Sore throat is a common symptom in children. Often this is due to colds. In case of high fever, sore throat, difficult to swallow and no cough or sniff, you can suspect tonsillitis. In case of sore throat without fever, sniffing or coughing or any other symptoms, there is rarely any disease behind it.
The course of the cold
Most colds follow one and the same pattern over time. First you get a sore throat, then you get sniffing, coughing and sneezing. The fever often comes on the second-third day. The sore throat sits for a few days, while the mucus, which is first transparent and then more and more colored, lasts for a week. The cough can last for up to three to four weeks after each cold.
Children of preschool age have on average between 6 and 10 colds per year. In 9 out of 10 cases, the child is able to fight the cold himself. As a parent, you mostly need to think about giving your child love and relaxation. Give the child pain relief if it seems to be in pain, clean the baby's nose and give nasal drops (type nezeril) if the nasal congestion is difficult. If you want, you can give 1-2 teaspoons of honey (to children over a year) for the evening against cough.
Should I go to the ER?
No. Not if the baby can breathe and eat. No one at the ER can help you with anything for your child that you can't do at home. At the ER, it is teeming with gastrointestinal virus and more cold viruses, so the risk is quite high that you go home with more viruses than you came with. Cough medicine on prescription has no proven effect. There are no medicines to help prevent colds.
In addition, the ER is not a child-friendly place. At the ER, the child is allowed to sit in a waiting room among other coughing, vomiting children. Often with a scary TV with children's programs in the background and doubtless dirty toys on the floor.
If your child has difficulty breathing even when the nose is clear and you do not have inhalations that work well enough at home, it is a good idea to go to the paediatric emergency room or child competent care center, then the child may need inhalations.
If the child has a fever and is under three months, or is lethargic and feeling unwell, you may need to go to the ER. But in case of a fever in a cold child over three months who feels pretty good between the fever spikes, you can stay home.
Should I go to the health center with a child with a cold?
In a cold without complications, there is nothing that a health care doctor can do for your child either. If the child has suspected tonsillitis, ear inflammation or pneumonia, it may be appropriate to seek medical attention.
Some colds are complicated by ear inflammation. It can be noted that the fever does not go away after a few days. Or the children have pain in the ear and are whining. Sometimes the eardrum bursts and it runs out of the ear.
If the child has suspected ear inflammation, give pain relief, let the child sleep with raised head end, and got to the health centre.
But then tonsillitis?
Tonsillitis, or streptococcal infection in the throat, is characterized by the child having high fever (almost always above 38.5 degrees) and sore throat, it hurts every time the child swallows. No coughing, no sniffing, no sneezing. In the surrounding area there are often others who are sick with streptococcal infections, with tonsillitis or sore throats or swine, or scarlet fever.
If it is the case for your child, you are right to go to the health centre with the child. There, the doctor should take a quick test for streptococci with a stick in the throat and prescribe Kåvepenin for ten days if it is positive. In adults, it has been established that antibiotic therapy reduces the risk of quinsy. Quinsy is uncommon in children and there are no safe studies on whether the risk of quinsy decreases in antibiotic treatment of tonsillitis in children. It seems that antibiotic treatment reduces the risk of spreading infection within the family.
It's a stupid idea to offer the better tasting Amimox when you think someone has tonsillitis. Sometimes the throat infection is caused by EBV virus instead and is called glandular fever. If you give Amimox to someone who has glandular fever, there is a risk that that person will get terrible itchy, measles-like rashes all over his body.
Isn't it safest to take streptococcal samples even if the child coughs and sneezes?
No, it really isn't. Between 5 and 25 out of 100 children have streptococci in their throats even when healthy. Of course, they also have it when they are cold and then the streptococcus test shows positive. There has been no beneficial effect of treating this with antibiotics (for example Kåvepenin) except in cases where the infection goes around the family and some family member gets tonsillitis again and again.
But then CRP?
CRP is a protein that the body produces to fight inflammation. In the case of high fever caused by bacteria, CRP is often significantly increased after 24 hours. In fever spikes, CRP is usually low. If your child has a typical cold, I cannot see that CRP adds anything positive, however it does mean a prick in the finger that hurts. If the child has suspected throat flux, CRP also does not add anything at all, as the antibiotic treatment is determined by the result of the streptococcus test (which is taken with a stick in the throat - really inconvenient!).
Sure I use CRP sometimes, but only if I wonder if there may be a bacterial infection that causes the fever. It may be good to know that ear infections usually do not produce increased CRP even though they are bacterial. If the doctor or nurse at the emergency room or health centre wants to do a blood test on your child: ask why. Will the answer determine how the doctor interprets your child's infection, what advice or what treatment the child receives then it is reasonable. But if it is done more or less as a precaution, your child can be saved the pain.
Colds in children are best cared for at home by their parent. Relaxation and love, painkillers and hot or cold drinks, what the child likes best. Free access to ice cream! Children who do not cough, sneeze or are snotty, but have a sore throat and more than 38.5 degrees of fever may have tonsillitis. Go to the health centre for a streptococcus test, antibiotics are recommended if positive.