Tonsillitis In Babies – 3 Causes And 9 Symptoms You Should Be Aware Of

Tonsillitis In Babies

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Tonsillitis is agonizing for babies and their parents too. Your baby is in such excruciating pain that he refuses to eat even when he is hungry. He cries often, and every time he opens his mouth you notice a visibly red throat, which is worrying.

Why do babies get tonsillitis, and how can you prevent it? Here, MomJunction explains you about the infection and how you can keep your baby away from it.

What Is Tonsillitis In Babies?

Tonsillitis is the inflammation of the tonsil tissue due to the infection caused by bacteria and virus, the kind that also affect adults.

Tonsils are a part of the lymphatic system and constitute the body’s first line of defense (1). They are present on the left and right dorsal side of the throat and are visible as two pink lumps at the back of the mouth. The tonsils protect the upper respiratory system from pathogens that enter the body through nasal or oral route. However, this makes them vulnerable to infections, leading to tonsillitis.

Causes Of Tonsillitis In Babies

Numerous types of bacteria or virus can invade the tonsils and cause inflammation. Following are the common ones:

  1. Common cold virus: The common cold is the leading cause for tonsillitis (2). A set of viruses including influenza virus, adenovirus, coronavirus, rhinovirus, cause cold.
  1. Group A streptococcus bacteria: Bacterial infection is the reasons for 30% of tonsillitis cases, with group A streptococcus bacteria being the principal cause (3).
  1. Other bacteria: Some other bacteria that can cause tonsillitis are chlamydia pneumoniae, streptococcus pneumoniae, staphylococcus aureus, and mycoplasma pneumoniae. In rare cases, tonsillitis is caused by fusobacterium, pertussis, syphilis, and gonorrhoea bacteria.

All the above cases have the potential to damage a baby’s health seriously if the infection lasts long.

[ Read: Bacterial Infections In Babies ]

How Long Does The Infection Last?

The span of the infection will depend on several factors viz. its intensity, the nature of the pathogen, the time of diagnosis, and the general health of the baby. An average case of tonsillitis usually resolves within three to four days but sometimes can persist for up to two weeks (4).

What Are Symptoms Of Tonsillitis In Babies?

Tonsillitis symptoms are quite similar to those seen in adults. Here is what you will observe if your baby just suffered a tonsil infection:

  1. Redness in the throat: Every time your baby opens his mouth you can see a distinct redness at the back of his throat, at the location of the tonsils. There could even be a yellowish or whitish layer atop the tonsils, indicating pus/aggregation of white blood cells.
  1. Pain while swallowing: The little one refuses to eat or drink anything, and even when he does, he stops halfway whimpering in distress. Tonsils rub against the throat when swallowing and during tonsillitis this action can cause excruciating pain.
  1. Coughing: Since there is irritation in the throat, your baby may repeatedly cough, thus aggravating the pain.
  1. Excessive drooling: Your baby may not want to swallow due to a throat infection. It leaves excessive saliva in the mouth, and your baby might drool more than normal.
  1. Earache: The pain from the tonsils can radiate to the ears, which makes the baby tug at them especially when he is swallowing and coughing. He may appear fussy whenever he tugs at his ears and cry.
  1. Fever: The body detects the presence of a pathogen, and therefore increasing the body temperature, noted as fever.
  1. Bad breath: Bacterial activity in the throat creates compounds that emit a foul smell, resulting in bad breath in your baby.
  1. Swollen lymph nodes: Tonsils are a part of the lymphatic system, and an infection can lead to the swelling of the lymph nodes around the neck and below the jaw (5). Swollen lymph nodes have lumps of varying sizes.
  1. Tonsillitis rash: It is also called scarlet fever, and occurs when the streptococcus group A bacteria is the cause of the infection. The bacteria releases a toxin in the body, forming red rashes on the neck, back, abdomen and the face (6). The tongue develops small sores, which give it a strawberry-like appearance. In severe cases, the tongue may turn dark red with the presence of white patches.

Tonsillitis can strike a baby at any age. If you notice any of above symptoms, then visit a doctor to get your baby’s throat checked.

[ Read: Throat Infection In Babies ]

How Is Tonsillitis Diagnosed?

