HF 5422

Caring for Your Child After a Tonsillectomy

Tonsillectomy

A tonsillectomy is surgery to remove lymph tissue (tonsils) that lies on either side of the back of the throat.

What to Expect

After you go home, you may expect:

  • Pain: Sore throat that may last 7-14 days. Ear, jaw, and neck pain that may not start until 3-4 days after surgery. This may last for 7-14 days.

  • Nausea and vomiting: The doctor may prescribe medicine to help this at home.

  • A yellow-grey membrane: You may notice this membrane where the tonsils were removed. It will slowly go away as the area heals in 3-4 weeks. It should not be swabbed to test for infection at any time during these 3-4 weeks. Contact your surgeon’s office with any concerns.

  • Bad breath: Your child’s may have bad breath while the throat is healing. Drinking plenty of liquids helps decrease the odor. You should still brush their teeth.

  • Snoring and voice changes: Your child may have a nasally voice and snore as the throat heals. If it lasts longer than a month, tell your doctor.

  • Fever: Your child may have a low grade fever up to 102°F for up to 7 days after surgery. This is normal.

  • Disturbed sleep: Your child may be restless or have bad dreams for a couple of weeks.

Pain Relief

Your doctor will prescribe medicine for sore throat and ear pain. Try to keep your child’s pain controlled so they can drink plenty of fluids.

Prescription medicine: You will be given prescriptions for post-op acetaminophen (Tylenol) and ibuprofen. You will be told of the dosages for both medicines on the day of surgery. Give pain medicines every 6 hours, around the clock, for the first 48-72 hours. After that time, you can try spacing them out, but if your child stops drinking or has increased pain, please go back to giving them every 6 hours. Most children require them every 6 hours for the full recovery period (7-10 days). Try to time the pain medicine so that your child takes it about 1 hour before meals. This will help to decrease pain when they swallow. A prescription may also be given for severe pain. It may be used as directed if acetaminophen (Tylenol) and ibuprofen don’t relieve the pain.

Ice: An ice pack may help. Try using a small bag of frozen corn or peas and put it in a plastic bag and wrap it in a towel. Place it on the throat for 20 minutes at a time.

Warm compress: A warm heating pad or compress may help with ear pain. Do not use the heating pad on HIGH. Your child should not sleep on it.

Humidifier: Use a humidifier or vaporizer to ease throat soreness during sleep.

Activity

Limit your child’s activity for one (1) week. Your child should:

  • Avoid strenuous exercise and activity, swimming, or lifting more than 25 pounds.

  • Be out of school or daycare for at least 1 week.

  • Get plenty of rest.

Diet

Your child may lose weight from eating less than normal. This is okay as long as they are drinking plenty of fluids. Follow the “tonsillectomy diet” for one (1) week. This means:

  • Begin with clear liquids such as: water, broth, apple juice, popsicles, Jell-O, Hi-C, and Kool-Aid. Cold or lukewarm liquids may feel better. Frequent small sips are better than quickly drinking a large amount of fluid and then not drinking for the next few hours.

  • Straws, sippy cups, bottles, and pacifiers are all okay to use.

  • Give your child other foods that they may like such as pudding, ice cream, milkshakes, and cream soup.

  • Your child may eat soft foods as when able to. Soft foods include scrambled eggs, mashed potatoes, macaroni and cheese, cooked cereal, yogurt, and apple sauce.

  • Some children eat solid foods earlier than others. Your child will eat solid foods when able to swallow better. It is normal if your child does not want to eat solid foods the first week. It is vital to drink plenty of liquids. Acidic or spicy foods (orange or grapefruit juice, tomatoes) may make your child’s throat more sore, but won’t do any harm.

  • Do not give your child foods that are rough and crunchy for an entire week. They may scratch your child’s throat and cause bleeding. This includes:

    • Popcorn

    • Pretzels

    • Potato chips, other chips

    • Crackers

    • Nuts

    • Cold cereal

Follow-Up

Your child will not have a follow-up clinic visit unless there is a problem. You may call at any time with questions or concerns.

When to Call

  • Any bleeding

  • Dehydration: Your child should be urinating at least twice in 24 hours

  • Nausea and vomiting that does not go away in the first 2 weeks after surgery

  • A fever over 102°F

  • Pain not controlled with medicine

  • A feeling that your child is not healing as they should (it takes about 7-10 days before they start to feel better)

Who to Call

If your child was seen for their pre-op appointment in the Pediatric ENT Clinic in Madison at the American Family Children’s Hospital, please call (608) 263-6420, option 3, Monday through Friday, 8:00 am – 4:30 pm.

If your child was seen for their pre-op visit in the Pediatric ENT Clinic in Rockford at the Women and Children’s Hospital, please call (779) 696-8499, Monday through Friday, 8:00 am – 5:00 pm.

After hours, weekends or holidays, please call the Madison/American Family Children’s Hospital phone number. This number will give you the paging operator. Ask for the otolaryngology (ENT) doctor on call. Leave your name and phone number with the area code. The doctor will call you back.

The toll-free number is 1-800-323-8942.