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How do I know if my child needs their tonsils out?

Learn the signs and symptoms of tonsillitis, and when it is time to remove your child's tonsils.

June 28, 2023

A child may need to have their tonsils removed if their tonsils are inflamed. An inflammation of the tonsils (known as tonsillitis) is most often caused by an infection. 

Tonsillitis is most common in preschool-age children to children in their mid-teenage years. 

Tonsillitis can be caused by group A Streptococcus bacteria, which is also the bacteria that causes strep throat. A child could also get tonsillitis from other bacteria and viruses.

Signs and symptoms of tonsillitis: 

  • Tonsils (located in the back of the throat) are red or swollen
  • Tonsils appear to have patches of white or yellow coating
  • Sore throat
  • Difficulty or painful swallowing
  • Fever
  • Lymph nodes in the neck are enlarged or tender
  • Voice is muffled, scratchy or throaty
  • Bad breath
  • Stiff neck
  • Headache

In younger children, other signs of tonsillitis include having a stomachache, drooling due to difficulty swallowing, refusing to eat, or acting fussy. 

Does my child have to have their tonsils out? 

If a child has tonsillitis, this does not necessarily mean they need their tonsils removed.

At-home remedies to treat tonsillitis: 

  • Make sure your child gets plenty of sleep and rest
  • Drink warm liquids to soothe the throat
  • Use a humidifier, as dry air can irritate the throat
  • For children over the age of 4, lozenges can help soothe the throat
  • Use a pain-reliever to treat throat pain and fever. Talk to your child’s doctor about which medications they can and cannot take

If the child’s tonsillitis is caused by a bacterial infection, a doctor may prescribe antibiotics. The most common type of antibiotic prescribed for tonsillitis is penicillin. Even if symptoms go away quickly, children must take the full course of antibiotics prescribed. Not taking antibiotics for the full time prescribed could cause the infection to worsen or spread. 

When your child needs their tonsils removed 

In some cases, some children do need to have their tonsils removed. Normally, a pediatrician will try other treatment methods before considering surgery to remove the tonsils (which is called a tonsillectomy). 

The most common reasons a child needs their tonsils removed are: 

The child has severe, recurring or chronic tonsillitis

  • The tonsils are very swollen, which is causing breathing problems
  • Antibiotics are not helping with the infection
  • Tonsillitis is affecting a child’s sleep
  • The child has had several cases of tonsillitis or strep throat in the past year

What should parents know about tonsil removal surgery 

A tonsillectomy is an outpatient procedure in which your child does not need to stay overnight in the health clinic or hospital. It takes about 20 to 30 minutes for an ear, nose and throat specialist to remove the child’s tonsils. As with any surgical procedure, there are a few medical risks associated with tonsillectomy. Talk to your doctor about how to prepare your child for tonsil removal surgery and what to expect before, during and after the procedure. 

Quality pediatric care for children of all ages 

Rocky Mountain Hospital for Children is a leader in the field of pediatrics, providing children of all ages with high-quality care and treatment. Our board-certified pediatricians are dedicated to improving your child’s health and wellbeing.

June 28, 2023
Rocky Mountain Hospital for Children at PSL, Rocky Mountain Hospital for Children at PSL

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