Skip Ribbon Commands
Skip to main content
Skip Navigation LinksBoys Town National Research Hospital > Knowledge Center > Articles > Ear, Nose & Throat > Tonsillitis in Children

 Tonsillitis in Children

​Tonsillitis is swelling and inflammation of the tonsils, lymphatic tissue that sits on either side of the back of the throat. The tonsils assist the immune system in fighting infections that enter through the mouth, but sometimes the tonsils themselves get infected. There are two types of tonsillitis: viral and bacterial.

Symptoms of Tonsillitis

Tonsillitis typically affects kids between preschool age and mid-teens with the following symptoms:

  • Red, enlarged tonsils
  • White or yellow coating or patches on the tonsils
  • Sore throat
  • Difficult or painful swallowing
  • Fever
  • Enlarged, tender lymph nodes in the neck
  • Scratchy, muffled or throaty voice
  • Stomachache (typically in younger children)
  • Stiff neck or headache

In children who cannot express what they're feeling, keep an eye out for:

  • Drooling due to difficulty or pain when swallowing
  • Refusal to eat
  • Unusual fussiness

Call your doctor if your child's sore throat doesn't go away after 24-48 hours; he or she has painful, difficult swallowing; or is extremely weak, fatigued or fussy.

Treatment of Tonsillitis

Viral tonsillitis typically resolves on its own, with no additional medical care necessary. If your child is suffering from viral tonsillitis, it's recommended to:

  • Encourage rest
  • Provide adequate fluids
  • Provide comforting foods and beverages to ease throat pain, such as soups, milkshakes, smoothies, ice pops, ice creams or non-caffeinated teas
  • Prepare a salt water gargle (¼– ½ teaspoon of salt dissolved in 8oz. of warm water)
  • Offer throat lozenges
  • Humidify bedroom air – moist air is kinder on a sore throat than dry air
  • Treat pain and fever as needed with over-the-counter ibuprofen or acetaminophen (avoid aspirin or aspirin products, as this may cause Reye's Syndrome)
  • Avoid irritants such as cleaning products and cigarette smoke

Bacterial tonsillitis is usually caused by the group A streptococcus bacteria. Your doctor can determine if the tonsillitis is bacterial or viral by doing a throat culture or strep test. Bacterial tonsillitis is typically treated with an antibiotic, such as penicillin. It's important to finish the prescribed dosage to ensure the bacteria are eradicated from the body.

If your child suffers from tonsillitis multiple times, your doctor may recommend surgery to remove the tonsils, known as a tonsillectomy.

Tonsillectomy Surgery & Recovery

A tonsillectomy in children is an outpatient procedure that involves removing the tonsils to prevent further infection. This is typically only done after repeated infections, such as five or more episodes in 12 months, or in bacterial cases that don't respond to antibiotics. Recovery for a tonsillectomy is normally 10-14 days.

When your child is recovering from his or her tonsillectomy, encourage drinking clear liquids for the first couple days. Examples include:

  • Apple or white grape juice
  • Sports drinks, such as Gatorade or PowerAde
  • Ice pops
  • Flat Sprite (stir to remove bubbles)
  • Water

When your child is ready to begin eating food again, make sure the food is easy to chew and free of coarse, crispy or rough edges. Examples include:

  • Applesauce
  • Ice cream
  • Milkshakes, eaten with a spoon instead of a straw
  • Mashed potatoes
  • Pudding
  • Smooth yogurt