Tonsillitis: Should My Child Have a Tonsillectomy?

Guides through decision to have your child have a tonsillectomy for tonsillitis. Includes common reasons to have a tonsillectomy. Describes how this surgery is done. Covers benefits and risks. Includes an interactive tool to help you make your decision.

Top of the pageDecision Point

Tonsillitis: Should My Child Have a Tonsillectomy?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Tonsillitis: Should My Child Have a Tonsillectomy?

Get the facts

Your options

  • Schedule a tonsillectomy for your child.
  • Treat tonsillitis with medicines and home treatment.

Key points to remember

  • Tonsillectomy may be no better than taking a
    wait-and-see approach for children who have only a few throat infections a
    year.
  • Your child may benefit from surgery if he or she is missing
    a lot of school because of repeated throat infections or has trouble sleeping
    because of enlarged tonsils that may block his or her airway. Talk with your
    doctor about the possible benefits of surgery for your child as well as the
    costs and risks of the procedure.
  • Tonsillectomy may reduce how
    often your child gets throat infections. But even without surgery, tonsillitis
    will probably occur less often as your child gets older.
  • For some
    children, tonsillectomy can greatly improve quality of life. Enlarged tonsils
    can block your child's upper airway and cause snoring and
    breathing problems. Surgery can help relieve these problems.
  • Doctors don't all agree on how many throat infections in a year point to
    the need for tonsillectomy. But a general guideline is 7 or more episodes of tonsillitis in 1 year, or 5 or more episodes a year for the past 2 years, or 3 or more episodes a year for the past 3 years. Any decision about surgery should be made with your doctor and be
    based on your own child's health and well-being.
FAQs

What is a tonsillectomy?

Tonsillectomy is surgery
to remove the
tonsils. It's a common surgery, especially in
children, but it is not done nearly as often as it was in the past.
Tonsillectomy may reduce how often your child gets throat infections. But even
without surgery, tonsillitis will probably occur less often as your child gets
older.

Your child will get a
general anesthetic and will be asleep during the
surgery. Your child may go home on the day of the surgery, or he or she may
stay in the hospital overnight. Tonsillectomy is usually performed by an
otolaryngologist, a doctor who specializes in ear,
nose, and throat problems.

Your child may have a lot of ear and
throat pain for up to 2 weeks after surgery. A fever up to
102°F (38.9°C) is also common.
Your child may also have bad breath for up to 2 weeks.

After
surgery, your child will feel tired for several days and then slowly become
more active. Your child should be able to go back to school or day care in 1
week and return to full activities in 2 weeks.

What else can you do to treat tonsillitis?

Watchful
waiting is a wait-and-see approach to treating tonsillitis. If it seems that
your child is getting fewer throat infections over time, he or she won't need
surgery. If your child keeps having infections that are getting in the way of
daily life, then you and your doctor can decide what to do next.

There are a few things you can do to help your child feel better at home.
Make sure that
your child gets plenty of rest. Over-the-counter medicines (such as acetaminophen) and
frozen treats (such as Popsicles) can help relieve a sore throat. Be safe with medicines. Read and follow all instructions on the label. If your child is age 8 or older, he or she can also gargle often with warm salt water to help relieve throat pain.

What are the risks of tonsillectomy?

The risks
include some bleeding after surgery. This is common, especially when the healed
scab over the cut area falls off. Other risks are much less common. They
include more serious bleeding and problems from the anesthesia during surgery.
Death during surgery is very rare.

Some children may get upset by being in a hospital.

What are the benefits?

For some children, surgery
can greatly improve quality of life. Enlarged tonsils can block your child's
upper airway and cause snoring and mouth breathing.
Tonsillectomy can help relieve these problems.

Children who have a
tonsillectomy because of repeated infections may have fewer and less severe
infections for at least 2 years after the surgery. But over time, many children
who do not have surgery also have fewer throat infections.

In some
cases when a child keeps getting
strep throat infections, especially if the infections
cause other problems, surgery may be the best choice.

Why might your doctor recommend a tonsillectomy?

Doctors usually only recommend surgery to remove tonsils when a child has
repeated infections of the tonsils that are causing serious problems or are
affecting a child's quality of life. Any decision about surgery should be made
with your doctor and based on your own child's health and well-being.

Tonsillitis caused by a virus usually goes away by itself. It will
probably occur less often as your child gets older. Researchers in one study
found that surgery is no better than taking a wait-and-see approach for
children who get tonsillitis less than 3 times a year.footnote 1 Your child may benefit from surgery if he or she is missing a
lot of school because of repeated throat infections or has trouble sleeping
because of enlarged tonsils.

