Everything to Know About Strep in Babies

Strep throat is incredibly common in children. In fact, according to Johns Hopkins Medicine, this is the culprit that causes 30 percent of sore throats in children. But can babies get strep throat too? And is strep in babies and toddlers as common as strep in older children? Here, pediatricians break down everything there is to know, including signs to look out for and treatment options for strep in babies.

Can Babies Get Strep Throat?

Babies Possible get strep throat, but this is very rare, says Sarah Terez MalkaMD, a pediatrician with Duration of Health, a health and medicine resource for travelers. Most babies have protective antibodies and immunity from their mothers, Malka explains. Plus, because of the small size of a baby’s tonsils, it’s harder for strep bacteria to multiply and create an infection.

Although strep throat is rare in children under 3 years old, it becomes more common between the ages of 5 and 15. “Younger and older children who come into contact with children in the age range that may have a higher risk of strep if they’re re-exposed by a sibling,” Malka added. That said, most sore throats in babies and young children are to blame for viruses rather than bacteria. .

What Causes Strep Throat in Children?

Strep throat is caused by Group A B-hemolytic Streptococcus (GAS) bacteria, says Ruben Espinoza, MD, a pediatrician with Banner Medical Group. Most often, children get strep throat through contact with other people who have GAS bacteria. “It can spread through direct contact such as sharing a cup, touching an infected surface or through respiratory droplets,” he said (for example, coughing and sneezing). According to Centers for Disease Control and Prevention (CDC), it can take up to five days after exposure for a person to develop strep throat.

It’s important to note that while strep is rare in infants and young children, exposure to GAS bacteria can cause other disease manifestations for them, such as scarlet fever and skin infections.

Wondering if Group A strep is connected to Group B strep? Even though they share a common name, these are two different types of bacteria, Malka said. Group B strep is another strep bacteria that is harmless and lives in the vaginal tracts of about 25 percent of women. However, if it is present during vaginal delivery, it can cause problems for the baby, such as bloodstream infection, fever and dizziness.

Yes, children can get strep throat from older siblings or their parents if they are asymptomatic carriers, or from a setting like daycare if there is an outbreak, Espinoza said. however, Alexis Phillips-Walker, DO, a pediatrician at Memorial Hermann Medical Group Pediatrics in Atascocita, Texas, cautions that this occurs only on rare occasions. “If parents are concerned, they should wear a mask to prevent the spread of droplets and avoid sharing food or drink with their children. It is best, if parents can, to limit contact until after 24 that is the time of the antibiotic course to prevent the spread,” he said.

Symptoms of Strep Throat in Babies, Toddlers and Children

For some children, exposure to GAS bacteria may not cause any symptoms, but others may experience “classic strep throat symptoms,” Malka says. According to experts, symptoms commonly seen in school-aged children age 5 and older include:

• A fever over 100.4 degrees Fahrenheit
• Swollen, painful lymph nodes in the front of the neck
• Sore throat
• Pain when swallowing
• Enlarged, red tonsils
• White patches or streaks of pus on the tonsils
• Small, red spots on the roof of the mouth
• Headache
• Stomach pain
• Nausea and vomiting
• Decreased appetite

Although infants rarely become infected with GAS, some signs of strep in infants include fever with restlessness and poor appetite, Phillips-Walker says, rather than “the typical sore throat symptoms that appear to older children.”

Wondering when to see a doctor? Phillips-Walker says parents should see their pediatrician if their child:

• Not one person has ever had a fever of 100.4 degrees Fahrenheit or more
• Over the age of one with a fever higher than 101 degrees Fahrenheit
• Have a fever for more than two days in a row
• Messier than usual
• Complains of a sore throat, stomach ache, headache or other symptoms

Along with strep throat, group A strep bacteria can cause other illnesses and skin rashes in children. “Sometimes GAS can produce a toxin, which causes the rash,” Espinoza explained. One of these diseases is scarlet fever, says Malka, which includes symptoms such as:

• A pink rash with rough, papery skin on the body, arms, legs or face
• High fever
• Swollen or swollen tongue
• Possible sore throat

Other types of skin infections that GAS bacteria can cause include:

• Cellulitis: It presents as an area of ​​warm, red, painful and swollen skin, says Malka. It may also be accompanied by fever.
• Impetigo: It’s “a rash consisting of red sores with a honey-colored crust, with or without fever,” Malka says.
• Scalded Skin Syndrome: This is a serious skin infection that occurs on rare occasions. It causes fever and large areas of blistering, peeling skin and is a medical emergency, Malka says.

