Tonsillitis in Babies: Causes, Symptoms, Diagnosis & Treatment

Tonsillitis in Babies

When your baby cries and refuses to eat what you offer her, it breaks your heart. It is difficult for parents to comprehend the cause of relentless crying in a baby, but if she is refusing to eat, then you know that there is something wrong with their mouth. Your baby may have trouble eating due to the inflamed tonsils at the back of her throat, which we clinically refer to as ‘tonsillitis,’ a condition that affects adults too. Here is everything you need to know about tonsillitis in babies and what you can do about it.

What Is Baby Tonsillitis?

Our lymphatic system has a set of tonsils which is considered a body’s front row of defences. Present on the upper and right dorsal sides of the throat, these two pink oval-shaped pads of tissue are responsible for filtering out any pathogens or bacteria that come their way when eating foods. The problem is that they’re susceptible to infections too and when harmful bacteria hit the jackpot, they get inflamed which results in what we call tonsillitis.

How Common Is It in Babies?

If you are wondering if babies get tonsillitis, you’ll be surprised to know that tonsillitis is very common in babies and almost all children experience several bouts of it from infanthood to childhood. And of course, adults get it too.

Causes of Tonsillitis in a Baby

There are many conditions which can lead to tonsillitis in babies. Here are the following causes of tonsillitis in babies in detail:

1. Common Cold

The common cold is the primary cause of tonsillitis involving a combination of viruses, such as the influenza virus, adenovirus, coronavirus, and rhinovirus.

2. Group A Streptococci Bacteria

Group A Streptococci bacteria is the most common kind of bacterial infection that results in tonsillitis in babies. The bacteria spread by coming into contact with people who are already infected with this virus and is acquired by coming in contact with mucus or by touching infected areas of their skin.

3. Different Bacteria

There are other different bacteria which contribute to tonsillitis in babies which are, chlamydia pneumonia, Streptococcus pneumonia, Staphylococcus aureus, mycoplasma pneumonia, Fusobacterium, pertussis, syphilis, and gonorrhoea bacteria.

How Long Will Your Baby Suffer?

The duration of tonsillitis in babies is based on various health and environmental factors. Firstly, it depends on your baby’s health, age, time of diagnosis, type of pathogen, and the intensity of the infection. The general consensus is that mild tonsillitis lasts for a mere 2 to 4 days from the time of infection while in severe cases it may persist up to 2 weeks.

Symptoms of Tonsillitis in Babies

Symptoms of viral tonsillitis in babies are very similar to that found in adults and we’ve listed them below.

1. Difficulty in Swallowing

As tonsils rub against the throat, it causes excruciating pain. Your baby may not be able to tolerate the pain and may refuse to swallow or eat food.

2. Bad Breath

Bacterial infections in the throat cause bad odour through compounds resulting from developing activity in the body, leading to bad breath in your baby.

3. Fever

Fever is your body’s way of signalling that something is wrong with it by raising the body temperature. When a pathogen invades the lymphatic system, the body starts up a fever which is a clear indicator of a bacterial infection or tonsillitis.

A baby suffering from fever

4. Too Much Drooling

A good way to spot tonsillitis in babies who haven’t yet started babbling is by noticing how much and how often they drool. Your baby’s refusal to swallow will lead to the accumulation of excess saliva in the mouth, thus leading to excessive drooling – a classic sign of tonsillitis.

5. Tonsillitis Rash

Commonly referred to as Scarlet Fever, when Streptococcus Group A Bacteria invades the body, the infection forms red rashes on the neck, back, abdomen, and face. Small sores are found on the tongue which mimics a strawberry-like appearance and it may later resemble a dark-red colour accompanied by white patches.

6. Coughing

Repeated coughing due to excruciating pain in the throat is a sign of tonsillitis.

7. Pain in the Ear

The pain from the tonsils may transfer to the ears and cause excruciating pain, which makes them tug at it. If your baby tugs her ears while swallowing and cries, you can be sure that it’s tonsillitis in the works.

8. Swelling of the Lymph Nodes

If areas around the neck and below the jaw look swollen, it is a sign of tonsillitis in babies and these nodes come with lumps of different sizes.

What Are the Complications of Tonsillitis in Infants?

