A tonsillectomy is a surgical procedure to remove the tonsils, tissue masses at the back of the throat. This procedure is commonly performed in children, often when enlarged tonsils cause breathing difficulties, especially during sleep, or when frequent tonsil infections occur. While tonsils are part of the immune system, their removal does not hinder the body’s ability to fight infections. The surgery is conducted under general anesthesia, ensuring the child is asleep throughout.
The First Hours After Surgery
Immediately following tonsillectomy, children typically wake in a recovery area, often groggy from anesthesia. A sore throat is expected, and some children may experience nausea or vomiting shortly after. Offering fluids as soon as the child is awake and able to swallow is important, as hydration is key. Many children can return home the same day, though younger children or those with specific health conditions may require an overnight stay.
Managing Discomfort
Children will experience throat pain following tonsillectomy, ranging from moderate to severe, lasting 7 to 14 days. Pain often peaks around the third to fifth day, and some children may also report ear or neck pain, which is referred pain from the throat. Regular pain medication is important to manage discomfort and encourage fluid intake. Acetaminophen and ibuprofen are commonly recommended and can often be alternated every three to six hours for continuous relief. Medications should be given on a schedule, even waking the child at night for the first few days, to ensure continuous pain control.
Non-pharmacological approaches can also help. Cool compresses applied to the neck or a cool-mist humidifier near the child’s bed can soothe the throat and ease breathing, especially if snoring occurs due to swelling. Distraction through quiet activities, such as reading or playing with toys, can also be beneficial in managing pain perception.
Eating and Drinking Guidelines
Staying well-hydrated is important during recovery; consistent fluid intake soothes the throat and prevents dehydration. Children should be offered cool, clear liquids initially, such as water, apple juice, or white grape juice. Popsicles, Jell-O, and ice cream are often well-tolerated and provide comfort.
As the child’s comfort improves, a gradual introduction of soft, bland foods is recommended for up to two weeks after surgery. Examples include cooked cereals, mashed potatoes, yogurt, pudding, and soft fruits like bananas or melon. Foods to avoid include anything acidic (like citrus juices or tomato products), spicy, hot, or crunchy and sharp (such as chips, crackers, or toast), as these can irritate the healing throat or dislodge scabs. Dairy products are generally acceptable, though some find they increase mucus production.
Resuming Normal Activities
Rest is important initially, as children often feel tired for several days after surgery. Quiet indoor activities are encouraged for the first three to five days. Children typically require one to two weeks away from school or daycare, depending on individual recovery and pain management needs.
Strenuous physical activity, including sports, rough play, and activities that involve turning upside down, should be avoided for approximately two weeks to prevent complications like bleeding. Travel that would place the child far from medical care, such as airplane travel or camping, should also be avoided for about two weeks post-surgery. A gradual return to full activity is advised, as complete recovery may take up to two weeks.
Monitoring for Concerns
Parents should closely monitor their child for specific signs indicating a complication requiring medical attention. Persistent or excessive bleeding, particularly bright red blood, requires immediate medical evaluation. While some blood-tinged mucus is normal, spitting up or vomiting significant amounts of bright red blood or blood clots should prompt an emergency visit.
Difficulty breathing, especially with noisy breathing or gasping, is also a serious sign. A low-grade fever (up to 101°F or 38.3°C) can be normal for the first few days, but a higher fever or one that doesn’t decrease with medication could signal infection or dehydration. Signs of dehydration include decreased urination, dry mouth, and lack of tears. Uncontrolled pain, despite regular medication, or persistent vomiting also warrant contacting a doctor.