Infant Illnesses | Spotlight on tonsillitis

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"Symptoms normally last around 3 to 4 days but sometimes it can take 2 weeks to resolve". (FreshSplash/Getty Images)
"Symptoms normally last around 3 to 4 days but sometimes it can take 2 weeks to resolve". (FreshSplash/Getty Images)
  • If your baby is lethargic with a rising temperature and bad breath, tonsillitis could be the cause. 
  • While uncommon in infants, tonsillitis can occur in children younger than five years old. 
  • A local expert explains how to treat it and when a doctor's visit is essential. 

Having a newborn baby is overwhelming enough, but if they show signs of illness, it can be really scary.

At Parent24, we've put together a series on common infant illnesses to help guide you when your baby is sick.

Together with a local paediatrician or doctor, we'll help you decide when you should actually panic – it's probably not as serious as you think, but let's be sure.

Catch more instalments of our #infantillness series here

A typical concern

"My one-year-old has come down with a fever and has bad breathe! I'm worried that it's serious because she won't eat anything! What could it be?"


Your baby might have tonsillitis. 

It isn't very common in babies who "are more likely to have upper respiratory tract symptoms such as a runny nose, congestion, snoring or a cough", Dr Michael Platten tells Parent24.

A specialist paediatrician at the Gauteng-based Life Bedford Gardens Hospital, Dr Platten says tonsillitis is "an inflammation of the oval-shaped glands on either side of the throat behind the tongue". 

What causes tonsillitis

"Tonsillitis is less likely to occur in those under 2 years of age. In those under 5 years of age it is commonly viral and those older than 5 years it is more likely bacterial. That said, there is overlap," Dr Platten explains. 

Dr Platten also advises that while it is unlikely to be misdiagnosed "initially" there is a possibility for a misdiagnosis since, "Symptoms change over time and sometimes a viral infection can change to a bacterial infection or the infection can spread beyond the tonsils into the neck". 

"It is therefore vitally important to maintain good communication with your healthcare provider to ensure that appropriate therapy is provided timeously as symptoms can sometimes change or progress quickly," he advises. 

MUST READ | 'My baby could have died!': Every new parent should know about this potentially fatal infection

Symptoms to look out for 

Dr Platten says the classic symptoms of tonsillitis include: 

  • Fever
  • Sore throat
  • Foul breath
  • Painful or difficulty swallowing
  • Tender glands in the neck
  • Tiredness

"Depending on how large the tonsils are, they might have drooling, gagging or vomiting, and in severe cases, difficulty breathing," Dr Platten advises. 

How long will it last? 

Your baby may be ill for anything from three days up to two weeks, Dr Platten says, "even with appropriate therapy", but this is to be expected with certain illnesses.

"For example, Ebstein Barr virus (glandular fever/infectious mononucleosis) can classically cause a fever, sometimes over 40°C, for two weeks, despite appropriate medication," Dr Platten explains. 

How is it spread? 

"This depends on the cause, but invariably it is spread in the same way that the common cold is spread – droplets from talking, coughing or sneezing or anywhere these droplets end up e.g. skin, surfaces." 


Dr Platten describes tonsillitis as a "self-limiting" infection which means that, while no medication is needed to treat it, attending to symptoms is essential. 

"The main way to assist recovery is through maintaining adequate hydration, taking a good amount of rest and controlling the fever and pain with age-appropriate medication (paracetamol; or ibuprofen in older children). If your healthcare provider prescribes an antibiotic, be sure to finish the entire course." 

When to call the doctor

"We normally say, 'When you are concerned'," Dr Platten tells us, noting the following as "signs of worsening symptoms": 

  • Difficulty breathing or swallowing;
  • Excessive tiredness or reduced responsiveness;
  • A fever that starts up again after it has disappeared previously;
  • An inability to maintain hydration (too painful to drink, vomiting, fluid refusal in younger children).

ALSO SEE Squeaky clean: How to sterilise baby bottles, and when to stop

Tips and advice for parents 

Here's some good advice to follow, according Dr Platten: 

You’ve got this. Trust yourself.

Keep your little one as hydrated as possible by letting them drink what fluids they will.

Offer some food, but do not force it. Softer food will probably go a long way, like purees. 

Good amounts of appropriate medication at correct doses should assist in alleviating some of the pain they experience.

Antibiotics can shorten the duration of the infection by a few days, but not for a viral case.

You can also ask a doctor or paediatrician directly via Health24 here: Ask an Expert 


Share your stories and questions with us via email at Anonymous contributions are welcome.

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