The doctor makes a conclusive diagnosis of the disease through the following steps of examination:

  1. Visual inspection of the throat: The infant’s throat is thoroughly checked for all the signs of tonsillitis. Visible symptoms are the first giveaway for the presence of the infection. Most medical professionals draw conclusions based on this one examination.
  1. Feeling for swollen tissue: Tonsils swell when they get infected and may also cause an inflammation of the lymph nodes around the neck. The doctor will feel the skin around the neck and jaw for any swelling or lumps.
  1. Checking the ears and nose: The pathogen may have entered the body through nose or ears, causing a secondary infection in these areas. Also, the infection of the tonsils can find its way into the different parts of the ear, nose, and throat (ENT) network.
  1. Laboratory testing of throat swab: A sterile medical swab is used to sponge some fluid from the tonsils, which is then sent to the laboratory to ascertain the exact type of bacteria or virus that caused tonsillitis. It even helps differentiate it from conditions such as strep throat. The latter is caused by streptococcus bacteria, but a baby could get inflamed and infected tonsils from other types of bacteria and viruses as well (7). Throat swab works at determining the precise cause.
  1. Blood test: The doctor may recommend a complete blood test. A high presence of lymphocytes, in combination with other symptoms, can conclude the presence of tonsillitis.

Once the condition is diagnosed, the doctor may recommend medication or simply ask you to take care of the little one at home, depending on the severity of the condition.

How To Take Care Of The Baby During The Infection?

Care is what makes a difference in the case of tonsillitis. In fact, it improves the efficacy of the medication as well. Here is what you can do to make your baby feel better during tonsillitis:

  1. Let him drink more liquids: If the baby is younger than six months, then he is already on an exclusive liquid diet of breast milk. For babies older than six months, you can feed thin purees and soups. Fluids naturally flush the tonsils, keeping them moist and subsiding the irritation. Do not give anything cold, hot or too sweet since it can irritate the tonsils.
  1. Let the baby get plenty of rest: Just like any other disease, rest is necessary to ensure a speedy recovery from tonsillitis as well. It helps soothe the irritation and reduce the severity of the fever.
  1. Install a humidifier (optional): A humidifier dissipates water vapor into the surroundings. Babies with tonsillitis can be sensitive to dry air since it has an abrasive effect on the sore tonsils. Healthy levels of humidity provide relief from tonsil pain. If it is not possible to install a humidifier, then just keep the baby away from drafts of dry air.

The infant should recover within two weeks after diagnosis, and that also brings an end to other miseries like fever, drooling and chronic cough.

Do not try any home remedies for tonsillitis in babies. Follow the treatment as prescribed by your doctor.

[ Read: Home Remedies For Cough In Babies ]

Treatment For Tonsillitis In Babies

The treatment for tonsillitis depends on the cause of the condition. For bacterial tonsillitis, the doctor will prescribe antibiotics that eliminate the targeted bacteria. In the case of viral tonsillitis, there is no medication prescribed, and the body is allowed to heal on its own (8). Medicines are administered to alleviate the pain and the intensity of symptoms (a cough, fever, etc.) so that the baby can feel better. Pain medicines such as acetaminophen or ibuprofen can be given to babies but consult your doctor before giving any medication to your infant.

Tonsillectomy: It is the surgical removal of tonsils when it gets prone to repeated bouts of infection. It is the last resort when tonsillitis recurs in the baby for more than seven times in a year. It can severely disrupt important activities such as feeding, breathing or sleeping.

Procedure: Tonsillectomy is performed at an outpatient hospital center under general anesthesia. Following are the key points in the process:

  1. Preparing for the surgery: The baby may have to undergo a blood test just to check his overall health and determine whether he is at a risk of excessive bleeding during the surgery.

Since the operation is performed under general anesthesia, there is a risk of food expulsion. Therefore, you will be asked not to feed the baby (including breastfeeding) up to four hours before the surgery (9).

  1. Administering anesthesia: Once you arrive with the baby for the operation, your baby is given a shot of general anesthesia.
  1. Operative procedure: There is no external incision involved, and the doctor will extract the tonsils through the mouth. The entire operation can last 30 to 60 minutes.
  1. Post operation: There are no stitches involved in the surgery, and all you see is an empty indentation on either side of the throat where the tonsils once existed (10).

The infant is discharged within a few hours after surgery, but younger babies may be put under overnight observation to prevent the onset of any probable complication.

Post discharge, you need to take care of your baby at home.

