The tonsils are areas of tissue on both sides of the throat, at the back of the mouth.  Children's tonsils help them to build up immunity and fight infection. In many children, the tonsils become repeatedly infected with bacteria and viruses, which make them swell and become painful. This is called tonsillitis.

What causes tonsillitis?

Tonsillitis is the word used when the tonsils are infected so swell and become painful. Both bacteria and viruses can cause an infection – these are usually picked up as part of everyday life so there is little you can do to prevent them although good hygiene including hand washing is important. 



What are the signs and symptoms of tonsillitis?

The main symptom of tonsillitis is a sore throat, which is particularly painful when swallowing. The child may complain of earache as well.

The tonsils may also have a white covering or spots, which are a sign that the body is fighting off the infection. The child’s neck may look a little swollen as well, and they may have a temperature. 

How is tonsillitis diagnosed?

Tonsillitis can be diagnosed by looking closely in the mouth, sometimes using a small torch to look at the back of the mouth.

If the doctor wants to work out whether it is a virus or bacteria causing the infection, they will take swab of the child’s tonsils. A swab is a large cotton bud that removes some of the coating on the tonsils so it can be examined under a microscope in the laboratory. 

How is tonsillitis treated?

In many cases, treatment is not needed. Drinking plenty of fluid, eating soft foods and sucking on a throat lozenge can be helpful.

Pain relief medicines, such as paracetamol and ibuprofen can help reduce the pain and also bring down a temperature. If the infection was caused by a virus, as most cases of tonsillitis are, antibiotics will not work so are not required. Most cases of tonsillitis disappear within a few days.

If the child has repeated bouts of tonsillitis, the doctor may suggest an operation to remove their tonsils.

What happens next?

Tonsils seem to grow during childhood and then shrink around the age of four. By the time the child reaches adulthood, their tonsils will have disappeared almost completely. This is because they are no longer needed, as the child's body will have other defence mechanisms to fight against infection.

The child may still get the occasional sore throat but this is unlikely to be caused by their tonsils.

Last review date:
November 2015