Doctors don't all agree on how many
throat infections in a year point to the need for tonsillectomy. But a
general guideline is 7 or more cases of tonsillitis in the past 1 year, or 5 or more cases a year for the past 2 years, or 3 or more cases a year for the past 3 years.

Some of the
serious medical problems that may mean your child should have a tonsillectomy
are:

  • Tonsillitis that lasts longer than 3 months,
    even with medicine.
  • Blocked air passages, which can lead to
    sleep apnea.
  • Trouble swallowing.
  • Tonsils that bleed heavily.

Talk with your doctor about the possible risks and
benefits of surgery for your child.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Have a tonsillectomy

Have a tonsillectomy

  • Your child will be asleep
    during the surgery.
  • Your child may go home on the day of surgery or
    may stay in the hospital overnight.
  • Your child may have a lot of
    ear and throat pain for up to 2 weeks after surgery.
  • Your child should be able to go back to school in 1 week and
    return to full activities in 2 weeks.
  • Surgery can improve quality
    of life for some children.
  • Tonsillectomy relieves problems caused by enlarged
    tonsils.
  • Surgery may reduce how often your child gets throat
    infections.
  • Some bleeding
    after surgery is common.
  • Less common risks include more serious bleeding and problems from
    anesthesia during surgery.
Treat tonsillitis with
medicines and home treatment

Treat tonsillitis with
medicines and home treatment

  • Over-the-counter pain medicines and frozen treats can
    relieve a sore throat.
  • Your child age 8 or older can gargle often with warm salt
    water to soothe a sore throat.
  • Make sure your child gets plenty of rest.
  • Your child may get
    better without surgery.
  • You avoid the costs, risks, and recovery
    time of surgery.
  • Surgery is no better than taking a wait-and-see
    approach for children who get tonsillitis less than 3 times a year.footnote 1
  • Your
    child may keep having infections that get in the way of daily life.

Personal stories about tonsillectomy

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

My son was
5 when he had his tonsils out. It took about 2 weeks for him to fully recover
and be able to eat all the things he likes. The first few days after surgery,
he was in a lot of pain, but he got better every day after that. Giving him
pain medicine helped a lot. The surgery was kind of scary but not as bad as I
thought it was going to be.

Leroy, age 32

My daughter
has been getting a lot of throat infections. But I really don't like the idea
of her having surgery. My doctor says that she will probably grow out of it. I
am going to take care of her myself for now and wait and see if that happens.

Maria, age
29

I think surgery would be best for my
child. He has missed school from chronic sore throats and doesn't sleep well at
night. I'm going to take time off from work so that I can stay home with him
after the surgery.

Shannon, age 36

Last year I went back and forth about
scheduling a tonsillectomy for my daughter. She wasn't getting sick that often,
but I wanted to do the right thing for her. Surgery seemed so drastic. But she
has had only one bad throat infection this year. I'm glad I decided not to have
her go in for surgery.

Katy, age 40

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose tonsillectomy

Reasons to choose other treatment

I'm worried about my child missing school because of repeated infections.

My child isn't missing much school because of infections.

More important
Equally important
More important

I'm worried about missing more work to take care of my child.

I'm not worried about missing work to take care of my child.

More important
Equally important
More important

I think the benefits of surgery are worth the small risk.

I'm worried about the risks of surgery.

More important
Equally important
More important

I want to get my child's tonsillitis taken care of now.

I can manage my child's tonsillitis with home treatment.

More important
Equally important
More important

I'm not worried about the costs of surgery.

I'm worried about how I'll pay for the surgery.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Scheduling a tonsillectomy

Using other treatment

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Is tonsillectomy a good choice if your child has only a few throat infections a year?
2, Can tonsillectomy relieve problems caused by enlarged tonsils that block your child's airway?
3, Even without surgery, will tonsillitis occur less often as your child gets older?

Decide what's next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure


Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits and References

Credits
AuthorHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Primary Medical ReviewerJohn Pope, MD - Pediatrics
Specialist Medical ReviewerCharles M. Myer, III, MD - Otolaryngology

References
Citations
  1. Baugh RF, et al. (2011). Clinical practice guideline: Tonsillectomy in children. Otolaryngology–Head and Neck Surgery, 144(IS): S1–S30.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Tonsillitis: Should My Child Have a Tonsillectomy?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Schedule a tonsillectomy for your child.
  • Treat tonsillitis with medicines and home treatment.

