It is hard to read the emotions of infants and toddlers. Still, what is a parent to do if a children who are yet to start talking refuse to swallow food and also go on crying? Such feed refusal can be an important sign of a common underlying condition: sore throat.
Such feed refusal can be an important sign of a common underlying condition: sore throat.
A sore throat infection in children can often go unnoticed due to their inability to communicate well. This leaves parents confused and concerned. However, understanding certain significant signs can help them ease the troubled child’s discomfort. What helps are an early diagnosis and looking out for the telltale signs of an infection.
Dr Kanchan Channawar, senior paediatrician at Kamineni Hospitals, Hyderabad, tells Happiest Health that while most sore throat infections are viral, one in every ten cases is bacterial.
Cry: Hint of sore throat in children
According to Dr Rashmi Jeenakeri, a Bengaluru-based neonatologist, since babies cannot formulate words and express themselves, it is hard to understand their emotions. But if a child is unusually cranky and refusing feeds, it mostly showcases an underlying problem and is one of the most important signs of a sore throat infection.
Taking such symptoms into account, Sumathi M from Bengaluru and her family sought early treatment for her two-year-old niece when she had a sore throat infection. She recalls her niece refusing feeds and getting very cranky. “She kept on saying ‘ganti’ (‘gantalu’ is neck in Kannada) while she touched her neck,” says Sumathi.
By evening, the child started developing a mild fever along with some cough. A pediatrician later told the family she had a viral infection that led to a sore throat which was causing her pain in swallowing food. “After taking her medications, she recovered within two days,” say Sumathi. The recovery was quick since viral infections naturally runs their course and are usually mild.
What causes sore throat in children
Dr Haridarshan GJ, consultant pediatrician, Apollo Hospitals, Bengaluru, lists out several factors that can lead to a sore throat infection in infants and toddlers:
- Viral infections: coronavirus, rhinovirus (common cold), adenovirus (respiratory infections), influenza (flu), parainfluenza virus (respiratory infections), coxsackie virus (HFMD)
- Bacterial infections: group A beta-hemolytic streptococcus (GABHS), diphtheria, haemophilus influenzae type b, staphylococcus aureus, mycoplasma, chlamydia pneumoniae, moraxella catarrhalis and yersinia are some bacterial causes. Among them, GABHS infection is common but challenging to diagnose. Missed diagnosis can lead to complications. Diphtheria is a serious respiratory infection that can be prevented with routine vaccination
- Some other uncommon causes of sore throat are allergies, peritonsillar abscess (a severe infection that spreads from the tonsils to the space surrounding it), retropharyngeal abscess (an infection that develops in the back side of the throat affecting the lymph nodes) and acid reflux
Viral vs bacterial
It is important to differentiate between viral and bacterial infections since the route of treatment is different for both, say doctors. Mistreating a viral infection with antibiotics increases antibiotic resistance in the body. This is because bacterial infections require antibiotics for treatment, while viral infections have self-limiting medications.
In case of a sore throat infection, doctors say the following primary and associated symptoms might be seen:
- Viral: Running and blocked nose, cold, redness of the eyes, diarrhea, rashes, fever
- Bacterial: Continuous high-grade fever, redness of the eyes, headache, tiredness, swollen lymph nodes (an effect of the body fighting the infection), whitish patches in the oral cavity
One of the main differences between a bacterial and viral infection is the degree of fever that the child might have developed and their level of activity. “Fever is intermittent when it comes to viral infections, but bacterial infections usually manifest continuous high-grade fever with chills wherein the child looks tired,” Dr Haridarshan says.
Dr Kanchan says, “If it’s a viral infection, a child will be inactive until the fever is gone and will return to their normal energy level after taking medications. But in case of a bacterial infection, the child has a toxic appearance.” Doctors say that a toxic appearance is characterised by lethargy that includes missing eye contact and inability to recognize parents or other people in the surroundings.
Usually, children do not complain more than once or twice when it comes to food. “Infants and toddlers can’t lie; if they are throwing tantrums due to discomfort, there is something wrong,” says Dr Haridarshan. “If they’re crying continuously for more than an hour and they start getting cranky, then there is some problem.”
He says any parent can identify the changes in their child’s appearance, which will help in understanding the hidden meaning behind such tantrums, and meeting a paediatrician is important.
Prevention and treatment
Dr Haridarshan stresses on the importance of diphtheria vaccination on time, along with maintenance of hand hygiene, and isolation from other family members, especially if it’s a viral infection.
Dr Rashmi says good pain management is the usual course of action. Usually, some anti-inflammatory and analgesic medications in the form of syrups are prescribed to treat sore throat infections. “Once the pain subsides, your child will be able to eat and drink without any discomfort,” she says.
Dr Kanchan advises that since children’s refusal to eat can lead to dehydration, make sure they are properly hydrated with lukewarm water.