Tonsils are located at the back of a child's tongue (lingual tonsils) and on both sides of the throat (palatine tonsils). They produce lymphocytes and antibodies to help fight against bacteria and viruses entering through the upper respiratory tract like adenoids. In children's puberty, their immune system matures, the tonsils' immune activity decreases, and the tonsils gradually shrink and lose function, becoming less important in overall immunity.
Tonsils can also become inflamed, turning red and swollen, sometimes with white or yellow pus spots. Children with tonsillitis may have swallowing problem (young kids might drool or refuse to eat), fever, stomach pain, vomiting, and swollen neck lymph nodes, and may even have difficulty breathing.
If tonsils are repeatedly and severely infected, the tonsils and adenoids can gradually enlarge, forming crevices that trap bacteria and increase the risk of chronic tonsillitis. This can lead to inflammation in nearby tissues, causing chronic pharyngitis, otitis media, or sinusitis. The most common bacteria causing tonsillitis is streptococcus; if not controlled, it can lead to complications like rheumatic heart disease or acute nephritis.
Besides repeated inflammation, genetics can also cause enlarged tonsils, affecting breathing and even leading to sleep apnea. Kids may snore, toss and turn in their sleep, and adopt different sleeping positions to breathe more easily. This uses up their energy, and lack of deep sleep can disrupt hormone secretion, leading to poor appetite and a thinner body build.
Enlarged tonsils can also reduce sleep quality, leading to poor concentration, hyperactivity, mood swings, and affecting learning and growth.
Bacterial tonsillitis usually requires a 5 – 10 day course of antibiotics; viral tonsillitis can be managed with symptom relief and plenty of rest. If there is an abscess, endoscopic drainage surgery may be needed. Adequate hydration and soft diet are recommended. And gargles with warm salt water is useful to help relieve symptoms.
Whether enlarged tonsils are due to genetics or acquired factors, if they negatively affect a child's daily life, parents should discuss tonsillectomy with a doctor. Removing the tonsils won't weaken the immune system, but can improve breathing and reduce future ear and throat infections.
Updated: 2025-07
Please note that all medical health articles featured on our website have been reviewed by Chiron Medical doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for personal consultation with a qualified health professional on the reader's medical condition.
