Tonsillitis in kids: symptoms and treatment

Kinderling News & Features

Tonsillitis is one of those things that can be quite difficult to pin down - do they have a cold, is it just a sore throat? And is your child making a fuss over nothing? 

Dr Elysia Thornton-Benko of Bondi Road Doctors explains how it’s spread, the different types children can get, how it’s treated and everything else in between! 

Listen to Elysia on Kinderling Conversation:

What is tonsillitis?

“There is a difference between big tonsils and tonsillitis,” says Elysia. “When you’re talking about tonsillitis, it’s the inflammation and the redness of the tonsils.” 

Sometimes you may see white bits on them, which is exudate, or pus, though Elysia notes that a child may have tonsillitis without the pus. 

How do kids get it?

“Tonsillitis could be caused by a virus or a bacteria,” says Elysia.

This is through respiratory droplets, ie. Saliva. So the germ has made its way up to your respiratory pathways after someone around you with the infection has sneezed or you’ve touched hands. 

How long is it contagious?

“I wouldn’t over think it as a parent too much. Tonsillitis just means the inflammation of the tonsils at the back of the throat. It depends on the cause as to that incubation period,” says Elysia. “Certainly while they have active symptoms, they are infective.” 

What should I look out for?

There are two different types of tonsillitis, caused by either bacteria or a virus. 

“The way a doctor or parent can tell the difference and how you would manage it is a little bit in the symptoms that you’re observing and that the child’s complaining of,” says Elysia. 

For the bacterial spectrum, your child may;

  • Be pale or off colour
  • Have a low or high fever
  • Complain of a “razor red sore throat”, their glands being sore, or neck pain
  • Not drink enough
  • Change behaviour
  • Display signs of breathing distress or difficulty

Elysia says all these signs are definitely an indication that it could be bacterial, so you should go to the doctor and likely some penicillin would be prescribed. Treatment for the bacterial form is usually a ten-day course of penicillin. 

For a virus case, antibiotics don’t work. Symptoms are often less serious and include;

  • Cold symptoms like a runny nose, sneezing and a cough
  • Sore, red throat
  • Mild fatigue
  • The child may not be fully themselves 

If they’re drinking normally, making good amounts of urine, going to the bathroom and they’re still alert, interested, interactive and not overwhelmed by pain, it’s most likely virus tonsillitis. 

In this case you’re just focussing on symptom control, conservative measures, and continuing to make sure they get enough fluid. Ensure they stay home, rest, and maybe you give some children’s paracetamol or ibuprofen, maybe some honey (only for children over 12 months of age), to soothe the throat. If there is deterioration, then seek medical advice when concerned. 

“If you’re not sure, definitely go [to the doctor],” Elysia recommends. “If you’ve got instinctive concerns then you should trust that.” She also says that closed up, narrower airways need medical attention, which you can identify through noisy breathing. 

When should a child have their tonsils taken out? 

Everyone has a slightly different opinion on whether or not tonsils need to be taken out after a certain amount of tonsillitis occurrences. 

Elysia suggests that usually after seven cases of confirmed tonsillitis in a year, then you’d be starting to very seriously consider the operation. 

Less than six could be considered normal for some children, and as the years go by they may suffer less. It does depend on the individual and it requires individual assessment in consult with a doctor.