Your child comes home from school complaining of a sore throat…how do you decide if he needs to see a doctor, or if you can just treat his symptoms at home?

Throat infections are called “pharyngitis”, or “tonsillitis” if the infection involves the tonsils. In children, these infections are usually caused by viruses, which do not require antibiotics. However, some cases can be caused by a bacteria called group A streptococci (GAS). This is what we call “Strep throat”.

Many of you know that I only recommend taking antibiotics when absolutely necessary, due to the harmful effects they have on our gut flora and immune systems. Strep throat in children, however, is one such situation where I feel that antibiotics are needed.

What if my child has Strep Throat and doesn’t receive antibiotics?

Untreated GAS pharyngitis can have serious complications, which are easily prevented by a short course of antibiotics inshAllah. These complications include:

Rheumatic Fever: an autoimmune inflammatory disease that can affect the heart, joints, skin, and brain. It can develop two to four weeks after a strep throat infection. It can cause permanent damage to the heart.
Spread of the infection to the ear, lungs, lining of the brain, or spinal canal.
Abscess formation around the tonsils and behind the throat.

Is it Strep Throat, or just a virus?

How is Strep Throat diagnosed?

It’s important to remember that no physical findings can clearly differentiate Strep Throat from viral or other bacterial causes. Therefore, the most effective way to determine if your child’s throat infection is bacterial or viral is to do a throat culture.

My experience here in Riyadh is that many doctors will make their decision to start your child on antibiotics based on physical findings alone, without testing for Strep Throat. My daughter had Strep Throat this winter and we had an awful experience trying to get her diagnosed. We had to visit 3 separate hospitals until I could finally find someone who would do a simple throat culture! One doctor told us that “we don’t see Strep Throat in this country” and therefore antibiotics were not needed. (Even though her throat culture later showed that she did indeed have Strep Throat!)

A rapid antigen detection test can also diagnose Strep Throat. The benefit to the rapid strep test is that results can be obtained in just a few minutes, while the throat culture results take 3 days to get back. The rapid strep test, however, can give false-negative results even when strep infection is present. The throat culture is therefore more accurate.

**In other words, if the rapid strep test is positive, start antibiotics. If it’s negative, do a throat culture just to be sure.

Don’t let your doctor prescribe antibiotics for your child unless he or she has either a positive rapid strep test, or a positive throat culture!

Many doctors will take a 10 second look at your child and prescribe antibiotics without doing one of these simple and inexpensive tests. This results in a great amount of over-use of antibiotics, not to mention the unnecessary damage done to your child’s gut flora. Read more here about the importance of a healthy gut flora.

You must start your child on antibiotics within 9 days of the onset of the infection in order to prevent Rheumatic Fever. When my daughter recently had sore throat, I waited a few days to start antibiotics. This gave her body a chance to mount an immune response to the infection, and will protect her from future infections inshAllah.

What can I do to minimize the harmful effects of antibiotics?

If your child must take antibiotics, make sure you start her on a good-quality probiotic right away. Find a probiotic with a minimum strength of 50 billion CFU (colony forming units) per day. This will replenish the healthy gut flora which the antibiotics kill off. The probiotics should not be given at the same time as the antibiotics, but instead given between doses.
Try to consume fermented foods with every meal in order to recolonize your digestive system with a wide range of bacteria. Examples are yogurt, laban, kefir, sauerkraut, kimchi, and pickles.
After completing the course of antibiotics, continue taking the probiotic supplement for at least 2 months. Also continue eating fermented foods on a daily basis.
Eat lots of pre-biotic foods: While probiotic-foods contain live bacteria, prebiotic foods feed the good bacteria already living in your gut. You can find prebiotics in items such as honey, bananas, oats, asparagus, Jerusalem artichokes, pure maple syrup, and legumes (beans, peas, and lentils).
Milk thistle (where to buy): taking antibiotics can put a heavy burden on your liver, which is responsible for breaking down the antibiotics. The herb milk thistle supports healthy liver function. It also promotes liver detoxification & waste elimination. The dosage for children is 5-10 mg per kilogram of body weight per day.
Glutamine (where to buy): the amino acid glutamine can repair the intestinal lining and eliminate yeast infections (yeast infections are a possible side effect of taking antibiotics).

For how long will my child be contagious?

For strep throat, your child is no longer contagious after taking antibiotics for 24 hours. With a viral sore throat, your child is no longer contagious once he has been free of fever for 24 to 48 hours.

