Kids Health Info

Day surgery: Tonsils and adenoids removed - discharge care

  • For children going home after having tonsils and adenoids removed.

    Eating and drinking

    • Eating and drinking is very important as it will help clean and heal the throat.
    • There are no restrictions on what children can have, however they often prefer softer foods.
    • Give pain relief 30 to 60 minutes before eating to relieve the pain of swallowing.
    • Make sure your child drinks plenty of fluids, including juice and cordial, throughout the day for the first few days following surgery.  If they are not eating a normal amount this will ensure they are getting some calories for energy.
    • Your child should continue with teeth brushing morning and night.

    Nausea and vomiting

    • If your child vomits stop giving food for an hour, then give fluids if he or she feels better.  If fluids are tolerated, start them on a light diet
    • If your child continues to vomit, contact your family doctor or your nearest hospital emergency department

    Care

    • Sore throat, ear pain, bad breath, voice changes and white patches in the throat can be normal for up to two weeks after tonsils are removed.  These things do not mean that there is an infection.
    • Check on your child at least twice during the night for the first two nights to see if there is any bleeding or difficulty with breathing.  For children under four years, it may be best to sleep in the same room.
    • If your child is swallowing a lot this may indicate bleeding.
    • If bleeding occurs take the child to the emergency department at The Royal Children's Hospital or to the nearest hospital emergency department if you live further away.
    • After having their adenoids removed, do not let your child sniff or blow their nose for two weeks. It may be up to a month before your child can breathe properly through their nose.

    Activity

    • It takes three weeks before healing is complete; do not go swimming until after this time.
    • 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.

    Pain management

    • Children may have significant levels of pain and need pain medication for up to two weeks.  Their pain 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.         

    Pain relief medications

    • We recommend that children receive regular pain relief for the first week after the operation including paracetamol (Panadol) and other medications prescribed by their doctor.
    • Paracetamol can be given up to four times a day, with at least four hours between doses. Do not give any medicine with paracetamol in it more than four times in 24 hours.
    • Do not give any over-the-counter preparation containing codeine.
    • Check the medicine packaging for the correct dose; your doctor may recommend a different amount, depending on the weight of your child.
    • It is important to give pain medications regularly rather than play catch up with the pain.
    • After five to seven days, the 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 visit your local doctor who may suggest different medications.

    Other ways to relieve pain

    • Where possible, children should be fully informed about what is going to happen and why.  They should be aware of what to expect after surgery.
    • The following techniques can be very useful when used together with pain relief medicine:
      • Distracting your child with a DVD, story, or a favourite quiet activity.
      • Comforting your child by touching, stroking or giving a massage.

    Follow up

     Unless you are told otherwise, please arrange a follow up appointment with your family doctor in two weeks.

    Contact The Royal Children's Hospital if your child:

    • Has any fresh bleeding from the nose or mouth, or in their vomit, or swallows more frequently.
    • Vomits more than four times after the surgery.
    • Cannot drink at all.
    • Has a temperature of 38°C or more.
    • If you have any questions or concerns about you child's care at home.

    Contact Details

    • Possum Ward   -  9345 5583   
    • Koala Ward      -  9345 5703  
    • Day Surgery     -  9345 6570 (7am-7pm Monday to Friday only)

    Please note - if your child was discharged from Day Surgery you will receive a phone call from a Day Surgery nurse the morning after the operation so you can discuss any questions or concerns you may have.

    Alternatively, contact the hospital switchboard on (03) 9345 5522 and ask to have the ENT registrar on call paged if you have any concerns.

    Further Information

    Factsheet developed by the RCH Surgery Centre.  First published 2005.  Updated July 2013.

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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.