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It’s the middle of the night and your baby is irritable, seems to be uncomfortable feeding and swallowing, and their crying sounds scratchy. You suspect a sore throat, and you’re worried it could be something more serious, like strep or tonsillitis.

Sore or scratchy throats are rarely a medical emergency on their own, but can still be troubling for new and veteran parents alike. Your first step is to observe your baby’s symptoms and keep a close eye on them.

Let your baby’s pediatrician know about all your baby’s symptoms. That will help your doctor determine if you need to bring your baby in to be seen or if you should keep them home to rest.

when to Seek emergency help

Always seek medical help right away if your baby is having difficulty breathing or swallowing.

There are a number of common causes for sore throat in babies.

Common cold

A sore throat in infants is often caused by a viral infection like the common cold. The main symptoms of a cold are nasal congestion and a runny nose. These may be in addition to the sore throat symptoms you are noticing in your baby.

On average, babies may have up to seven colds in their first year of life as their immune system develops and matures.

If you suspect your baby has a cold, you may want to consider keeping them home from child care if:

  • They have a fever. A good rule of thumb, and a rule at most child care facilities, is to keep your baby home while they have an active fever and for an additional 24 hours after the fever breaks.
  • They seem really uncomfortable. If your baby is crying a lot or seems unlike their normal self, consider keeping them home.

If your child attends day care, you’ll want to check the center’s policies, too. They may have additional requirements for keeping sick children home.

Tonsillitis

Infants can experience tonsillitis, or inflamed tonsils. Tonsillitis is usually caused by a viral infection.

If your baby has tonsillitis, they may not be interested in feeding. They may also:

  • have difficulty swallowing
  • drool more than usual
  • have a fever
  • have a scratchy-sounding cry

Your pediatrician may prescribe infant acetaminophen or infant ibuprofen, if needed. If your baby is already eating solids, they’ll need to stick with soft foods.

When deciding if you need to keep your child home from child care, follow the same guidelines for a cold.

Hand, foot, and mouth disease

Hand, foot, and mouth disease is caused by various viruses and is common in children under 5. Symptoms may include a fever, sore throat, and mouth pain. Your baby may have blisters and sores in their mouth, too. These may make it difficult to swallow.

You will likely also see a rash of red bumps and blisters on your baby’s hands, feet, mouth, or buttocks.

Your pediatrician may recommend fluids, rest, and infant acetaminophen or infant ibuprofen, if needed.

Hand, foot, and mouth disease is very contagious. Keep your child home from child care facilities until the rash has healed, which may take 7 to 10 days. Even if they are no longer acting as though they are sick after a few days, they’ll continue to be contagious until the rash has healed.

Strep throat

Strep throat is a type of tonsillitis that is caused by a bacterial infection. While it’s uncommon in children under age 3, it’s still a possible cause for sore throat.

Symptoms of strep throat in infants may include a fever and very red tonsils. You may also feel swollen lymph nodes on their neck.

If you suspect your baby has strep throat, contact their pediatrician. They can perform a throat culture to diagnose it. They may prescribe antibiotics, if needed.

If your baby is under 3 months, call their pediatrician at the first signs of a sore throat, such as refusing to eat or remaining fussy after eating. Newborns and infants under 3 months don’t have a fully developed immune system, so their pediatrician may want to see or monitor them.

If your baby is over 3 months, call your pediatrician if they have other symptoms in addition to seeming to have a sore or scratchy throat including:

  • a temperature over 100.4°F (38°C)
  • a persistent cough
  • unusual or alarming cry
  • isn’t wetting their diapers as usual
  • seems to have ear pain
  • has a rash on their hand, mouth, torso, or buttocks

Your pediatrician will best be able to determine if you need to bring your baby in to be seen, or if you should keep them home and try home remedies and rest. The pediatrician can also advise you on whether your baby should be kept home from child care and for how long they may be contagious.

Always seek emergency medical care right away if your baby is having difficulty swallowing or breathing. You should also seek emergency medical care if they have unusual drooling, which may mean they’re having trouble swallowing.