Home Care

Here are some important points about tonsillectomy care for the infant once he returns home:

  • The doctor will prescribe a list of antibiotics as part of post-operative care. Follow the prescription without fail since these medicines will play a crucial role in preventing an infection at the site of the surgery.
  • If your baby can feed solid food, then the doctor will recommend certain dos and don’ts for feeding. Adhere to the diet plan to prevent discomfort and infection.
  • Pain after surgery peaks at about five to six days after the operation. If the baby seems to find it unbearable and the current medication is not helping, then visit a doctor for consultation.
  • It will take about a fortnight for the grazed tonsil site to heal. During this duration, the baby may sometimes have blood-stained saliva. It is normal, but if there is too much blood in the saliva or the bleeding continues even after the recovery period, then you must get the infant checked by the doctor.

Tonsillectomy can be painful, but in situations of repeated tonsillitis, it is the best way to keep your little one safe from any serious aggravation.

[ Read: How To Cure Mouth Ulcer In Infants ]

What Are The Complications Of Tonsillitis?

When left untreated for an extended period or ignored despite being chronic, tonsillitis can lead to the following ramifications:

  1. Adenoid infection: Adenoid is part of the lymphatic tissue, just like tonsils, and is also referred as pharyngeal tonsil. It is located at the back of the nasal cavity. Acute infection of tonsils can infect the adenoid, causing it to swell just like tonsils, resulting in obstructive sleep apnea (11). In such cases, the adenoid will have to be surgically removed along with the tonsils.
  1. Obstructive sleep apnea: Enlarged tonsils due to tonsillitis can obstruct the windpipe, making it difficult for the baby to breathe. This could, eventually, lead to a complicated condition like sleep apnea.
  1. Peritonsillar abscess: When the infection spreads from the tonsils to the surrounding tissue it leads to the formation of a pus-filled pocket that will appear whitish externally. This is called peritonsillar abscess. If the infection subsequently spreads to the gums, then it may cause problems during teething.
  1. Otitis media: A pathogen can quickly find its way to the ear from the throat through the eustachian tube. Here it can attack the eardrum (tympanic membrane) and the middle ear, which may lead to a whole new bunch of complications.
  1. Rheumatic fever: When group A streptococcus bacteria cause tonsillitis, and if the condition is left untreated for a very long time then it may cause rheumatic fever, which is a severe inflammation of different organs of the body.
  1. Poststreptococcal glomerulonephritis: Streptococcus bacteria can find its way to various internal organs of the body. If it enters the kidneys, then it causes poststreptococcal glomerulonephritis. Here the blood vessels in the kidney inflame, thus making the organ inefficient in filtering blood and forming urine.

Tonsillitis can be awful, but fortunately, there are easy ways to prevent the baby from catching an infection of the tonsil.

How To Prevent Tonsillitis?

Follow these easy precautions on a daily basis:

  1. Keep the surroundings clean: Bacteria is found in household dust, and while it can be harmless to adults, it may lead to an infected tonsil in a little one. Keep the air and surroundings clean. Avoid taking the baby outdoors on extremely windy days when there is a high probability of inhaling contaminated dust particles. Wash the baby’s toys, bottles, and utensils to prevent infection from the oral route.
  1. Give regular bath: Bathing washes away the bacteria present on the body, thus reducing the chances of the infant catching an infection when he puts his hands in his mouth.
  1. Keep the baby away from those with throat infections: Do not let someone even with a sore throat hold the baby or get close to him. Most upper respiratory infections transmit from one person to another through the air. Even a faint cough by the infected person is sufficient to trigger full-blown tonsillitis in a baby. If you are infected, wear a mask when around the baby and wash hands with a disinfectant soap before handling the infant or his personal items. Avoid getting cuddly or kissing the baby until your throat infection is cured.

Some basic hygiene and care can go a long way in preventing tonsillitis in babies. As the condition is contagious, take care that it does not spread to other kids in the house, to avoid double trouble!

Have an experience to share? Do let us know in the comment section below.

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Rohit Garoo

Rohit Garoo took writing as a profession right after finishing his MBA in Marketing. Earlier he graduated with a Bachelor’s degree in Botany & Zoology from the autonomous St. Xavier’s College in Mumbai. Rohit has also done a Stanford University certification course on breastfeeding. This botanist-zoologist turned writer excels at life sciences, and at MomJunction he writes everything about pediatrics and maternal care. In between writing and being overly curious, he spends time cooking, reading, and playing video games. LinkedIn profile – linkedin.com/in/rohit-garoo-263115aa
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