have a running joke with a good friend about how many times her children have been tested for strep throat. Many – and they’ve never actually had it! It’s fun to tease, but honestly, I get it. How’s a parent to know when a sore throat is strep throat? And isn’t it scary not to treat strep throat? Here are some of the responses to common questions I often share in my office – and with my best friends:

  • It’s always okay to call or email your pediatrician asking to have your child tested. There are some signs that make it more likely your child has strep. Strep throat usually has a rapid onset of sore throat, trouble swallowing, fever, enlarged lymph nodes (commonly called “glands”). It doesn’t tend to come with nasal congestion – runny nose, cough, hoarse voice, mouth sores, or red eyes. Some younger kids have a stomachache, pain, or nausea. Some kids get a rough red rash on their trunk.
  • Most sore throats are caused by viruses, not bacteria, and don’t require antibiotics. To know for sure if it’s strep throat, a test is needed. Doctors can’t reliably tell just by looking in a child’s throat whether there’s a bacterial infection caused by group A Streptococcus (strep). If the test is negative, no antibiotics are needed and a child’s symptoms can be cared for at home with fluids, rest, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), and love.
  • If a test confirms strep throat, antibiotics are needed. The antibiotics make your child feel better and prevent rare complications of the strep infection, including kidney damage and acute rheumatic fever (which can cause a serious heart condition). This is why it’s important to finish all of the antibiotics even when your child starts to feel better.
  • Strep throat is rare in children under age 3 and so are its complications.
  • Strep is contagious and spreads through saliva or nasal secretions shared through close contact with infected children and adults (at school, daycare, or home). It takes 2 to 5 days from contact with these germs to show signs of illness. You can prevent it from spreading by washing your hands frequently and thoroughly. After treatment with an antibiotic for 24 hours, a child is no longer contagious. If they feel better and have not had a fever within 24 hours, they can return to school or daycare.
  • Tonsils only need to be removed very rarely. We used to remove everyone’s tonsils. Now we understand that a tonsillectomy can be risky and only needs to be done in when a child is getting many episodes of strep throat each year. Talk with your doctor if you’re concerned your child may need a tonsillectomy.

Resources for Parents:

My Doctor Online
Strep Throat
Tonsillectomy in Children (Emmi)

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