The tonsils are lumps of tissue on both sides of the back of the throat that are part of the body's germ-fighting (immune) system. When kids get tonsillitis, the tonsils get swollen and irritated. Tonsillitis is usually caused by an infection from a virus or bacteria (types of germs).

Children with tonsillitis have throat pain. The pain may make it hard to swallow, talk, eat, and drink. It's important to make sure your child drinks plenty of liquids to prevent dehydration (not enough water in the body).

Healthcare providers treat tonsillitis caused by bacteria with antibiotics. Antibiotics have no effect on viruses, so they are not prescribed for tonsillitis caused by viruses.

Here's how to keep your child comfortable and make sure they get enough liquids while they heal.

• If antibiotics were prescribed, be sure your child takes all the doses exactly as directed, even if they feel better. This is the best way to kill the harmful germs.
• For throat pain or fever, you can give acetaminophen (Tylenol® or a store brand) or ibuprofen (Advil®, Motrin®, or a store brand). Follow the package directions for how much to give and how often. Don't give ibuprofen to babies under 6 months old.
• Don't give aspirin to your child or teen. It can cause a rare but serious illness called Reye syndrome.
• In kids 6 years and older:
  • Offer a throat lozenge. To prevent choking, make sure your child is sitting up and awake and that an adult is nearby.
  • Try a saltwater gargle a few times a day. Mix ¼ teaspoon of salt in 8 ounces of warm water and have your child gargle, then spit out the saltwater.
• Offer your child plenty of liquids. Warm herbal (no caffeine) tea, soup, watered-down white grape juice, an oral electrolyte solution (such as Pedialyte® or a store brand), and water are all good choices. Crushed ice or flavored ice pops will also help your child stay hydrated. Babies can continue to breastfeed or take formula.
• If your child is having trouble drinking, try giving small amounts of liquids every few minutes through a straw, an oral syringe, a medicine cup, or a kitchen teaspoon.
• Offer your child soft foods that are easy to swallow. Avoid salty, spicy, crunchy, or acidic foods (like citrus fruits), which can irritate a sore throat.
• Let your child rest as needed.
• Your child can return to school and activities when they feel better and haven't had a fever for 24 hours. Check with your healthcare provider if you're not sure whether your child is ready to return to school and activities.
• Follow up with your healthcare provider as instructed.

Your child:

• Has throat pain that gets worse
• Is eating or drinking very little
• Has a new or higher fever
• Gets new symptoms, such as a rash, a cough, ear pain, or vomiting

Your child:

• Isn't drinking at all or has signs of dehydration, such as a dry or sticky mouth, sunken eyes, less pee or darker pee than usual, little or no tears when crying, or unusual sleepiness
• Develops severe throat pain, especially if it's on one side of the throat
• Has neck swelling, trouble swallowing or breathing, or drooling

You know your child best. If they have symptoms that worry you or seem very sick, call your healthcare provider or take them to the ER.

What are the symptoms of tonsillitis? Common symptoms include a sore throat, fever, swollen glands in the neck, and pain when swallowing. Some kids with tonsillitis will have other symptoms, such as a runny or stuffy nose or a cough.

How do healthcare providers know if tonsillitis is caused by a virus or bacteria? If it's not clear whether tonsillitis is caused by a virus or bacteria, healthcare providers can do a throat culture to check for different types of bacteria, such as strep. To do a throat culture, the healthcare provider rubs a cotton swab (like a long Q-tip®) on the tonsils and back of the throat. The swab is then used for one or both of the following:

• To do a "rapid" strep test to check for the bacteria that causes strep throat. The results are back in a few minutes.
• To be sent to a lab to see if strep or other bacteria are causing the tonsillitis. These results are back in 1–3 days.

Can tonsillitis be prevented? Getting tonsillitis once doesn't protect someone from getting it again. To help prevent the spread, kids (and adults) should:

• Wash their hands well and often with soap and water. Scrub for at least 20 seconds, rinse, and dry thoroughly. If soap and water aren't available, use a hand sanitizer with at least 60% alcohol.
• Avoid sharing food, drinks, dishes, eating utensils, napkins, or towels with others. Wash dishes in hot, soapy water.
• Cover their mouth and nose with a tissue when coughing or sneezing, then throw it away and wash their hands. If a tissue isn't available, they should sneeze or cough into their elbow or upper arm, not their hands.