Following are the complications an infant may come across if tonsils are left untreated or ignored for too long:

1. Sleep Apnea

Severe tonsillitis disrupts sleep patterns in babies which results in sleepiness during the day. The swollen tonsils obstruct airway passages which interfere with regular breathing patterns. Sleep apnea occurs when breathing becomes shallow during sleep and the common indicator is noticing anywhere between 5 to 30 pauses in breathing during sleep.

2. Abscess

Infected tonsils secret a viscous fluid consisting of white blood cells, cell debris, and dead cells which we refer to as ‘pus.’ An abscess occurs when the pus gets trapped in the space between the soft tonsil tissues and this may leak into the bloodstream and lead to more complications. Draining the abscess is possible but physically difficult as the areas are hard to reach.

3. Acute Glomerulonephritis

When tonsillitis is caused by Streptococcus Group A Bacteria, the bacteria strains may result in inflammation of the kidneys which is known as acute glomerulonephritis. Glomeruli are small filtering screens found in the kidneys which filter out waste and toxic substances from the blood. Scar tissue formation results when the kidneys get inflamed due to infections spreading to the glomeruli, thus interfering with its ability to reduce blood toxicity, a condition known as AGN.

4. Rheumatic Fever

Rheumatic fever is noted by signs of inflammation in the joints, rash, stomach pain, weight loss, and fatigue. It occurs when the immune system’s response against the infection is delayed in cases when the Streptococcus Group A bacteria cause tonsillitis. Severe cases may lead to medical emergencies since the inflammation may happen to the heart valves in babies and a blend of anti-inflammatory medications with antibiotics is required for effective and immediate treatment.

How Is It Diagnosed?

Doctors conduct the following tests and medical examinations for diagnosing tonsillitis in babies:

1. Visual Medical Examination

Tonsillitis can be spotted by just looking at the throat. Doctors have a feel for this and easily make out when a child gets tonsillitis.

A doctor examining the throat of a girl

2. Feeling Swollen Tissues

Tonsillitis causes inflammation of the lymph nodes in the neck area. The doctor may touch and feel the skin in the neck and below the jaw to diagnose any signs of swelling and conclusive indicators of tonsillitis.

3. Checking ENT (Ears, Nose, and Throat)

The ears and nose are affected areas when tonsillitis occurs in the throat as the infection is known to spread. The vice versa is true as well since bacterial infections from the ears and nose may branch down to the throat and result in tonsillitis. Checking for secondary infections like these through medical examination is what doctors do to assess tonsillitis.

4. Swabbing of the Throat

Collecting fluid samples from the tonsils by means of a cotton swab and sending those to the lab for testing is another way to diagnose tonsillitis. Lab testing also confirms whether it is truly tonsillitis or simply strep throat. Throat swabs pinpoint the exact cause of tonsillitis in babies.

5. Blood Test

Your baby’s doctor may recommend a series of blood tests to find out the number of lymphocytes in the blood. A high number of lymphocytes in blood samples is a major indicator of tonsillitis.

After a diagnosis of the condition, your doctor may prescribe your little one some medications or simply ask you to take care of your little one at home, depending on how severe the infection is.

Treatment of Tonsillitis in Babies

Mild cases of tonsillitis do not require treatment and gradually go away with proper nutrition and plenty of rest at home, especially viral tonsillitis. For cases of bacterial tonsillitis, antibiotics are required for treatment. Severe tonsillitis cases may warrant a tonsillectomy which is a surgical procedure designed for the removal of tonsils at the back of the throat. Intravenous fluids may be administered to babies who get dehydrated as a result of tonsillitis.

Tonsillectomy is usually recommended if there are frequent severe episodes of tonsillitis which don’t go away naturally and result in sleep apnea or bleeding of the tonsils. Your doctor may recommend your child to go for a tonsillectomy if she has:

  • Recurrent episodes of tonsillitis which occur throughout the year.
  • Tumour in her throat or nasal passages.
  • Difficulty in breathing and swallowing due to swollen tonsils and adenoids (a type of lymph tissue located behind the nose).
  • Swelling of the lymph nodes below the lower jaw which persists for more than six months, despite taking antibiotics.

Repeated ear and sinus infections which do not involve chronic tonsillitis may warrant a surgical procedure which involves removing the adenoids in children. Sleep apnea develops when swollen tonsils accompany swollen adenoids which makes breathing during sleep start and stop way too often, thus disrupting sleep cycles and proper breathing patterns.

How to Take Care of Your Infant During the Infection?

