What Every Parent Should Know About Tonsillitis

Learn what you can do to prevent it, and what to do once those swollen tonsils make an appearance

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While it may be scary to discover that your child has a throat infection, they’re more common than you may think. And while most people will actually have throat infections at least once in their lifetime, complications are rare and the infection usually goes away within a few days (usually less than a week).

“I think of tonsillitis as a variety of causes for inflammation of the tonsils,” said Jocelyn Kohn, MD, an Ear, Nose and Throat (ENT) specialist at Stanford Medicine Children’s Health, who also sees patients in the East Bay as part of their partnership with John Muir Health. “That can come with a variety of symptoms—most notably, sore throat. But sometimes, it comes along with other symptoms, like fevers, pain with swallowing, swollen lymph nodes, among others.”

One of the most common types of throat infection is tonsillitis—one that attacks the tonsils, those oval-shaped pads on each side of the throat. The tonsils are just one part of the immune system and act as a line of defense against illness in the body, helping trap germs that enter the nose and mouth. Tonsillitis is often the result of an upper respiratory infection that can be either viral or bacterial. And even though the inflammation itself is usually mild, the underlying illnesses may be contagious. While adults can also get it, it’s way more common among kids. “The most common age range that I’ve seen is somewhere in 5—15 range, but it’s not unheard of in adults,” explained Dr. Kohn.

So how can one prevent tonsillitis, especially if it’s easy to catch it? While no illness or infection is 100 percent preventable, there are some good lifestyle practices that may reduce your kids’ risk.

With February being Kids ENT Month, here are some ways parents can prevent and address tonsillitis.

Washing your hands often

This is a good general practice and should be taught to children from an early age: Washing their hands constantly and keeping hand sanitizer in their backpack can help combat multiple infections or diseases. And if, for some reason, kids can’t wash their hands at a particular moment, make sure they know to avoid touching their nose or mouth.

Not sharing food, drink, or utensils with others

Even if it’s a close relative or friend, it’s better to just stick to your own food items to minimize risks. At school, it’s good practice to avoid water fountains and either pack utensils solely for your kids or have them use disposable ones. Sharing is caring, but not when it comes to your kids’ health.

Replacing your toothbrush regularly

The CDC recommends replacing your toothbrush every three to four months, since the bristles become frayed after a while and are not as effective at cleaning. Keep in mind that it’s vital to replace toothbrushes after an oral infection of any sort. Bad oral hygiene is harmful for the overall wellbeing of both kids and adults.

Staying away from someone with a sore throat or tonsillitis

COVID has definitely helped us perfect this practice—if someone is sick, we do our best to stay as far from them as possible. Tonsillitis—like most throat infections—can be contagious and shows many common symptoms, so it’s always good practice to be aware of your environment and the people in it.

Keeping your child at home if they’re ill

It’s important to take care of others too! Just as you would expect any parent to keep their child at home if they’re showing any illness symptoms, make sure you do the same to ensure everyone stays as healthy as possible. Other kids at school may be immunocompromised and more susceptible to getting sick, so don’t forget to keep them in mind too.

Treating tonsillitis

Even if you’ve taken every precaution, there’s still a chance of catching tonsillitis. Medical professionals need to identify whether the infection is viral or bacterial to ensure proper treatment. While viral infections are more common, hospitals tend to see more bacterial infections because the symptoms tend to be more severe.

“If it’s been proved to be a bacterial infection, we treat it with antibiotics. Penicillin or an antibiotic in the penicillin family are used commonly by pediatricians. If it’s thought to be more viral in nature, we’re just managing symptoms,” said Dr. Kohn.

Although viral infections can’t be treated with antibiotics, there are still some home remedies that can be used to alleviate symptoms, which include:

• Drinking warm liquids
• Eating cold foods
• Gargling with salt water
• Getting plenty of rest
• Staying hydrated

While tonsillectomy, or the removal of the tonsils, used to be a more common procedure, it’s now reserved for extreme cases of tonsillitis. The guidelines state that if a child has had at least seven episodes in the past year, or five episodes in each of the previous two years, or three episodes in each of the previous three years, along with at least one other symptom (such as fever, swollen lymph nodes, fluid secreting from the tonsils or a positive strep A test), doctors will consider the child for tonsil removal.

Though these guidelines, known as the “Paradise Criteria,” are strict, context and patient history are always considered when weighing options. “If they’ve had complications or have other complex things going on, of course, we take that into consideration, and that may push us towards an earlier surgery beyond just strictly following the guidelines alone,” explained Dr. Kohn.

Strep throat vs. tonsillitis–how to tell them apart

Parents also ask about the difference between strep throat and tonsillitis. To put it simply, strep throat is a specific variety of bacterial tonsillitis. A strep throat usually means tonsillitis, yet tonsillitis doesn’t always mean strep. A rapid test is performed whenever doctors suspect strep, and strep throat is only determined when symptoms are present.

If your child’s symptoms do not improve after a few days or seem to be getting worse, it’s time to see a doctor. Learn more about the Stanford Medicine Children’s Health ENT program.