Tonsillitis in Babies: Symptoms, Diagnosis & When to Seek Care

Tonsillitis in Infants: Rare Under Age 2

Tonsillitis (tonsil inflammation) is uncommon in babies <2 years. Peak incidence: ages 1–4. Most cases are viral; bacterial (Group A Strep) requires antibiotics.

Signs in Babies

• Fever
• Sore throat (refusing feeds, drooling)
• Difficulty swallowing
• Swollen, red tonsils (may see white exudate)
• Enlarged tender neck nodes
• Irritability, sleep disruption

Action

If suspected, see pediatrician. Throat swab (rapid strep/culture) guides treatment. Viral: supportive care. Bacterial: 10-day penicillin/amoxicillin. Complete the course to prevent rheumatic fever.

Red Flags

• Dehydration (dry mouth, no tears, <3 wet diapers/day)
• Difficulty breathing, stridor
• Peritonsillar abscess (trismus, uvular deviation)
• Recurrent episodes (>7/year, >5/yr for 2 yrs, >3/yr for 3 yrs) → consider tonsillectomy.