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Tonsillitis In Babies: Causes, Symptoms And Treatment

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Tonsillitis is an inflammation of the tonsil tissue due to an infection caused by bacteria or a virus, the kind that also affects adults. It is a painful condition and impacts swallowing (1). It can occur in babies from any age, but is most common from toddler age. 

In this post, MomJunction will tell you about tonsillitis in babies, its symptoms, causes, and treatment.

What Is Tonsillitis In Babies?

Tonsils are a part of the lymphatic system and constitute the body’s first line of defense (2). 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 nose or mouth. However, this makes them vulnerable to infections, leading to tonsillitis.

Causes Of Tonsillitis In Babies

Numerous types of bacteria or viruses can invade the tonsils and cause inflammation. Following are the common pathogens that affect tonsils:

  1. Common cold virus: The common cold is the leading cause for tonsillitis (3). A set of viruses, including influenza virus, adenovirus, coronavirus, rhinovirus, cause cold.
  1. Group A streptococcus bacteria: Bacterial infection is the reason for 30% of tonsillitis cases, with group A streptococcus bacteria being the principal cause (4).
  1. Other bacteria: Some other bacteria that can cause tonsillitis are chlamydia pneumoniae, streptococcus pneumoniae, and staphylococcus aureus.

If your baby gets infected, some simple home care tips can be followed to mitigate the symptoms.

Symptoms Of Tonsillitis In Babies

Tonsillitis symptoms in babies are quite similar to those seen in adults. Here are some of the symptoms you might notice if your baby has a tonsil infection (5) (6):

  1. Redness in the throat: There is a distinct redness at the back of the baby’s throat, at the location of the tonsils. There could even be a yellowish or whitish layer atop the tonsils, indicating pus/aggregation of the white blood cells.
  1. Pain while swallowing: Tonsils rub against the throat when we swallow. When your baby has tonsillitis, this action can cause pain. Owing to this, babies may refuse to eat or drink anything and may cry a lot.
  1. Coughing: Since there is irritation in the throat, your baby may 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 they are swallowing and coughing. The baby may appear fussy and even cry when they tug the ears.
  1. Fever: The body detects the presence of a pathogen, thereby 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.
  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 (7).
  1. Tonsillitis rash: It is also called scarlet fever and can occur when the streptococcus group A bacteria is the cause of the infection. The bacteria release a toxin in the body, forming red rashes on the neck, back, abdomen, and face (8). 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 affect babies of all ages. If you notice any of the above symptoms, then visit a doctor to get your baby’s throat checked.

How Is Tonsillitis Diagnosed?

The doctor diagnoses the disease through the following steps of examination (9):

  1. Visual inspection of the throat: The infant’s throat is thoroughly checked for all the signs of tonsillitis. 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 the 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 develop inflamed and infected tonsils from other types of bacteria and viruses as well. 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.

Treatment For Tonsillitis In Babies

Earlier, doctors would recommend the removal of adenoids and tonsils as a part of treatment for children. However, due to medical advancements, there are alternative treatment options now
(6).

The treatment for tonsillitis depends on the cause of the condition. An antibiotic will be prescribed if bacterial. Medicines could be administered to alleviate the pain and the intensity of symptoms (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. If the infection is severe, tonsillectomy could be advised, although it is considered as a last resort.

Tonsillectomy: It is the surgical removal of tonsils when the baby 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.

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

Home Care Tips For Managing Tonsillitis And Tonsillectomy

Home care can improve the efficacy of the medication and help the baby recover soon after the tonsillectomy. Here is what you can do to make your baby feel better during tonsillitis (1):

  1. More liquids: If the baby is younger than six months, then the baby 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 wound.
  1. Plenty of rest: Rest is necessary to ensure a speedy recovery from tonsillitis. It helps soothe 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.

If the inflammation of the tonsils has resulted in tonsillectomy, you can care for the baby in the following ways once they return home:

  • The doctor will prescribe any antibiotics as part of post-operative care. Follow the prescription without fail since these medicines will play a crucial role in preventing infection at the site of the surgery.
  • If your baby is on solids, 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 the case of repeated tonsillitis, it is the best way to keep your little one safe from severely aggravated tonsils. The infant should recover within two weeks after diagnosis.

Do not try any home remedies for tonsillitis in babies. Follow the treatment as prescribed by your doctor. Once your baby is treated, follow the preventive steps to avoid reoccurrence.

How To Prevent Tonsillitis?

Follow these easy precautions daily (10):

  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 they put the hands in the mouth.
  1. Keep the baby away from those with throat infections: Do not let someone with a sore throat or cold get close to or hold the baby. Most upper respiratory infections are transmitted from one person to another through the air. Even if the infected person coughs faintly, the baby could end up with full-blown tonsillitis. If you are infected, wear a mask when around the baby and wash hands with a disinfectant soap before handling them or their personal items. Avoid kissing or cuddling the baby until your throat infection is cured.

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 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 adenoids 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 and a doctor must be seen.
  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 tonsillitis caused by group A streptococcus bacteria 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 a way to various internal organs of the body. If it enters the kidneys, then it causes post-streptococcal glomerulonephritis. Here the blood vessels in the kidney inflame, thus making the organ inefficient in filtering blood and forming urine.

As complications of tonsillitis could be distressing for babies, it is wise to take prompt measures to avoid them. Below are some questions that are worth a check.

Frequently Asked Questions

1. How long does the infection last?

The span of the infection will depend on several factors, such as 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
(6).

2. Is tonsillitis contagious in babies?

Tonsillitis is contagious if caused by a virus.

Tonsillitis can be problematic, but fortunately, there are easy ways to prevent the baby from catching an infection of the tonsils. 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 the experience to share? Do let us know in the comments section below.

References:

1. Tonsillitis; The Royal Children’s Hospital, Melbourne
2. Suzumoto M et al.; Functions of tonsils in the mucosal immune system of the upper respiratory tract using a novel animal model, Suncus murinus.; National Center For Biotechnology Information (2006)
3. Tonsillitis; National Health Service, UK
4. Tonsillopharyngitis; Merck Manual Professional Version
5. Tonsillitis; Healthy Children; American Academy of Pediatrics
6. Tonsillitis; National Health Service; Scotland
7. Tonsillitis; Better Health Channel; Victoria State Government
8. Scarlet Fever: All You Need to Know; Centers For Disease Prevention And Control
9. The Difference between a Sore Throat, Strep & Tonsillitis; Healthy Children; American Academy of Pediatrics
10. Pharyngitis and Tonsillitis in Children; Stanford Children’s Health
11. Pediatric Apnea of Prematurity; Children’s Hospital

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