Enlarged Tonsils: How to Care for Your Child

Enlarged tonsils are common in kids. Health care providers treat enlarged tonsils if they interfere with eating, sleeping, or breathing.

Tonsils are small glands on either side of the back part of the throat. Their main job is to help stop bacteria from getting farther down the throat.

Many kids have enlarged tonsils. This can be an ongoing (chronic) condition or a temporary effect of an infection. Health care providers aren't sure what causes chronically enlarged tonsils, but secondhand tobacco smoke and air pollution can make them larger.

If the tonsils are very large, a child may snore or have trouble swallowing certain foods. Some kids with enlarged tonsils have obstructive sleep apnea. This is when a person has pauses in breathing during sleep because the tonsils partially block the airway. A test performed overnight in the hospital called a sleep study can help determine if your child has sleep apnea by looking for these pauses.

Tonsils enlarged from an infection usually return to a normal size when the infection gets better. Chronically enlarged tonsils may also shrink as children get older.

Treatment depends on the size of the tonsils and whether they interfere with eating, sleeping, or breathing. Most of the time treatment is not necessary. But sometimes, the health care provider might recommend a medicine to shrink the tonsils or surgery to remove them (a tonsillectomy). Occasionally some kids with sleep apnea may need to wear a special mask at night that helps with breathing.

• Give your child any prescribed medicine as directed by the health care provider.

• Make sure your child follows up with the health care provider as recommended.

• Make your home and car smoke-free. If anyone in your family smokes, call 1-800-QUIT-NOW for advice on quitting.

Your child has new signs of sleep problems, such as:

• Being very tired during the day and falling asleep during school.

• Loud snoring or labored breathing with gasping sounds at night.

• Poor performance in school.

• Problems with friends.

• Bedwetting.

• Disruptive behavior.

Your child has:

• Trouble breathing while awake.

• Difficulty swallowing food or liquids.

• Pauses in breathing while asleep and becomes limp, or develops choking or gagging. If you see these symptoms and cannot wake your child, call 911.

Children who have their tonsils removed aren't more prone to infection than other kids. Other tissues in the body take over for the tonsils to help prevent infection.