Key points to remember

  • Tonsillectomy may be no better than taking a
    wait-and-see approach for children who have only a few throat infections a
    year.
  • Your child may benefit from surgery if he or she is missing
    a lot of school because of repeated throat infections or has trouble sleeping
    because of enlarged tonsils that may block his or her airway. Talk with your
    doctor about the possible benefits of surgery for your child as well as the
    costs and risks of the procedure.
  • Tonsillectomy may reduce how
    often your child gets throat infections. But even without surgery, tonsillitis
    will probably occur less often as your child gets older.
  • For some
    children, tonsillectomy can greatly improve quality of life. Enlarged tonsils
    can block your child's upper airway and cause snoring and
    breathing problems. Surgery can help relieve these problems.
  • Doctors don't all agree on how many throat infections in a year point to
    the need for tonsillectomy. But a general guideline is 7 or more episodes of tonsillitis in 1 year, or 5 or more episodes a year for the past 2 years, or 3 or more episodes a year for the past 3 years. Any decision about surgery should be made with your doctor and be
    based on your own child's health and well-being.
FAQs

What is a tonsillectomy?

Tonsillectomy is surgery
to remove the
tonsils . It's a common surgery, especially in
children, but it is not done nearly as often as it was in the past.
Tonsillectomy may reduce how often your child gets throat infections. But even
without surgery, tonsillitis will probably occur less often as your child gets
older.

Your child will get a
general anesthetic and will be asleep during the
surgery. Your child may go home on the day of the surgery, or he or she may
stay in the hospital overnight. Tonsillectomy is usually performed by an
otolaryngologist, a doctor who specializes in ear,
nose, and throat problems.

Your child may have a lot of ear and
throat pain for up to 2 weeks after surgery. A fever up to
102 F (38.9 C) is also common.
Your child may also have bad breath for up to 2 weeks.

After
surgery, your child will feel tired for several days and then slowly become
more active. Your child should be able to go back to school or day care in 1
week and return to full activities in 2 weeks.

What else can you do to treat tonsillitis?

Watchful
waiting is a wait-and-see approach to treating tonsillitis. If it seems that
your child is getting fewer throat infections over time, he or she won't need
surgery. If your child keeps having infections that are getting in the way of
daily life, then you and your doctor can decide what to do next.

There are a few things you can do to help your child feel better at home.
Make sure that
your child gets plenty of rest. Over-the-counter medicines (such as acetaminophen) and
frozen treats (such as Popsicles) can help relieve a sore throat. Be safe with medicines. Read and follow all instructions on the label. If your child is age 8 or older, he or she can also gargle often with warm salt water to help relieve throat pain.

What are the risks of tonsillectomy?

The risks
include some bleeding after surgery. This is common, especially when the healed
scab over the cut area falls off. Other risks are much less common. They
include more serious bleeding and problems from the anesthesia during surgery.
Death during surgery is very rare.

Some children may get upset by being in a hospital.

What are the benefits?

For some children, surgery
can greatly improve quality of life. Enlarged tonsils can block your child's
upper airway and cause snoring and mouth breathing.
Tonsillectomy can help relieve these problems.

Children who have a
tonsillectomy because of repeated infections may have fewer and less severe
infections for at least 2 years after the surgery. But over time, many children
who do not have surgery also have fewer throat infections.

In some
cases when a child keeps getting
strep throat infections, especially if the infections
cause other problems, surgery may be the best choice.

Why might your doctor recommend a tonsillectomy?

Doctors usually only recommend surgery to remove tonsils when a child has
repeated infections of the tonsils that are causing serious problems or are
affecting a child's quality of life. Any decision about surgery should be made
with your doctor and based on your own child's health and well-being.

Tonsillitis caused by a virus usually goes away by itself. It will
probably occur less often as your child gets older. Researchers in one study
found that surgery is no better than taking a wait-and-see approach for
children who get tonsillitis less than 3 times a year.1 Your child may benefit from surgery if he or she is missing a
lot of school because of repeated throat infections or has trouble sleeping
because of enlarged tonsils.

Doctors don't all agree on how many
throat infections in a year point to the need for tonsillectomy. But a
general guideline is 7 or more cases of tonsillitis in the past 1 year, or 5 or more cases a year for the past 2 years, or 3 or more cases a year for the past 3 years.

Some of the
serious medical problems that may mean your child should have a tonsillectomy
are:

  • Tonsillitis that lasts longer than 3 months,
    even with medicine.
  • Blocked air passages, which can lead to
    sleep apnea.
  • Trouble swallowing.
  • Tonsils that bleed heavily.

