Carrie Madormo, RN, MPH, is a freelance health writer with over a decade of experience working as a registered nurse in a variety of clinical settings.

Lyndsey Garbi, MD, is double board-certified in pediatrics and neonatology. She is  an assistant professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell  and chief pediatrician at Blueberry Pediatrics.

Strep throat, also called acute pharyngitis , is a common respiratory illness caused by the bacteria group A Streptococcus (Group A Strep). It is most commonly seen in children ages 5 to 15. Possible symptoms include a sore throat, fever, headache, nausea, and vomiting. The bacteria is spread through saliva and nasal secretions from person-to-person contact. 

Strep throat in babies and toddlers under 3 is rare. Babies who are diagnosed with strep throat usually have mild symptoms that may include fever, irritability, and difficulty feeding. However, it is possible for babies to become seriously ill from the bacteria group B Streptococcus (Group B Strep).

This article will discuss the symptoms of strep throat in children and how to treat it. It will also list the signs of a Group B Strep infection in babies and when to call your healthcare provider. 

Yes, babies can get strep throat, but it is rare. Even when babies contract strep throat, their symptoms are usually mild and do not require treatment. However, children over age 3 are more likely to get sick with strep throat and are at a higher risk of experiencing complications.  

Strep throat is most common in children aged 5 to 15. Sore throats and respiratory illnesses are common in kids of all ages. Each year there are about 11 million visits to ambulatory care centers for a sore throat in children ages 3 to 18. Strep throat makes up about 15% to 30% of those cases. Strep throat tends to be more common during the coldest months of the year.  

Group A Strep (GAS) is the bacteria that causes strep throat and other illnesses. Group B Strep (GBS) is a type of bacteria that generally lives in the body and usually does not cause illness. 

Pregnant people can be carriers of GBS without knowing it. This bacteria can then be passed to their babies during childbirth, leading to serious illness. 

It is recommended for all pregnant people to be tested for GBS before they go into labor. In women, GBS is found in the vagina and the rectum. GBS can be passed from mother to child during the birth process. 

It’s important to note that it is rare for someone to pass GBS to their babies. It’s estimated that 1 to 2 out of every 100 people who are positive for GBS will transmit the bacteria to their baby. The risk is much lower for individuals treated with antibiotics during labor. 

When you are pregnant, your healthcare provider will recommend a GBS screening sometime between 36 and 38 weeks of pregnancy. Your healthcare provider will take a sample from the vagina and the rectum to culture. If your culture comes back positive for GBS, intravenous (IV) antibiotics will be administered to you once labor starts. 

Children over age 3 are most likely to experience strep throat symptoms. Signs of strep throat usually present about two to five days after being exposed. Common signs of strep throat in school-aged children and teenagers include:

Children under 3 are much less likely to experience strep throat. When they do, the symptoms are often mild and may include:

Signs of infection from GBS in babies include:

It is possible for both children and adults to be carriers of strep. Carriers would test positive if tested for strep but have no symptoms. 

It is very rare for people who are carriers of GBS to transfer the bacteria to their babies via breast milk. If someone is not treated for GBS during childbirth, there is a slight chance that the baby could be exposed while breastfeeding. It is helpful to remember that breast milk also contains beneficial antibodies that will protect a child from strep as well.  

It is possible for pregnant people to be carriers of strep. Most carriers of both GAS and GBS are not aware that they carry the bacteria. All pregnant people should be screened for GBS towards the end of their pregnancies. 

Your healthcare provider will recommend a strep test for your child when they strongly suspect that your child has strep throat. It’s estimated that strep throat is the cause of about 20% to 30% of sore throats in children and 5% to 15% of sore throats in adults.

If your child has a sore throat with classic viral symptoms, they most likely do not have strep throat. It is not recommended to test for strep in children who have the following virus symptoms:

Strep throat can be detected with a rapid antigen detection test (RADT) or a throat culture. These tests are highly sensitive. Testing is usually not recommended for adults or children under age 3 .  

Strep throat in children needs to be diagnosed and treated by a healthcare provider. When left untreated, the symptoms can last for about eight to 10 days. Children who do not receive antibiotics will stay infectious for up to a week.

While it is rare, untreated strep throat can lead to serious complications in children. Possible complications include:

Children with strep throat need to receive treatment as soon as possible to relieve the symptoms and reduce the risk of spreading the illness. 

Antibiotics are prescribed to treat strep throat. Taking antibiotics as prescribed can shorten the duration of symptoms and help prevent possible complications.

The recommended antibiotics for strep throat are penicillin or Moxatag (amoxicillin). If your child has a penicillin allergy, your healthcare provider may recommend Keflex (cephalexin),  Duricef (cefadroxil), Cleocin (clindamycin), Zithromax (azithromycin), or Biaxin (clarithromycin).  

Strep throat is very contagious among children and easily spreads in crowded environments like schools and daycares. To limit the spread, children should stay home until they are fever-free (afebrile) and have been taking antibiotics for at least 12 hours.

Strep throat can be painful for children. Fortunately, antibiotic therapy provides relief quickly. In addition, gargling with warm salt water can help relieve throat pain. Tylenol (acetaminophen) can also relieve pain and reduce the discomfort from a fever.  

Strep throat is a respiratory illness caused by the bacteria Group A Strep. It most commonly affects school-aged children and teenagers. It is rare for babies to be diagnosed with strep throat. Treatment includes antibiotics, staying home, and natural remedies to ease discomfort. It is possible for babies to become seriously ill from the bacteria Group B Strep. Most pregnant people are screened for GBS before going into labor, so they do not pass it on to their babies. 

It’s scary any time your child is sick. While it is possible for strep throat to lead to serious complications, it’s helpful to remember that those complications are very rare. Most children who receive treatment with antibiotics get better quickly and fully recover from strep throat. If you are unsure if your child should be tested for strep throat, talk with your healthcare provider. 

Antibodies passed from a person to a baby via breast milk can help protect the baby against several illnesses, including strep. 

Strep throat carriers are usually not contagious to babies. Infants and young toddlers are unlikely to become sick with strep throat. If they do contract strep throat, the symptoms are usually mild. 

GBS can cause serious illness in babies and children. Possible signs of GBS include:

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Centers for Disease Control and Prevention. Signs and symptoms of Group B strep.

Le Doare K, Kampmann B. Breast milk and Group B streptococcal infection: vector of transmission or vehicle for protection? Vaccine. 2014;32(26):3128-3132. doi:10.1016/j.vaccine.2014.04.020

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American Academy of Pediatrics. Group A streptococcal infections.

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