Tonsil and Adenoid Surgery: Discharge Instructions

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KEY POINTS

• Tonsil and adenoid surgery is a procedure to remove the tonsils and adenoids from the back of the throat.
• Follow the full course of treatment prescribed by your child’s healthcare provider. If your child’s healthcare provider prescribed an antibiotic, make sure that your child takes all of it according to instructions.
• Ask your healthcare provider what symptoms or problems you should watch for and what to do if your child has them.

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What is tonsil and adenoid surgery?

Tonsil and adenoid surgery is a procedure to remove the tonsils and adenoids. The tonsils and adenoids help the body fight infections such as colds. However, the body can still fight infection if they are removed.

• Your child has 2 tonsils, one on each side of the back of the throat. They look like reddish, oval-shaped masses and may be easy to see.
• The adenoids are high in the throat behind the nose and the roof of the mouth and cannot be seen without special equipment.

Your child may have both the tonsils and adenoids removed at the same time. Some children only have the tonsils or the adenoids removed.

How long will it take to recover?

For a week or so after surgery, your child will have a sore throat. Your child may also:

• Lack energy and tire easily for several days
• Be restless at night and not sleep well
• Have problems with constipation for several days because of the effects of the pain medicine or because your child will not feel like drinking very much liquid

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider. Common recommendations include:

• If an antibiotic has been prescribed, make sure that your child takes all of it according to instructions.
• Let your child rest at home for the first 48 hours after surgery. Activity may be slowly increased as your child's strength increases. There is no rule for the right time to go back to school, but a guideline is 7 to 10 days after the tonsils are taken out. Rough play and contact sports should not be allowed until 14 days after tonsil or adenoid surgery. Contact your child's school for make-up work.

  Try to give your child a drink (2 or 3 ounces) every hour during waking hours for the first 2 days after surgery. This helps the kidneys get rid of waste products and will help lessen problems with constipation and healing. Fruit juice nectars, Jell-O, custard, Popsicles, or Gatorade are good choices. Your child should not drink through a straw after surgery until the throat is completely healed. Using a straw may increase the risk of bleeding.

• Give frequent small feedings of soft foods and cool liquids. They usually are most comfortable for your child. As your child's appetite gets better, encourage your child to eat solid foods. Ask your child’s provider about what kinds of foods are best. Let your child have favorite foods.
• A very sore throat or ear pain is normal after the tonsils are removed. Expect pain in the ears between the 3rd and 7th days because the same nerve that goes to the tonsils also goes to the ears.
• Your healthcare provider may recommend nonprescription medicine, such as acetaminophen, ibuprofen, or naproxen, to treat pain and fever. Use pain medicines exactly as directed by your healthcare provider. Read the label carefully and give your child the correct dose.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems.
  • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.
  • Acetaminophen may cause liver damage or other problems. Do not give more doses than directed. To make sure you don’t give your child too much, check other medicines your child takes to see if they also contain acetaminophen. Unless recommended by your healthcare provider, your child should not take this medicine for more than 5 days.
• You can put cool compresses or ice packs on your child's neck to help your child feel more comfortable. You can also have your child suck on ice chips or chew gum.
• It’s normal for children to have a fever between 99°F (37.2°C) and 101°F (38.3°C) for the first few days after surgery. The fever will be worse if your child doesn't drink enough liquids and gets dehydrated. Give acetaminophen for fever.
• Bad breath is normal for a week or 2 after surgery. It comes from a white to yellowish scab that forms over the area where the tonsils were removed. You can help your child's breath by giving your child a mild salt and water mix to gargle.
• Your child should not have bleeding from the nose or mouth after going home. Check on your child once or twice during the first night after surgery. If there is any bleeding bigger than the size of a dime, call your child’s healthcare provider right away. Take your child to the emergency room right away if your child has bleeding that doesn’t stop.

  Between the 5th and 10th days after surgery, the scab will break away from the surgery site and your child may spit up some bloody mucus. If the bleeding does not stop in 20 to 30 minutes, or if your child is spitting out large amounts of blood rapidly, take your child to the emergency room.

Ask your child’s provider:

• How and when you will get your child’s test results
• How long it will take your child to recover
• If there activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

When should I call my child's healthcare provider?

Call your child’s provider right away if:

• There is any bleeding from the mouth or nose
• The fever goes over 102°F (38.8°C)
• There are any signs of dehydration
• Your child has vomiting that lasts more than 12 hours