When you become a parent, there are certain things you’ll never be truly prepared for until you experience them. Those things include sleep deprivation and public tantrums, but worst of all is a sick kid. Having a child who’s experiencing any sort of health issue is every parent’s worst nightmare—especially when the solution to their ailment is a procedure you know nothing about like tonsil surgery. But if there’s something that unites all mothers, it’s our innate need to help our children no matter what.
For half a decade now, The Everymom has strived to be a go-to resource for whatever kind of motherhood moment you’re in: the good, the bad, the scary. We’ve put together a comprehensive guide with the help of the medical experts at Ann & Robert H. Lurie Children’s Hospital of Chicago’s Division of Otolaryngology (ENT) to answer all your questions regarding common surgical procedures. They’re sharing everything you need to know about tonsil and adenoid surgery.
Pediatric Tonsil Surgery: A Guide for Parents
1. What is tonsil/adenoid surgery and why might my child need it?
These surgeries are very commonly performed surgeries for children each year. Widely accepted reasons for having one of these procedures include a child experiencing sleep apnea, or periods when they stop breathing at night; significant blockage of the nasal passage and uncomfortable breathing; and recurrent sore throats. If a child experiences seven episodes of tonsillitis in one year, five episodes in each of two consecutive years, or three episodes in each of three consecutive years, the child is a candidate for tonsil removal. Pediatric ear, nose, and throat physician-surgeons typically perform this procedure.
2. Is this an inpatient or outpatient procedure?
Most tonsillectomies and adenoidectomies are done on an outpatient basis. In the immediate recovery area, patients are monitored to make sure they are eating and drinking well enough and their pain is controlled. Some children who do not meet this criteria will end up staying the night for observation. Additionally, all children under 3 years old and those with other chronic medical conditions are always monitored overnight.
3. What’s the best way to physically prepare a child for this surgery at home?
Even though this is a routine procedure, surgery can be scary for kids (and their loved ones!). Talking with children about what it will be like can help assuage any fears. Parents and caregivers should always feel free to reach out to their care team with specific questions or concerns.
A 1-3 year old child may not be able to be prepared for surgery, per se, although child life can see some as needed. Parents need to provide love and a sense of safety, since they can’t explain what is happening to a young child.
4. Can they eat beforehand? Should they stay hydrated?
In general, the stomach must be completely empty for the day of the procedure. Depending on the time of the procedure, the child may have to stop eating or drinking the night before and drinking clear liquids an hour before. A nurse will give specific directions tailored to your child’s procedure before it’s scheduled.
5. How painful is this procedure?
The child will be under general anesthesia during the procedure and monitored by a pediatric anesthesiologist. They will experience no pain during the procedure. Following the procedure, it’s typical for a child to experience a sore throat for one to two weeks. Over-the-counter pain medications are likely to be recommended.
6. What things will be done to manage my child’s pain during the procedure? What are some things I can do at home to manage pain?
The pediatric anesthesiologist will ensure the child safely remains asleep and does not feel pain during the procedure. In addition to pain medication, the doctor may recommend increased fluid intake, a soft food diet, and refraining from rigorous play while the child recovers at home.
7. What is normal behavior for a child after surgery?
It’s normal to feel sleepy, dizzy, uncomfortable, or even sick to your stomach when you wake up. It’s also normal to have a sore throat. The nurses and doctors will be there to help. Usually a child is awake and able to communicate by two hours after the procedure.
8. What will the post-operative and recovery phase look like?
It can take one to three weeks to fully recover from these procedures. In some patients, healing can be tricky since tonsils are located in a highly-used part of the body, and the procedure can make it difficult or painful to swallow fluids.
9. Post-procedure, what symptoms should I be monitoring for that might suggest I should contact our doctor?
A child should be taken to the emergency department following the procedure if they experience the following: bleeding more than a teaspoon or clots of blood—may happen immediately after surgery, or at home; dehydration due to decreased fluid intake; fever not improved by the pain medications; or difficulty breathing due to swelling of the surgical area.
10. Can my child still have sleep problems after tonsil surgery?
Sleep problems can be complex, and although a tonsillectomy and/or adenoidectomy are often quite effective in relieving sleep issues in children, some may continue to have issues. This can relate to obesity, syndromic conditions, and craniofacial features. Working with the otolaryngologist and sleep lab physicians to come up with strategies for residual sleep apnea may be needed. Lurie Children’s has a complex sleep disorder team, for example, who work with some of these children.
11. Can my child still get strep throat and other throat infections after surgery?
Yes, the throat can still become infected by strep after tonsillectomy, although generally the incidence of strep infections goes down significantly after the procedure.
12. What can a child eat after having tonsils and adenoids removed? Is there anything they should avoid?
Soft foods are generally recommended for about one to two weeks, but this will depend on your child’s individual needs. The key is not so much what to avoid but rather to encourage good hydration. We don’t set dietary restrictions per se, but it’s generally easier to swallow softer solids than crunchy things right after surgery.
13. Can tonsils and adenoids grow back after removal?
It’s very rare for tonsils and adenoids to grow back and to grow back to the point that they would be noticeable, cause problems, or need to be removed again. However, the tonsils and adenoids don’t always have a clearly defined border or end. They’re part of a conglomeration of lymphoid tissue located throughout the pharynx or throat, so not 100 percent is removed. Sometimes what’s left can grow.
14. Can adenoid removal affect speech?
Removing the adenoids can change the amount of air that goes through your child’s nose when they talk. When the adenoids are very large, the speech can sound like you have a stuffy nose (hyponasal resonance). If this is the case, adenoid removal allows for more air to pass through the nose, improving the quality of the sound. It’s very rare that removing the adenoids causes a problem where too much air goes through the nose when you speak (hypernasal resonance). Removal of the adenoids does not impact language development or change a child’s articulation.
Want to learn more? Check out more expert resources about tonsillectomies from Lurie Children’s Hospital here.
This post was in partnership with Ann & Robert H. Lurie Children’s Hospital of Chicago, but all of the opinions within are those of The Everymom editorial board. We only recommend brands we genuinely love.