Skip to main content

Tonsils and Kids: What Parents Should Know About Problems, Surgery, and Recovery

April 21, 2025

Your daughter woke up this morning with a sore throat, and you took a peek at her tonsils. They’re red and inflamed…again. What’s next when it comes to treatment?

You probably don’t pay much attention to the tonsils on an everyday basis. Most of the time, we swallow and speak without regard for these little flaps of tissue in the back of the throat. But when your throat hurts, it’s often the tonsils’ fault.

Sore throats are very common, especially during the cold and flu season. They can be caused by various medical conditions, including seasonal allergies.

During the late fall, winter, and early spring, contagious illnesses run wild as we spend more time indoors in close proximity to each other. Viruses and bacteria, like those responsible for the common cold, the flu, RSV, COVID-19, and strep throat, are seemingly everywhere.

Many of the infections listed above can cause symptoms such as a sore throat. A sore throat occurs when the throat itself and the tonsils become irritated and inflamed, with the latter known as tonsillitis.

When is tonsillitis a reason for concern? Keep reading for the details.

Defining


To understand tonsillitis, you first need to understand what the tonsils are and what they do. While they might seem unimportant, they actually play a key part in protecting your health.

“The tonsils, which are two round masses in the back of the throat, are part of the immune system,” says Michael Abdelmisseh, MD, with West Tennessee Medical Group. “They basically serve as defenders, working to catch and stop germs that come into the body through the mouth or the nose. White blood cells found in the tonsils help to kill off the germs captured by the tonsils, which keeps the germs from causing infection.”

Michael Abdelmisseh, MD, a pediatric physician with WTMG.
Michael Abdelmisseh, MD, a pediatric physician with WTMG.

Ideally, tonsils serve as defenders against infection. However, they can sometimes become infected themselves, leading to inflammation and irritation, known as tonsillitis.

Symptoms of tonsillitis can include:

  •     Bad breath
  •     Difficulty swallowing
  •     Fever
  •     Red, swollen tonsils
  •     Sore throat, which may be severe
  •     Swollen lymph nodes in the neck
  •     White or yellowish coating on the tonsils

Sometimes a sore throat is simply that and will resolve on its own within a day or two, but when is it necessary to seek medical attention for a sore throat?”

Check in with your child’s pediatrician if they have any of the symptoms listed above that linger for more than two days. It’s also a good idea to see a medical provider if swallowing causes intense pain that makes it difficult to eat or drink, or if your child is very weak.

How Tonsillitis Is Treated


Most of the time, tonsillitis is treated by treating the underlying infection that caused it. A rapid strep test can be used to determine if your child’s sore throat is the result of strep throat. If so, the infection will be treated using an antibiotic.

The majority of tonsillitis-causing infections are viral rather than bacterial, making antibiotics ineffective. In some cases, your child’s pediatrician may prescribe an antiviral medication to help expedite the recovery from viruses such as the flu or COVID-19

Usually, though, treatment for a viral infection will include treating individual symptoms. To relieve the pain of tonsillitis, treatment may include taking over-the-counter pain relievers or anti-inflammatory medications, sucking on throat lozenges or hard candy, gargling with saltwater, drinking warm liquids, or eating cold popsicles. It’s also important to get plenty of rest, both for the body and for the voice.

“In certain cases, surgical removal of the tonsils may be recommended,” Dr. Abdelmisseh says. “A tonsillectomy is typically recommended for children who have frequent bouts of tonsillitis, which can be frustrating for both children and their parents. Sometimes we also recommend removing the tonsils if they’re particularly large, making it difficult to swallow or breathe.”

In rare cases, a tonsillectomy may be recommended if a bacterial infection causing tonsillitis does not improve after treatment with antibiotics.

What Happens During a Tonsillectomy


A tonsillectomy is fairly straight-forward. If your child’s pediatrician recommends removing the tonsils, it is a basic procedure performed under general anesthesia, usually on an outpatient basis.

During the procedure, surgery is done through your child’s mouth, with no incisions in the skin. There are two types of tonsillectomies, one is a more traditional procedure where both tonsils are entirely removed and the other procedure, known as intracapsular tonsillectomy, leaves behind a small layer of tissue to protect the muscles underneath the tonsils.

Children who undergo the intracapsular tonsillectomy often recover more quickly with reduced pain and less risk of complications.

Sometimes, a tonsillectomy is combined with the removal of the adenoids in a procedure known as an adenoidectomy. The adenoids are similar to the tonsils but found in the nasal cavity. If both the tonsils and adenoids are enlarged, it can make it particularly difficult to breathe.

Like a tonsillectomy, an adenoidectomy is performed through the mouth, with no incisions in the skin. Both procedures typically require less than thirty minutes individually, while when combined into one procedure, they generally last between 45 minutes and one hour.

In the past, removal of the tonsils was a right of passage for most people during childhood. Today, it isn’t recommended as often, but both tonsillectomy and adenoidectomy remain among the most common surgical procedures in children.

If you are curious as to whether your child’s body will be equipped to handle infection after a tonsillectomy, good news, the answer is yes! While the tonsils are part of the immune system, the body simply adapts after they’re removed to fend off infection in other ways.

Wondering if your child’s sore throat could be tonsillitis? A West Tennessee Medical Group pediatrician can help you navigate this health challenge and others. Find one here.