A parent's guide to tonsils and tonsillitis


10 minutes

21 October 2019

Female doctor inspecting young girls throat
Last updated:

Surgical removal of the tonsils is one of the more common kids’ hospital procedures in Western Australia. Here's why, and everything else you need to know.

In the constant battle to keep your kids healthy, tonsils can sometimes become enemy number one.

Inflamed tonsils are the cause of many sore throats and sleepless nights. And in severe cases, they must be surgically removed.

A bit about tonsils

The tonsils are two small glands at the back of your throat, one on either side.

They’re meant to help protect you against infection, but sometimes the tonsils themselves get infected.

When this happens, it’s called tonsillitis.

This might never happen to your kids. Some whole families get through their early years with no problems at all.

But when tonsillitis does strike, you’ll want to know how to identify it and what to do.

To help with that, we’ve called in Dr Paul Bumbak, a paediatrician who’s been removing tonsils for over 10 years.

What are the symptoms of tonsillitis?

“Tonsillitis symptoms are of rapid onset,” Dr Bumbak says. “Symptoms include fever, sore throat, enlargement of tonsils and difficulty swallowing.”

These cold-like symptoms are probably the ones you’ll hear about most. If your child suffers these, and you can spot the two swollen glands at the back of the throat, there’s a good chance they’ve got tonsillitis.

Sometimes the tonsils also have white patches or pus on them, which is a sign you need to take your child to the doctor.

Headache, bad breath, a stiff neck and pain in the ears are a few other symptoms that can help you separate tonsillitis from a common cold or flu.

Full list of tonsillitis symptoms1

  • Sore throat
  • Red, swollen and painful tonsils, sometimes with white patches
  • Fever
  • Difficulty or pain when swallowing
  • Headache
  • Bad breath
  • Swollen lymph nodes in the neck
  • Stiff neck
  • Pain in the ears

No matter what you observe, always consult with a doctor to help confirm if your child is suffering from tonsillitis.

They’ll also be able to point you towards the best treatment option.

How do you treat tonsillitis?

How you treat tonsillitis actually depends on what sort of tonsillitis you’ve got. That’s right, there are multiple kinds – as if the nine different symptoms weren’t enough.

If bacteria caused your tonsillitis, you may be in luck. These cases can sometimes be treated with antibiotics. Only 15 per cent of cases are bacterial though2, so don’t count on it.

If a virus caused your tonsillitis, the symptoms usually clear up on their own.

In both of the above scenarios, tonsillitis might not be a big deal for you. A quick course of antibiotics, or a period of lying low, and you could be in the clear.

But there are two cases that can become a real pain in the neck.

These are when tonsillitis becomes chronic – meaning it comes back again and again – or the tonsils become so large that they make it hard to breathe.

For these cases sometimes tonsillectomy, or surgical removal, is the recommended treatment.

Chronic tonsillitis

In some kids, tonsillitis can drag on for months or even years.

Symptoms will flare up for a while and the child may have to miss school before they calm down again.

Sore throats at night, trouble sleeping and trouble swallowing can mean that both kids and parents lose a lot of sleep.

Over the months, the knock-on effects of sleep deprivation can start to impact family dynamics and performance in school.

If the tonsils affect sleep breathing, you should report this to your doctor.

Sleep disturbed breathing

“Sleep disturbed breathing symptoms include loud snoring, witnessed apnoeas, periods when the child is gasping for air or choking, and possible enuresis,” says Dr Bumbak.

For those of us who aren’t doctors, enuresis means bed wetting and apnoeas are temporary pauses in breathing.

Knock-on effects apply here too, says Dr Bumbak.

“During the day, the child may have hypersomnolence (extreme sleepiness) or hyperactivity.

Attention problems that lead to reduced school performance are also common. The impact of recurrent sleep fragmentation has also been associated with significant cardiovascular, neurologic and metabolic abnormalities in adults.”

According to Dr Bumbak, “tonsillectomy has become the surgical therapy of choice for these sleep disorders.”

What happens if I need a tonsillectomy?

If your doctor has recommended a tonsillectomy, you or your child will be in for a trip to the hospital.

The patient is put to sleep under anaesthetic. After a 30-minute surgery, they wake up and are monitored in recovery.

Like other surgeries, tonsillectomy has a few risks. They include adverse reactions to anaesthetics and swelling of the tongue after surgery which can cause breathing problems. In rare cases, bleeding can occur during surgery, or the surgery could lead to infection.

For these reasons, the patient usually spends the night for monitoring and is released the next day.

“Ideally, upon return to home from the hospital, [the patient should] ‘take it easy’ for a period of 14 days. There should be no school attendance during this time,” says Dr Bumbak.

Recovering well also means staying hydrated and eating foods like applesauce that are easy to swallow.

Spicy or crunchy foods can cause pain or bleeding. Take pain medications as directed by your surgeon or the hospital staff.

The good news is that tonsillectomy is a common, low-risk surgery.

The not-so-good news is that there’s a long public hospital waiting list for tonsillectomies in Western Australia.

How long? Well, it’s often over 100 days long3.

Want to get covered for tonsillectomy?

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What if I have to wait for a tonsillectomy?

If you have private hospital insurance and are covered for tonsillectomy, you skip the public waiting list. The average private wait time is two weeks4.

But the public wait can be quite long. The 100-day wait referenced above is actually just part of the picture. There are a few other waiting periods involved, and you can read about them in this guide to accessing elective surgery in Australia.

“It takes its toll on some parents unfortunately,” says Dr Bumbak of this waiting game.

“The problem is that people just think ‘Only my child’s got a problem,’ but in all reality, you have 4,000 kids waiting to be seen.”

Know your health cover and your wait times

When it comes to your kids’ health, the best thing you can do is to be prepared.

For tonsil health that means knowing whether you’re covered for tonsillectomy – and if you’re not covered, it means knowing how long your public wait could be.

1 Health Direct - Tonsilitis (2019)
2 Better Health Channel - Tonsilitis (2013)
3 AIHW - Elective surgery wait times multilevel data (2020)
4 HBF - Wait Times Report (2018)