What to know about strep throat in babies

Share on Pinterest

According to the Centers for Disease Control and Prevention (CDC), around 3 in 10 children who have a sore throat have strep throat.

People often associate a sore throat with strep throat, but most sore throats are not due to strep.

A sore throat can develop for various reasons, including non-strep bacteria, viruses, and allergens.

Some symptoms of strep throat include:

• a sore throat with rapid onset
• painful swallowing
• fever
• swollen, inflamed tonsils that may have white patches or pus
• red spots on the roof of the mouth, called petechiae
• swollen lymph nodes
• headache
• nausea

Vomiting is also a common symptom in children.

In infants under 3 years old, strep throat rarely causes a sore throat. Instead, it may cause:

• irritability
• cold symptoms
• fever
• feeding issues

If someone has a cough or stuffy nose, the sore throat is more likely due to a cold virus.

Strep throat is rare in infants under 3 years old.

Sometimes, children and babies get repeated bouts of strep throat. This may be because they are in frequent contact with someone who is a strep carrier.

Although strep throat is rare in infants, anyone can get it, including breastfed babies.

Some research suggests that breast milk protects against many infections during infancy. However, it is unclear if breastfed babies have a lower chance of getting strep throat than formula-fed babies.

A rapid strep test is the only way to confirm a strep throat diagnosis. A doctor cannot confirm a strep diagnosis by simply examining a person’s throat.

If a strep test is negative but the doctor suspects a false negative, they may take a throat culture swab.

Doctors are more likely to take cultures from young people because of the risk of complications, such as rheumatic fever. However, they rarely test for strep throat in infants under the age of 3 years.

Strep throat treatment involves antibiotics, such as amoxicillin or penicillin. The symptoms should resolve within a few days of receiving antibiotic treatment.

Untreated strep throat can lead to rheumatic fever, which can damage the heart. Rheumatic fever is common in people aged 5–15 years. It is rare in those under 3 years old, however.

Some symptoms of rheumatic fever include:

• fever
• joint swelling and pain
• chest pain, difficulty breathing, a rapid heartbeat, and other heart-related symptoms
• fatigue
• uncontrollable body movements
• nodules and rash, though these are rare

Other complications that can occur if strep bacteria spread to other parts of the body include:

• ear and sinus infections
• tonsil abscesses
• post-streptococcal glomerulonephritis, which is a type of kidney disease

If an infant is displaying symptoms of strep throat, a person should consult a doctor. Without treatment, strep throat could lead to serious complications in infants.

Strep throat is rare in infants, but when it does occur, it requires prompt treatment to prevent complications.

Antibiotics are an effective treatment for strep throat.

Once a person gets strep throat, it is possible to get it again. It is a contagious disease with no vaccine.

Some ways to prevent the spread of strep include:

• frequent hand-washing
• covering the face when coughing or sneezing
• using alcohol-based hand sanitizer when soap and water are unavailable
• not sharing utensils and plates with people who are sick
• avoiding contact with people who have strep and are still contagious

People are contagious if they have a fever and have not been taking antibiotics for at least 24 hours.

GBS is another bacterium that primarily affects infants. If an infant gets it during the first week of life, they have early onset GBS infection and will likely have symptoms on the day of their birth.

Infants who develop the disease later may have no symptoms at birth and will appear healthy during their first week of life. When this happens, the infant has late onset GBS infection.

Some symptoms of GBS infection in babies include:

• fever
• feeding problems
• irritability
• difficulty breathing
• lethargy
• a blue tinge to the skin

According to the World Health Organization (WHO), 1 in 5 pregnant people carry GBS bacteria. The bacteria live in the gastrointestinal and genital tract. The bacteria can pass to the baby during pregnancy.

GBS can cause a host of infections, including:

• pneumonia
• meningitis
• sepsis

Infants are at higher risk of getting GBS if a pregnant person:

• tests positive for this bacteria late in their pregnancy
• gets a fever while in labor
• spends 18 or more hours in labor after their water breaks

One 2018 article suggests that breast milk contaminated with GBS bacteria may increase the likelihood of infants developing late onset GBS infection. However, there is also research that points to the protective benefits of breastfeeding.

Doctors diagnose GBS infections by taking and testing samples of blood or spinal fluid. It may take a few days to receive test results. Also, doctors sometimes order a chest X-ray.

Most people who receive prenatal care during pregnancy undergo routine screening for GBS bacteria.

Treating GBS infections involves antibiotics called beta-lactams, such as ampicillin and penicillin. Doctors usually treat infants with intravenous (IV) antibiotics. They may also administer IV fluids and supplemental oxygen.

Babies who develop GBS infection may experience long-term complications, such as developmental disabilities and deafness. GBS infection is fatal in around 4–6% of infants.

Newborns are at higher risk of GBS infection than other age groups. In an average year, around 930 infants in the United States develop a GBS infection at birth. About 1,050 develop late onset GBS infection.

Preventions strategies for GBS infections involve testing for GBS bacteria during pregnancy and administering antibiotics to those in labor who have a higher chance of passing on GBS bacteria.

There is no conclusive research into how infants develop late onset GBS infection. This means that there are currently no effective prevention strategies.

GAS and GBS are the most common types of Streptococcus bacteria. These bacteria cause an infection called strep throat.

Strep throat is rare in babies, and when it does occur, it is usually treatable.

GBS infection is common in newborns and infants and can lead to serious complications without treatment. As with strep throat, doctors treat GBS infections with antibiotics.