Talk with your doctor about the possible risks and
benefits of surgery for your child.

2. Compare your options

  Have a tonsillectomy
Treat tonsillitis with
medicines and home treatment
What is usually involved?
  • Your child will be asleep
    during the surgery.
  • Your child may go home on the day of surgery or
    may stay in the hospital overnight.
  • Your child may have a lot of
    ear and throat pain for up to 2 weeks after surgery.
  • Your child should be able to go back to school in 1 week and
    return to full activities in 2 weeks.
  • Over-the-counter pain medicines and frozen treats can
    relieve a sore throat.
  • Your child age 8 or older can gargle often with warm salt
    water to soothe a sore throat.
  • Make sure your child gets plenty of rest.
What are the benefits?
  • Surgery can improve quality
    of life for some children.
  • Tonsillectomy relieves problems caused by enlarged
    tonsils.
  • Surgery may reduce how often your child gets throat
    infections.
  • Your child may get
    better without surgery.
  • You avoid the costs, risks, and recovery
    time of surgery.
  • Surgery is no better than taking a wait-and-see
    approach for children who get tonsillitis less than 3 times a year.1
What are the risks and side effects?
  • Some bleeding
    after surgery is common.
  • Less common risks include more serious bleeding and problems from
    anesthesia during surgery.
  • Your
    child may keep having infections that get in the way of daily life.

Personal stories

Personal stories about tonsillectomy

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"My son was 5 when he had his tonsils out. It took about 2 weeks for him to fully recover and be able to eat all the things he likes. The first few days after surgery, he was in a lot of pain, but he got better every day after that. Giving him pain medicine helped a lot. The surgery was kind of scary but not as bad as I thought it was going to be."

— Leroy, age 32

"My daughter has been getting a lot of throat infections. But I really don't like the idea of her having surgery. My doctor says that she will probably grow out of it. I am going to take care of her myself for now and wait and see if that happens."

— Maria, age
29

"I think surgery would be best for my child. He has missed school from chronic sore throats and doesn't sleep well at night. I'm going to take time off from work so that I can stay home with him after the surgery."

— Shannon, age 36

"Last year I went back and forth about scheduling a tonsillectomy for my daughter. She wasn't getting sick that often, but I wanted to do the right thing for her. Surgery seemed so drastic. But she has had only one bad throat infection this year. I'm glad I decided not to have her go in for surgery."

— Katy, age 40

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose tonsillectomy

Reasons to choose other treatment

I'm worried about my child missing school because of repeated infections.

My child isn't missing much school because of infections.

       
More important
Equally important
More important

I'm worried about missing more work to take care of my child.

I'm not worried about missing work to take care of my child.

       
More important
Equally important
More important

I think the benefits of surgery are worth the small risk.

I'm worried about the risks of surgery.

       
More important
Equally important
More important

I want to get my child's tonsillitis taken care of now.

I can manage my child's tonsillitis with home treatment.

       
More important
Equally important
More important

I'm not worried about the costs of surgery.

I'm worried about how I'll pay for the surgery.

       
More important
Equally important
More important

My other important reasons:

My other important reasons:

  
       
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Scheduling a tonsillectomy

Using other treatment

       
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Is tonsillectomy a good choice if your child has only a few throat infections a year?

  • Yes

  • No
  • I'm not sure

You are right. Surgery may be no better than taking a wait-and-see approach in children who get tonsillitis less than 3 times a year.

2.
Can tonsillectomy relieve problems caused by enlarged tonsils that block your child's airway?

  • Yes
  • No

  • I'm not sure

You are right. Surgery can relieve problems caused by enlarged tonsils, such as snoring and mouth breathing.

3.
Even without surgery, will tonsillitis occur less often as your child gets older?

  • Yes
  • No

  • I'm not sure

You are right. Even without surgery, tonsillitis will occur less often as your child gets older.

Decide what's next

1.
Do you understand the options available to you?

2.
Are you clear about which benefits and side effects matter most to you?

3.
Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

     
Not sure at all
Somewhat sure
Very sure

2.
Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

 

Credits
ByHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Primary Medical ReviewerJohn Pope, MD - Pediatrics
Specialist Medical ReviewerCharles M. Myer, III, MD - Otolaryngology

References
Citations
  1. Baugh RF, et al. (2011). Clinical practice guideline: Tonsillectomy in children. Otolaryngology–Head and Neck Surgery, 144(IS): S1–S30.

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