Natural remedies for sore throat in children

1) Sip warm liquids

Herbal teas, ginger and honey in warm water, or turmeric milk can all help to ease the pain of a sore throat.

2) Gargle with sea salt and water

Studies have found that gargling 2-3 times a day with warm salt water can reduce swelling in the throat and loosen mucus. Dissolve half a teaspoon of sea salt in one cup of water.

3) Raw Honey (for children aged 1 and older)

Raw honey also soothes the throat and eases swelling. It inhibits bacteria, viruses, and fungi.

4) Elderberry Syrup

Research shows that elderberry syrup:

not only reduces symptoms of a viral illness, but also shortens the duration of the illness. It does this by strengthening the immune system.
may have anti-inflammatory and antiviral properties.
may also help reduce swelling and congestion in the nose and sinuses.

Here’s an easy recipe to make your own elderberry syrup.

5) Bone Broth

Bone broth keeps you hydrated and is packed with immune-boosting minerals. Here’s an easy recipe for nourishing bone broth. I usually make this Creamy Vegetable Soup with bone broth and give to my kids when they’re feeling under the weather.

6) Garlic

Garlic also inhibits bacteria, viruses, and fungi. I crush a small clove of garlic and we eat it mixed with raw honey. This has worked very well in helping my children recover from illness alhamdulillah.

7) Costus Root (قسط الهندي)

In several ahadith, the Prophet صلى الله عليه وسلم mentioned the use of Costus Root in the treatment of tonsiliits:

“It is upon you to use ‘Al ‘Uood al Hindee’ [i.e. Qist/Costus], for indeed it contains seven cures; it is inhaled through the nostrils to relive throat aches/tonsillitis and placed in the sides of the mouth for the relief of Dhaat al Janb (pleurisy)” [Collected by Bukhaaree and Muslim.]

Al Imaam Ahmad and the authors of the Sunnan collected a Hadeeth on the authority of Jaabir that the Messenger of Allaah – صلى الله عليه وسلم – said: “If a child is inflicted with tonsillitis or a headache, then let his mother take al Qist al Hindee, scrub it with water and let him inhale it as droplets through his nostrils.”

8) Vitamin C

Make a smoothie with strawberries, kiwi, oranges, and kale to sooth your throat and give your immune system a boost. Here’s a recipe for Our Favorite Smoothie.

9) Echinacea (where to buy)

Another powerful immune booster. This meta-analysis showed that echinacea decreased the odds of developing the common cold by 58%.

10) Colloidal Silver

Colloidal silver has powerful antibacterial ability, even against antibiotic-resistant superbugs! Read more here about how colloidal silver works. And email me (drlauraskitchen@gmail.com) if you’d like to find colloidal silver here in Riyadh.

11) Probiotics

Did you know that 80% of your immune tissue resides in your digestive tract? Eating probiotic foods, or taking a good quality probiotic supplement, will improve the health of your gut. Read more here about the importance of our bacterial friends.

We sometimes make probiotic popsicles from our leftover kefir smoothies. This can ease throat pain while giving your child a boost of probiotics.

12) Sleep

Getting a good night’s sleep is just as important as a healthy diet and exercise when it comes to building a healthy immune system. Click here to find out if your child is getting enough sleep.

13) Essential oils

Essential oils can fight germs, boost the immune system, and reduce inflammation.

Some of my favorites are:

Age 6 months and up: Lemon, Lavender, and Cinnamon Bark (for diffusion only).

Age 2 and up: Frankincense, Thyme, Myrrh, Clove, and Oregano.

Peppermint: diffuse with care around 3-6 year olds and apply topically at a concentration of 1 drop in 2 teaspoons carrier oil. After age 6 you can apply peppermint at a dilution of 1 drop in 1 teaspoon of carrier oil.

Eucalyptus: also diffuse with care around 3-6 year olds and apply topically at a concentration of 1 drop in 1 teaspoon carrier oil.

Note: Don’t use essential oils on babies less than 3 months of age.

To use essential oils you can:

Diffuse the oil in a diffuser.
Add 2-3 drops of essential oil to 1 teaspoon of carrier oil (olive, coconut, sweet almond, or jojoba). Apply directly to the neck, chest, behind the ears, or the soles of the feet.
Add about 5 drops of oil to a large bowl of hot water. Sit near the bowl and drape a towel over your head. You can put small children on your lap. Breathe in the steam from the bowl for 5 minutes. And of course be careful with small children who like to grab things!