What to Know About a Tonsillectomy in Children

Medically Reviewed by Amita Shroff, MD on July 29, 2023
4 min read

A tonsillectomy is a common procedure to remove your tonsils. Over the last few decades, the number of tonsillectomies performed on children has continually gone down. Here’s what you need to know about tonsillectomies in children.

A tonsillectomy is a routine surgery to remove your tonsils. The tonsils are two lumps of tissue that rest at the back of your throat — one on each side. They are a part of your immune system and help protect your body from infections. Your tonsils help your body to recognize different germs that enter it. Your body learns how to fight these germs for when they come back into your body at a later time.

Tonsillectomies are among the most common procedures performed on kids and teens. The tonsils are removed from the back of the throat. Your child might also have an adenoidectomy, which is a procedure that removes the adenoids. These are soft glands at the top of the throat and behind the nose. They can't be seen like tonsils can. 

Your child’s pediatrician might recommend a tonsillectomy if their tonsils are very swollen, they are frequently infected, or they affect your child's sleep. Normal tonsils are small, but when they are swollen they become red and ovular. They may even become so swollen that they meet to touch at the back of your throat. If your child's tonsils are too swollen, they become large enough where it can be hard for them to breathe properly. It can be especially hard for your child to breathe at night if their tonsils are swollen. Severely swollen tonsils can even cause sleep apnea (breathing stops temporarily).

Sleep apnea is when your breathing repeatedly stops and starts. If an apnea episode is prolonged, it could be dangerous, especially in an infant or toddler. It can make your child have a poor night of sleep, which can affect their life in waking hours. Your child's school performance can be affected by lack of sleep, along with the possibility of heart, physical growth, and behavioral problems.

Another reason your child might need a tonsillectomy or adenoidectomy is because of frequent infections. Tonsil infections can cause sore throats that may force your child to miss school or other events. These infections, called tonsillitis or adenoiditis, are considered repetitive if your child has seven or more infections in a year.

Tonsils can cause other problems, such as:

  • Tonsil stones
  • Bleeding from the tonsils
  • Difficulty swallowing
  • Blocked nasal passages
  • Tumors in the throat or nasal passage

Your doctor will carefully consider whether or not your child needs a tonsillectomy. Since 1965, the number of tonsillectomies performed each year has gone down significantly. This is due to possible complications. One in ten children has difficulty breathing and one in twenty children has bleeding tonsils after the surgery. Because of these complications, doctors will often only perform the surgery if it is truly necessary.

Tonsillectomies are fairly simple procedures. Most only take around 30 minutes to do and your child can go home the same day.

Before the surgery. Your child’s pediatrician will let you know in the weeks before your child’s tonsil removal if they need to stop taking any medications. Your child will also have to stop eating and drinking in the hours before their surgery.

It’s important that in the hours before the tonsillectomy that your child only drinks clear liquids like water or Pedia-Lyte. Since this is a surgery that requires anesthesia, your child needs to have an empty stomach. Eating or drinking too close to the scheduled surgery time can cause it to be put off for a different date.

During surgery. After giving your child anesthesia, an ear, nose, and throat (ENT) surgeon will open your child’s mouth and remove the tonsils (and possibly adenoids). The ENT may remove the tonsils completely, which is called a traditional tonsillectomy, or leave a bit of small layer of tissue behind to help protect the throat. The second option is called an intracapsular tonsillectomy.

Leaving behind some tonsil tissue can help to protect the throat muscles. It also helps your child to have a speedier recovery and lowers the risk of bleeding after surgery. Most kids who have an intracapsular tonsillectomy also are able to drink and eat more easily after surgery and don’t feel as much pain.

After surgery, your child will be moved to a recovery room where they can wake up from the anesthesia. Most children can go home the same day, but sometimes children under the age of three will be kept overnight.

It may take a week or two for your child to fully recover from their tonsillectomy. During this time, they are more likely to get colds or infections, so it’s important to follow your pediatrician’s aftercare advice closely. Typically, your child will need a week off of school and two or three weeks off of physical activity or strenuous exercise to recover.

While your child is recovering, watch out for blood clots or if they vomit blood. Most kids recover with little difficulty, but you should contact your pediatrician if you notice any of these symptoms:

  • Fever
  • Nausea
  • Rashes
  • Bad breath
  • Diarrhea
  • Difficulty breathing

Stick with a diet of liquids and soft foods after the tonsillectomy to keep your child comfortable.