Strep Throat in Babies and Toddlers: Signs and Treatment

It's likely that your little one may have a sore throat from time to time. Although a viral infection is the most common cause of this condition in infants and babies, strep throat is another possible cause. Learn all about what strep throat is, what causes it in babies and toddlers, how to recognize its symptoms, and how you can treat it.

What Is Strep Throat and Can Babies or Toddlers Get It?

Strep throat is a bacterial throat infection caused by the Streptococcus pyogenes bacterium. It can cause a sore throat and inflammation in the tonsils and is often confused with viral throat infections.

Besides making the throat feel scratchy and sore, strep throat can lead to fever, rash, and even kidney inflammation if it’s left untreated. The good news is that strep throat is easy to treat with antibiotics.

Although strep throat is most commonly seen in children aged 5 to 15 years old, it can occur at any age. This means that even babies and toddlers can have strep throat, though cases are rare in this age group.

What Are the Symptoms of Strep Throat in Babies and Toddlers?

The symptoms of strep throat in infants, older babies, and toddlers may differ from those of adults and older children.

Strep Throat Symptoms in Babies

The symptoms of strep throat in infants tend to be mild, and may include the following:

• a low fever

• thickened or bloody nasal discharge

• being unable to sleep

• irritability

• refusing to feed

• swollen glands in the neck area

• redness in the throat or tonsils

• a fine, red rash on the torso, legs, and arms.

Strep Throat Symptoms in Toddlers

Among the symptoms of strep throat in toddlers are the following:

• a thick or bloody nasal discharge

• a mild fever

• crankiness

• lack of appetite

• swollen glands in the neck

• tummy pain and/or vomiting.

Strep Throat Symptoms in Children Over 3 Years Old

For older children, strep throat can cause:

• an extremely sore throat

• swollen glands

• a temperature over 102 degrees Fahrenheit (38.9 degrees Celsius)

• pus on the tonsils.

What Causes Strep Throat?

The bacterium Streptococcus pyogenes, also known as group A streptococcus, is the cause of strep throat.

This type of bacteria is highly contagious and can be transmitted through airborne droplets when an infected person sneezes or coughs, or when someone shares food or drinks with an infected person. It’s also possible for your baby or toddler to become infected if they touch a contaminated surface and then touch their nose, mouth, or eyes.

How to Protect Your Little One Against Strep Throat

Here's what you can do to reduce the chances of your infant or toddler (or anyone in your family) being exposed to the bacteria and getting strep throat:

• Wash hands frequently. Wash your hands before touching or feeding your little one and have other family members and any guests do so as well when they enter the house. Clean your baby's hands often and supervise older toddlers and children to make sure they do a good job of washing their hands.

• Cover coughs and sneezes with a tissue or upper arm. Everyone who cares for your little one should use either a tissue or the crook of the elbow when coughing or sneezing. Encourage your toddler to do this too and be sure to throw out any used tissues.

• Avoid sharing drinking cups or utensils. This can help prevent your little one from coming into contact with the bacteria if the items were used by an infected person.

How Is Strep Throat Diagnosed?

If you suspect your child has strep throat, it’s safest to take them to their healthcare provider. The provider may have a rapid strep test on hand, which can offer results within minutes. A negative result often means the infection is presumed to be caused by a virus.

However, up to a third of negative rapid strep tests can give a false negative (meaning the result is negative, even if your child has strep throat). So even if you get a negative result from the rapid test, if your healthcare provider suspects strep throat as being the cause of the sore throat, your provider may swab your child’s throat to test for the presence of the streptococcus bacterium, just to be sure. The results of the throat culture may be available within a day or two.

What Is the Treatment for Strep Throat?

Strep throat in children is easy to treat. If the results of the tests come back positive, your healthcare provider will probably prescribe antibiotics that can be given orally or by injection.

Make sure that your little one takes the full course of antibiotics, even if they're feeling better and their symptoms improve before the course is up. For children older than 3, it is extremely important that strep throat is successfully treated in order to prevent serious complications, including abscesses of the tonsils or kidney problems.

When Should You Contact Your Healthcare Provider?

If you notice your little one is sick, it’s always a good idea to check in with your healthcare provider. You should contact your provider if you notice any of the following:

• A sore throat that doesn't improve over the course of a day. Notice if your little one's throat seems to be painful most of the time.

• A fever. Use a baby thermometer to check your little one's temperature to see whether they have a fever (a rectal temperature of 100.4 degrees Fahrenheit or higher). This information may also help your provider decide whether you need to bring your baby in if you talk on the phone.

• Excessive drooling. This may indicate your baby is finding it hard to swallow, which could be a sign of a sore throat.

• Signs of dehydration. The signs of dehydration include a dry mouth or less frequent urination (for example, if you change fewer than six wet diapers a day for infants).

Very rarely, a group A strep infection can lead to additional complications like ear infection, sinusitis, abscesses in the tonsils, infection of the lymph nodes, or scarlet fever, so it's important to consult your child's healthcare provider and follow any recommended treatment plan.

What Is the Difference Between a Sore Throat, Tonsillitis, and Strep Throat?

You may have heard the terms tonsillitis, strep throat, and plain old “sore throat” used interchangeably, and could be wondering what's the difference is between them. Here is a brief breakdown:

• Sore throat. In babies and young children, this common symptom usually stems from a viral infection, which can cause inflammation in the throat and around the tonsils, but not the tonsils themselves. Viral infections do not require a specific medicine, and your child should get better in 7 to 10 days. Sometimes a sore throat may be accompanied by a cold, and in some instances, even a mild fever.

• Tonsillitis. Tonsillitis is an inflammation of the tonsils due to a viral or bacterial infection. This infection can cause the tonsils to swell and become larger than normal, and even make them red. A sore throat is a common symptom of tonsillitis, and it often comes with the feeling of pain or discomfort when swallowing. If tonsillitis is due to a bacterial infection, your healthcare provider will prescribe a course of antibiotics.

• Strep throat. Strep throat is an infection that’s caused by the Streptococcus pyogenes bacterium and not a virus. A sore throat is the chief symptom, but in older children, the tonsils sometimes become very inflamed, too.

If you suspect your child’s throat is bothering them, consult your healthcare provider, who can make a diagnosis and recommend the appropriate treatment.

The Bottom Line

The good news about strep throat is that it’s incredibly rare in infants and toddlers and is typically mild when it does occur in children under the age of 3. Even for older children, a course of antibiotics is usually enough to treat it. Of course, if you’re at all concerned about how your little one is feeling, check in with your healthcare provider for expert advice and to rule out any health concerns that require treatment.

_{How We Wrote This Article The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.}