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Tonsils and Your Child’s Health: When a Sore Throat Becomes Something More

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 happens next when it comes to treatment?

Most of us don’t think about our tonsils until they start causing problems. Normally, we talk, eat, and swallow without giving these small flaps of tissue in the back of the throat much thought. But when a sore throat strikes, the tonsils are often to blame.

Sore throats are very common, especially during cold and flu season. They can be caused by many conditions, including viral infections, bacterial infections, and even seasonal allergies.

During late fall, winter, and early spring, we tend to spend more time indoors and in close contact with others. This increases the spread of contagious illnesses like the common cold, flu, RSV, COVID-19, and strep throat.

All of these infections can lead to a sore throat. When the tonsils become irritated and inflamed, the condition is called tonsillitis.

What Are Tonsils and What Do They Do?

To understand tonsillitis, it helps to know what the tonsils are and why they matter.

“The tonsils, which are two round masses in the back of the throat, are part of the immune system,” says Michael Abdelmisseh, MD, a pediatric physician 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, which keeps the germs from causing infection.”

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

Ideally, the tonsils help protect the body from illness. But sometimes, they themselves become infected, leading to tonsillitis.

Symptoms of Tonsillitis

Signs your child may have tonsillitis include:

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

Sometimes a sore throat clears up on its own within a day or two. But when symptoms linger, it may be time to seek care.

When to Call Your Pediatrician

Contact your child’s pediatrician if:

  • Symptoms last more than two days
  • Swallowing causes intense pain
  • Your child is too weak to eat, drink, or stay active

How Is Tonsillitis Treated?

Treatment depends on what’s causing the infection. If a rapid strep test confirms a bacterial infection like strep throat, antibiotics will likely be prescribed.

However, most cases of tonsillitis are viral, which means antibiotics won’t help. In those cases, symptom management is key. Your pediatrician might recommend:

  • Over-the-counter pain relievers or anti-inflammatory medications
  • Throat lozenges or hard candy
  • Gargling with warm saltwater
  • Drinking warm liquids or eating cold popsicles
  • Plenty of rest and hydration

In some cases, antiviral medications may be prescribed, particularly for infections like the flu or COVID-19.

When Is a Tonsillectomy Needed?

In certain cases, surgical removal of the tonsils may be recommended.

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

A tonsillectomy may also be needed if a bacterial infection does not improve after antibiotics.

What to Expect During a Tonsillectomy

A tonsillectomy is a straightforward procedure done under general anesthesia, often as an outpatient surgery.

The surgeon removes the tonsils through the mouth—no external incisions are required. There are two main types of tonsillectomies:

  • Traditional Tonsillectomy: Complete removal of both tonsils
  • Intracapsular Tonsillectomy: Removes most of the tonsils but leaves a small layer of tissue to protect nearby muscles

Intracapsular tonsillectomy may lead to quicker recovery and less discomfort.

In some cases, the adenoids (similar tissue found in the nasal cavity) are removed at the same time. This combined procedure is called an adenoidectomy. If both tonsils and adenoids are enlarged, they can interfere with breathing and swallowing.

Both procedures are typically completed within 30 to 60 minutes and allow children to return home the same day.

Will My Child Still Be Protected from Illness?

Parents often wonder whether removing the tonsils will impact their child’s immune system. The good news is that the body can still fight off infection after a tonsillectomy. Other parts of the immune system simply take over.

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.

Updated: July 16, 2025