There are several ways that will help you fight a tonsillitis infection, be it bacterial or viral. Try these remedies to help your infant suffering from a tonsillitis infection:

1. Drinking Plenty of Fluid

Tonsillitis results in dehydration as babies find it difficult to swallow and thus refuse to eat. Make sure your young one drinks plenty of water and stays hydrated throughout the day. You can give her cold drinks or ice props to soothe the throat and even mix water and honey to make a throat tonic. Don’t give honey to your infant if she is less than 1 year.

2. Warm Compress

A warm compress around the neck or throat soothes the pain and provides relief to an extent. You can use a warm water bottle for the same.

3. Acetaminophen

If your child is between 3-6 months old, you may give her acetaminophen to control his fever. For babies under 3 months, it is recommended to consult a doctor before putting them on any medications. Aspirin is not recommended because it is associated with ‘Reye’s Syndrome,’ a severe medical illness that’s rare.

4. Say ‘No’ to Smoking and Tobacco

Don’t smoke around your child or let anyone consume tobacco at home since air pollutants are known to irritate the throat and cause difficulty in breathing and result in excruciating pain.

5. Use a Humidifier

Installing a humidifier at home to moisten the air makes it easier for kids to fall asleep at night. Change the water in the units every day and clean regularly as per the instructions to prevent bacteria from accumulating and spreading.

6. Encourage Gargling

If your child is old enough to understand what you say, teach her to gargle using warm saltwater. Take 1/2 teaspoon of pink salt and mix it with 8 ounces of warm water until it gets dissolved. Show her how to gargle and make sure she spits out the water once she’s done.

7. Throat Lozenge and Hard Candy

If your child understands instructions and does not swallow when she is told, you may consider giving her some hard candy or throat lozenge. These promote saliva production which cleans different areas of the throat.

If your child has undergone a tonsillectomy, she will require clear fluids like warm broth, water, apple juice, ice pops, and gelatin. Carbonated beverages and juices with high-acid content are not recommended since they sting and cause pain in the throat. Where nutrition comes to play, a light diet that’s easy on the throat is recommended. Some food recommended after the surgical procedure include wheat cream, mashed potatoes, pasta with butter, puddings, warm soups, yoghurt, scrambled eggs, fruit custards, and gelatin. Avoid foods that scratch the throat like chips and raw vegetables during the first two weeks after the surgery because this is the period when the risk of bleeding is high in babies. Don’t skip meals and make sure your child eats frequently, even if it is less. If your child does not want to eat because of a difficulty in swallowing, give her pain relievers for the throat like hard candy and coax them into sipping fluids and juices to prevent dehydration.


If your child’s immune system is weak, then she may be more susceptible to tonsillitis infections at home or outside. The best way to prevent a tonsillitis case is by preventing the sharing of drinking and eating utensils at home. Encourage frequent hand washing and practice good hygiene. Boosting immunity naturally through proper nutrition, getting plenty of fresh air and exposure to sunlight are some of many good strategies for preventing tonsillitis. Fruits and vegetables are high in antioxidants and boost the immune system, so make sure your young one gets her daily dose of fruits and veggies during mealtimes. Make smoothies and juices if she doesn’t like eating too much and prefers to drink.

Home Care for Infants

Where home care is concerned, make sure you dust the rooms frequently and sponge out harmful bacteria in the living rooms and around the house by practising proper hygiene. Make sure to change the filters and clean them frequently, especially if you’re using air humidifiers. Don’t let your child come in contact with sick people or anyone who is infected with tonsillitis as a rule of thumb. That’s easier said than done but you have to dust and broom the rooms regularly since your child’s immune system is developing at this age, which makes her more susceptible, especially if she’s going to daycare or kindergarten.

Scrub her toys too and anything she plays with since bacteria may land on those too. Get her started on her antibiotics if you suspect she has a mild case of bacterial tonsillitis and makes sure your child drinks plenty of water and fresh fruit and vegetable juices throughout the day to stay hydrated and boost immunity.

Although mild tonsillitis isn’t that harmful, bacterial tonsillitis may reach a league of its own if left untreated. If you notice any signs of muscle stiffness, fever as high as 39.5 degrees Celsius, neck stiffness and sore throat which doesn’t go away after two to three days, consult a doctor immediately since it may develop into a severe complication.

Also Read: Rheumatic Fever in Children

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