How Should I Look After My Child Following Tonsillectomy?

Eating and drinking

  • Eating and drinking is very important as it helps clean and heal the throat.
  • There are no restrictions on what children can have, but they often prefer softer foods.
  • Do also encourage foods that must be chewed such as toast. Chewing produces saliva which keeps the throat clean.
  • Give pain relief 30 to 60 minutes before eating to relieve the pain of swallowing.
  • Make sure your child drinks plenty of fluids through the day, including juice and cordial particularly in the first few days following surgery; if they are not eating a normal amount this will ensure they are getting calorie intake.
  • Your child should continue with teeth brushing at least morning and night.
  • In older children, soothing antiseptic gargles may be used.

Nausea and vomiting

  • If your child vomits stop giving food for an hour, then give fluids if he or she feels better; if this is tolerated start a light diet.
  • If your child continues to vomit, contact your doctor.

Pain management

  • Children may have significant levels of pain and need pain medication for up to two weeks; it may get worse before it gets better, and this is commonly at four to five days after surgery.
  • Signs of pain in young children may be crying more often or refusal to eat or drink.
  • Regular pain relief for the first week after the operation is recommended including paracetamol and other medications prescribed.
  • Paracetamol can be given up to 4 times a day, with at least 4 hours between doses.
  • After 5 to 7 days pain levels should have reduced and most children can be managed with paracetamol as needed.
  • If your child’s pain is not controlled using these medications please inform your doctor who may suggest different medications.

Other ways to relieve pain

  • Where possible, talk to your child about what is going to happen and why; they should be aware of what to expect after surgery.
  • Distracting your child with a DVD, story, or favourite activity, and comforting your child by touching, stroking or giving a massage can help in addition to pain medication.

Observation

  • For the first two nights, check your child at least twice during the night for bleeding or difficulty breathing; for children under 4 years, it may be best to sleep in the same room as your child.
  • Swallowing a lot may indicate bleeding.
  • If bleeding occurs call the doctor and take the child to the emergency department.
  • Sore throat, ear pain, bad breath, voice changes and white patches in the throat can be normal for up to two weeks after tonsillectomy; this does not mean that there is infection.
  • Earache is common after tonsillectomy because the nerve to the tonsil is the same one as to the ear. It is not a cause for concern.
  • After adenoidectomy do not let your child sniff or blow the nose for 2 weeks. It may be up to a month before your child can breathe properly through the nose.

Activity

  • It takes 3 to 4 weeks before healing is complete; do not go swimming until after this.
  • It is common for children to be very limited in their activity levels for up to 10 days.
  • The amount of activity should be guided by how the child feels.
  • Many children need two weeks home from school or kindergarten.

Contact the doctor if your child:

  • Has any fresh bleeding from the nose or mouth, or in the vomit, or swallows more frequently.
  • Vomits more than 4 times.
  • Cannot drink at all.
  • Has a temperature of 38°C or more.
  • Or if you have any questions or concerns about the child’s care at home.
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