New Guidelines on When Kids Need Tonsillectomies
Most Children With Sore Throats Don’t Need Tonsillectomies, but Bed-wetters Might
Changing Attitutes to Tonsillectomies continued...
And more tonsils began to be taken out as a way to open up the airway and improve sleep.
As sleep improves, research suggests behavior, growth, school performance, and even bed-wetting does, too.
“I’ve seen kids like this,” says Drake. “Kids are so tired that their brains can’t hear the signal from their bladders that it’s time to go, and you take the tonsils out and the problem resolves.”
That benefit, Drake acknowledges, is still controversial.
In fact, a study published in December in the Journal of Urology which followed a group of more than 300 children -- 257 who were undergoing tonsillectomies and 69 who were having surgeries for other reasons -- found no difference in the rates of bed-wetting before or after surgery in either group.
Still, doctors say the idea isn’t all that far-fetched.
“Not wetting the bed requires a level of neurological control that’s upset by a lot of different things,” Paradise says. “I’m quite willing to believe that anything that upsets a child’s equilibrium could have an effect on that, including poor sleep.”
Improvement in Care for Kids Having Surgery
Several of the guidelines suggest ways doctors and parents can improve the care of kids having tonsillectomies.
One of the strongest recommendations is against the use of antibiotics just before or just after surgery.
“They are commonly given, and there’s no evidence that antibiotics offer any benefit,” says study researcher Reginald F. Baugh, MD, professor and chief of otolaryngology at the University of Toledo Medical Center in Ohio. “You run the risk of allergic reactions and there are the harms of overprescribing.”
In drafting the statement that advises doctors to counsel parents about the importance of pain management in kids after surgery, Baugh says the panel that reviewed the evidence behind the guidelines was alarmed to learn that many parents don’t give medications to control pain after the procedure.
“That was one thing we really learned, about the importance of telling parents about the need to give pain meds in these kids,” Baugh says.