How Strep Throat in Children is Diagnosed

Strep throat is usually diagnosed with a strep test, where a swab is taken from the throat, Espinoza said. If the test is positive, your pediatrician will prescribe treatment options. However—while the commonly used rapid strep test catches most cases of strep—if the test is negative, but your provider suspects your child has strep throat, they will send the swab to be further tested for GAS bacteria, and results may take several days, the CDC notes.

Because strep throat is rare in infants and young children, the American Academy of Pediatrics (AAP) says that children under 3 don’t usually need testing when they have a sore throat—they’re really only tested when there’s a high suspicion for it (ie, they have siblings with the disease which is strep throat). Additionally, strep throat usually does not cause long-term complications in infants and young children, the way it can for children over 3 years of age.

It’s also important to note that between 5 and 15 percent of children carry strep bacteria in their throats. “This means they are positive for strep, but not infected,” Malka said. “This is why it’s so important that they only get a strep test when they have classic strep throat symptoms and are in the right age range for strep throat (over age 3),” he says.

If the baby has a strep rash or pus, your pediatrician can check the sores for strep bacteria, or your pediatrician can make a diagnosis just by sight. For newborns with a fever, as well as very sick babies and young children who have been admitted to the hospital, doctors will often test their blood for bacteria, including strep bacteria, Malka said.

How Is Strep Throat Treated in Children?

Children with a positive strep test are usually given oral antibiotics such as penicillin, amoxicillin and cephalosporin (or azithromycin or clindamycin in case of allergy), Malka says. “While strep throat gets better on its own in most cases, treating it with antibiotics can help it get better a few days faster and prevent a serious complication called rheumatic fever, which can lead to lifelong heart problems,” he added. The CDC states that school-aged children and adolescents are more at risk for rheumatic fever than adults. Your pediatrician will usually prescribe a 10-day course of antibiotics to prevent any complications, but many children will start to feel better sooner than that.

Malka cautioned that pediatricians should not prescribe antibiotics without a strep test: “Over 60 to 75 percent of sore throats in children are caused by viruses and do not require antibiotics… Treating sore throats using antibiotics when it’s not caused by strep won’t help your child get better faster and can cause antibiotic resistance and other complications.” (Antibiotics are only given to treat bacterial infections, not viral ones.)

For rare cases of strep throat in infants and young children, Phillips-Walker says treatment usually consists of managing symptoms with fever and pain relievers such as Tylenol and Motrin. However, infants and young children with strep rashes and skin diseases caused by GAS bacteria are treated with antibiotic ointments for smaller infections, or oral antibiotics for diseases such as cellulitis or scarlet fever, Malka said. In rare instances, more severe cases of strep infections may require IV antibiotics given in a hospital.

How to Prevent Strep in Babies, Toddlers and Children

Because strep throat in children is caused by the transmission of GAS bacteria through respiratory droplets, experts recommend practicing safe hygiene practices when trying to prevent the disease. This includes teaching your child to:

• Wash their hands properly
• Do not share food, drink or utensils with a sick person
• Avoid touching their face and putting things in their mouths
• Cover their coughs and sneezes
• Avoid contact with someone with strep throat until they have taken antibiotics for at least 24 hours and are fever-free
• Stay home when sick to avoid infecting others

Watching a baby battle illness is never fun, but you can feel confident knowing there are ways to keep your child happy and healthy. For any specific questions about strep in babies and children, contact your pediatrician.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult a qualified physician or health professional regarding your specific circumstances.

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