Acute Pharyngitis: Presumed Strep (Child)

Home care

Medicines

Follow these guidelines when giving your child medicine at home:

• If your child has pain or fever, you can give them medicine as advised by your child's healthcare provider.

• Don't give your child any other medicine without first asking the provider.

Follow these tips when giving fever medicine to a normally healthy child:

• Don’t give ibuprofen to children younger than 6 months old. Also don’t give ibuprofen to an older child who is vomiting constantly and is dehydrated.

• Read the label before giving fever medicine. This is to make sure that you are giving the right dose. The dose should be right for your child’s age and weight. If you have any questions about dosing, ask your child's healthcare provider.

• If your child is taking other medicine, check the list of ingredients. Look for acetaminophen or ibuprofen. If the medicine contains either of these, tell your child’s healthcare provider before giving your child the medicine. This is to prevent a possible overdose.

• If your child is younger than 2 years, talk with your child’s healthcare provider before giving any medicines to find out the right medicine to use and how much to give.

• Never give aspirin to a child or teen. It could cause a rare but serious condition called Reye syndrome.

  Note: Don't give your child any other medicine without first asking your child's healthcare provider, especially the first time.

General care

• Keep your child home from school or day care until the provider tells you if your child has strep throat. Strep throat is very contagious. 

If strep throat is confirmed

• The healthcare provider will prescribe antibiotics. Follow all directions for giving this medicine to your child. Make sure your child takes the medicine as directed until it's gone. You should not have any left over.

• Limit your child's contact with others until they are no longer contagious. This is 24 hours after starting antibiotics and they do not have a fever, or as advised by your child’s provider. 

• Tell people who may have had contact with your child about their illness. This may include school officials and daycare center workers.

• Wash your hands with clean, running water and soap before and after caring for your child. This is to help prevent the spread of infection. Others should do the same.

• Give your child plenty of time to rest.

• Encourage your child to drink liquids.

• Older children may prefer ice chips, cold drinks, frozen desserts, or ice pops.

• Older children may also like warm chicken soup or drinks with lemon and honey. Don’t give honey to a child younger than 1 year old.

• Don’t force your child to eat. If your child feels like eating, don’t give them salty or spicy foods. These can irritate the throat.

• Older children may gargle with warm salt water to ease throat pain. Have your child spit out the gargle afterward and not swallow it. 

Follow-up care

Follow up with your child’s healthcare provider, or as directed.

When to get medical advice

Call your child's healthcare provider right away if any of the following occur:

• Fever of 100.4°F (38°C) or higher, or as directed by your provider (see Fever and children, below)

• Symptoms don’t get better after taking prescribed medicine or seem to be getting worse

• Ear pain, sinus pain, or headache that is new or getting worse

• Painful lumps in the back of neck

• Lymph nodes are getting larger 

• Your child can’t swallow liquids, has lots of drooling, or can’t open their mouth wide because of throat pain

• Signs of dehydration. These include very dark urine or no urine, sunken eyes, and dizziness.

• Noisy breathing

• Muffled voice

• New rash

Call 911

Call 911 if any of the following occur:

• Trouble breathing

• Confusion

• Feeling drowsy or having trouble waking up

• Unresponsive

• Fainting or loss of consciousness

• Fast (rapid) heart rate

• Seizure

• Stiff neck

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For 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 fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

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

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider