What is tonsillitis?

Tonsillitis is an inflammation of the tonsils. Tonsils are the lumps of tissue on both sides of the back of your child’s throat. Tonsils are part of the immune system. They help fight infection. Recurrent tonsillitis is when your child has tonsillitis many times in 1 year. Chronic tonsillitis is when your child has a sore throat that lasts 3 months or longer.

What causes tonsillitis?

Tonsillitis may be caused by a bacterial or a viral infection. Tonsillitis can spread from an infected person to others through coughing, sneezing, or touching. The germs can spread through kissing or sharing food and drinks. Germs spread easily in schools and daycare centers and between family members at home.

What are the signs and symptoms of tonsillitis?

  • Fever and sore throat
  • Nausea, vomiting, or abdominal pain
  • Cough or hoarseness
  • Runny or stuffy nose
  • Yellow or white patches on the back of the throat
  • Bad breath
  • Rash on the body or in the mouth

How is tonsillitis diagnosed?

Your child’s Paediatrician will look into your child’s throat and feel the sides of his neck and jaw. He will ask about your child’s signs and symptoms. Your child may need any of the following:

  • A throat culture may show which germ is causing your child’s illness. A cotton swab is rubbed against the back of your child’s throat.
  • Blood tests may show if the infection is caused by bacteria or a virus.

How is tonsillitis treated?

Treatment may decrease your child’s signs and symptoms. Treatment also may lower the number of times that he gets tonsillitis in a year. Your child may need any of the following:

  • Paracetamol: Decreases pain and fever. It is available without a doctor’s prescription. Ask how much to give your child and how often to give it. Follow directions as on the package insert.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This is available with or without a doctor’s prescription. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child’s Paediatrician.
  • Antibiotics help treat a bacterial infection.
  • A tonsillectomy is surgery to remove your child’s tonsils. Your child may need surgery if he has chronic or recurrent tonsillitis. Surgery may also be done if antibiotics are not working.

How can I care for my child?

  • Help your child rest. Have him slowly start to do more each day. Return to his daily activities as directed.
  • Encourage your child to eat and drink. He may not want to eat or drink if his throat is sore. Offer ice cream, cold liquids, or popsicles. Help your child drink enough liquid to prevent dehydration. Ask how much liquid your child needs to drink each day and which liquids are best.
  • Have your child gargle with warm salt water. If your child is old enough to gargle, this may help decrease his throat pain. Mix 1 teaspoon of salt in a cup of warm water. Ask how often your child should do this.
  • Prevent the spread of germs. Wash your hands and your child’s hands often. Do not let your child share food or drinks with anyone. Your child may return to school or daycare when he feels better and his fever is gone for at least 24 hours.

Bring your child in to the Emergency centre for any of the following:

  • Your child suddenly has trouble breathing or swallowing, or he is drooling.

When should I seek immediate care?

  • Your child is unable to eat or drink because of the pain.
  • Your child has voice changes, or it is hard to understand his speech.
  • Your child has increased swelling or pain in his jaw, or he has trouble opening his mouth.
  • Your child has a stiff neck.
  • Your child has not urinated in 12 hours or is very weak or tired.
  • Your child has pauses in his breathing when he sleeps.

When should I contact my child’s Paediatrician?

  • Your child has a fever.
  • Your child’s symptoms do not get better, or they get worse.
  • Your child has a rash on his body, red cheeks, and a red, swollen tongue.
  • You have questions or concerns about your child’s condition or care.

What Is a Tonsillectomy?

A tonsillectomy is surgery to remove the tonsils.

Tonsillectomy is one of the most common surgeries in children. But they’re done less often than in the past because large tonsils may shrink on their own over time.

Why Are Tonsillectomies Done?

Kids usually have a tonsillectomy because:

  1. Their tonsils are so big they block the airway and make it hard to breathe. Swollen tonsils can make it hard to breathe, especially during sleep. A child might snore and stop breathing for short periods while asleep when the tonsils get in the way. This is called obstructive sleep apnea. Apnea can make kids miss out on healthy, restful sleep, which can lead to learning, behavior, growth, and heart problems.
  2. Their tonsils get infected often. A health care provider might recommend removing the tonsils if a child gets a lot of tonsillitis. Experts define “a lot” as when a doctor diagnoses a child with at least 3 infections a year, or more than 5 infections over 2 consecative years.

What Happens Before a Tonsillectomy?

Your health care provider will let you know if your child should stop taking any medicine in the week or two before the surgery. You’ll also be told when your child should stop eating and drinking the night before because the stomach must be empty on the day of the procedure.

Surgery, no matter how common or simple, can be scary for kids. Help prepare your child by talking about what to expect.

What Happens During a Tonsillectomy?

An ear, nose, and throat (ENT) surgeon will do the surgery while your child is under general anesthesia. This means an anesthesiologist will keep your child safely and comfortably asleep during the procedure.

The surgery is done through your child’s open mouth. There are no cuts through the skin and no visible scars.

Can I Stay With My Child During a Tonsillectomy?

Usually, parents can stay with their child until the anesthesiologist gives medicine. Then you’ll go to a waiting area until the surgery is over.

How Long Does a Tonsillectomy Take?

A tonsillectomy usually takes about 20 to 30 minutes, though it can take a little longer.

What Happens After the Tonsillectomy?

Your child will wake up in the recovery area. Many kids go home the same day, though some may stay overnight. In general, kids under 3 years old and those with serious sleep problems (like apnea) usually stay overnight.

Depending on the type of surgery done, recovery after a tonsillectomy may take a week or more. Expect some pain and discomfort after the tonsils are removed, which can make it hard for kids to eat and drink.

Are There Any Risks From Tonsillectomy?

There are risks with any surgery, including infection and problems with anesthesia.

Sometimes children get dehydrated from not drinking enough when they go home, and may need to come back to the hospital for fluids.

Rarely, bleeding might happen during the surgery, right after it, or up to 2 weeks later. Call the doctor right away if your child coughs up, throws up, or spits out bright red blood or blood clots. Doctors might need to do another procedure to stop the bleeding.

How Can I Help My Child Feel Better?

Give your child pain medicine as directed by your health care provider.

Kids should rest at home for a few days following surgery and take it easy for a couple of weeks. They can return to school or childcare when they can eat normally, are sleeping well, and don’t need pain medicine.

Offer plenty to drink, and soft foods like yoghurt, soup or mashed potatoes until your child is ready for solid foods.

Kids should avoid blowing their nose for 2 weeks after surgery, as well as any rough playing or contact sports.

When Should I Call the Doctor?

Call the doctor if your child:

  • gets a fever
  • vomits after the first day or after taking medicine
  • has a sore throat despite taking pain medicine
  • isn’t drinking enough liquids

Call the doctor right away if your child vomits blood or something that looks like coffee grounds, or has trouble breathing.

What Else Should I Know?

After tonsillectomy, kids can still get colds, sore throats, and throat infections. They won’t get tonsillitis unless the tonsils grow back, which is uncommon.

Even though the tonsils are part of the immune system, removing them doesn’t affect the body’s ability to fight infections. The immune system has many other ways to fight germs.