Some home remedies may be helpful for an infant with a sore throat.

Humidifier

Setting up a cool-mist humidifier in baby’s room may help ease sore throat symptoms. If your baby has a stuffy nose, the humidifier may help them breathe easier.

Set up the humidifier away from your baby so they won’t touch it, but close enough they can feel the effects. Hot-water vaporizers are a burn hazard and shouldn’t be used. You’ll want to clean and dry your humidifier each day to prevent bacteria or mold from forming. This can make your child ill.

You can use a humidifier until your baby’s symptoms improve, but let your pediatrician know if your baby isn’t getting better after a few days.

Shop for cool-mist humidifiers online.

Suction (for 3 months to 1 year)

Babies aren’t able to blow their noses. Instead, you can use a suction bulb to suck out nasal mucus. Saline drops may help loosen up the mucus to make it easier to remove it with suction.

Shop for infant suction bulbs online.

Frozen liquids (for older infants)

If your baby has already started solids, you may want to give them a frozen treat to soothe their sore throat. Try giving your baby a formula Popsicle or frozen breast milk in an infant Popsicle mold. Observe them while they try this frozen treat to watch for signs of choking.

Shop for infant Popsicle molds online.

Can I give my baby honey water?

It’s not safe to give honey to an infant under 1 year. Don’t give your baby honey water or any other remedies that contain honey. It can cause infant botulism.

The treatment for your infant’s sore throat will depend on what’s causing it. If it’s caused by a common cold, your pediatrician will likely not recommend medication unless they have a fever.

You can keep your infant comfortable by setting up a cool-mist humidifier in their room. Offer them plenty of breast or bottle milk. Fluids can help keep your baby hydrated until their symptoms improve.

Antibiotics may be needed if your baby’s sore throat is caused by a bacterial infection like strep. Your pediatrician will be able to diagnose your baby and prescribe antibiotics, if needed.

Is it safe to give baby over-the-counter medicine?

Over-the-counter cold and cough medications aren’t recommended for babies. They won’t cure cold symptoms and, in some cases, may make your child sick.

The only exception is if your baby has a fever. For babies over 3 months, talk to your pediatrician about giving your baby acetaminophen or ibuprofen for a fever, if needed. They can also let you know the correct dose that’s safe for your baby.

Will Benadryl help baby sleep and is it safe?

Only use diphenhydramine (Benadryl) if your pediatrician specifically recommends it. It generally isn’t safe for infants.

If sore throat is caused by a cold, your baby will likely recover within 7 to 10 days. It may take slightly longer for your baby to recover if the sore throat is caused by hand, foot, and mouth disease, or from tonsillitis or strep throat.

Keep your pediatrician up to date on your baby’s recovery and let them know if baby’s symptoms don’t improve after several days.

It may not be possible to prevent sore throats completely, especially if they’re caused by the common cold. But taking the following measures may help reduce the risk of your little one getting sick again:

  • keep your baby away from other infants, siblings, or adults showing signs and symptoms of a cold or sore throat as much as possible
  • if possible, avoid public transportation and public gatherings with a newborn
  • clean your baby’s toys and pacifiers often
  • wash your hands before feeding or touching your baby

Adults can sometimes catch a sore throat or cold from infants. To prevent this, be sure to wash your hands often. Teach everyone in your household to cough or sneeze into the crook of their arm, or into a tissue that’s then tossed out.

Keep an eye on baby’s symptoms and report them to your pediatrician. They’ll be able to help you figure out if you need to take your baby to a doctor’s office or clinic to be checked out, or if you should keep them home to rest.

In most cases, your baby will recover within 7 to 10 days. You may need to keep them home from child care facilities for some of this time. Check with your care provider and your child’s pediatrician to find out how long baby should be kept home. This may include keeping baby home from other activities, too, like baby and me classes.

Once your baby is fully recovered and back to their smiling self, you can resume all day-to-day activities — from walks to the park to playing with siblings.