Sore Throat in Babies & Toddlers

Content reviewed against published AAP, AAP, CDC guidelines

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Sore throat (pharyngitis) in babies and toddlers is most commonly caused by viral infections such as the common cold. Babies cannot verbalize throat pain, so parents may notice feeding refusal, fussiness, drooling, or crying during swallowing. Strep throat (Group A Streptococcus) is rare in children under 3 years but becomes more common in preschool and school-age children. Most sore throats resolve within 5-7 days without specific treatment.

Key takeaways

  • Sore throat (pharyngitis) in babies and toddlers is most commonly caused by viral infections such as the common cold.
  • Most common cause: Viral upper respiratory infection (common cold)
  • Emergency: Drooling with inability to swallow and neck extended forward (possible epiglottitis)
  • Home care: Offer cold or room temperature fluids frequently in small amounts

Possible Causes

Viral upper respiratory infection (common cold)common
Hand-foot-and-mouth disease or herpanginacommon
Croup (laryngotracheitis)common
Strep throat (Group A Streptococcus) — rare under age 3uncommon
Mononucleosis (Epstein-Barr virus)uncommon
Peritonsillar abscessrare
Retropharyngeal abscessrare
Epiglottitisrare

When to Seek Help

Emergency — Call 911 or go to ER:

  • Drooling with inability to swallow and neck extended forward (possible epiglottitis)
  • Severe difficulty breathing with sore throat
  • Significant neck swelling with fever and toxic appearance (possible deep space infection)

Urgent — See doctor today:

  • Difficulty opening mouth (trismus) or muffled voice with fever
  • Unilateral neck swelling with high fever (possible peritonsillar abscess)
  • Complete inability to swallow liquids for more than 8 hours
  • Sore throat with drooling and stridor

Same-day appointment:

  • Sore throat with fever lasting more than 3 days
  • Sore throat with sandpaper rash (possible strep/scarlet fever)
  • Throat pain with significant feeding reduction but still taking some fluids
  • Sore throat in child with known strep exposure

Monitor at home:

  • Mild sore throat with cold symptoms (runny nose, cough) and adequate fluid intake
  • Brief feeding fussiness during a viral illness that resolves in 2-3 days
  • Sore throat improving day by day with symptomatic care

By Age

0-6 months

Normal: True sore throat is uncommon in this age group. Fussiness during feeding may be due to nasal congestion rather than throat pain.

Worry if: Complete feeding refusal with signs of dehydration. High fever (over 38°C/100.4°F) in baby under 3 months always requires evaluation regardless of cause.

6-12 months

Normal: Mild throat discomfort with viral colds is common. Baby may briefly fuss at start of feeds but continues eating.

Worry if: Drooling with inability to swallow, stridor or noisy breathing, neck swelling, or fever with complete feeding refusal lasting more than 12 hours.

1-3 years

Normal: Frequent sore throats with viral illnesses, especially in daycare settings (6-8 viral infections per year is normal). Toddlers may point to throat or refuse certain foods.

Worry if: Muffled "hot potato" voice, trismus (difficulty opening mouth), unilateral neck swelling, drooling with high fever, or sore throat with sandpaper-like rash (possible scarlet fever).

Home Care

  • Offer cold or room temperature fluids frequently in small amounts
  • Cold foods like yogurt, applesauce, or ice pops can soothe throat
  • Use age-appropriate pain relief (acetaminophen; ibuprofen for babies over 6 months)
  • Run a cool-mist humidifier in the bedroom
  • For toddlers over 1 year, honey (half to one teaspoon) can soothe throat pain
  • Avoid acidic or rough-textured foods that may irritate
  • Offer soft, easy-to-swallow foods when baby is ready to eat
  • Do NOT give cough drops or hard candy to children under 4 (choking risk)
  • Warm (not hot) broth or soup for toddlers may provide comfort

Frequently asked questions

What causes sore throat?
Viral upper respiratory infection (common cold) (common); Hand-foot-and-mouth disease or herpangina (common); Croup (laryngotracheitis) (common); Strep throat (Group A Streptococcus) — rare under age 3 (uncommon); Mononucleosis (Epstein-Barr virus) (uncommon); Peritonsillar abscess (rare); Retropharyngeal abscess (rare); Epiglottitis (rare)
When is this an emergency?
Drooling with inability to swallow and neck extended forward (possible epiglottitis). Severe difficulty breathing with sore throat. Significant neck swelling with fever and toxic appearance (possible deep space infection)
What can I do at home?
Offer cold or room temperature fluids frequently in small amounts. Cold foods like yogurt, applesauce, or ice pops can soothe throat. Use age-appropriate pain relief (acetaminophen; ibuprofen for babies over 6 months). Run a cool-mist humidifier in the bedroom. For toddlers over 1 year, honey (half to one teaspoon) can soothe throat pain. Avoid acidic or rough-textured foods that may irritate. Offer soft, easy-to-swallow foods when baby is ready to eat. Do NOT give cough drops or hard candy to children under 4 (choking risk). Warm (not hot) broth or soup for toddlers may provide comfort
When should I call the doctor?
Sore throat with fever lasting more than 3 days. Sore throat with sandpaper rash (possible strep/scarlet fever). Throat pain with significant feeding reduction but still taking some fluids. Sore throat in child with known strep exposure

Sources

AAPAAPCDC

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Symptoms

swollen tonsilsmouth soresrefusing to eatdrooling

Bottom line

Most cases of sore throat in babies are not emergencies. However, seek immediate care if drooling with inability to swallow and neck extended forward (possible epiglottitis).

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.