The short answer
Most children with sore throats do not need their tonsils out, because tonsillitis is common and usually clears up on its own. Surgery is worth discussing when a child has severe tonsillitis many times a year, over more than one year, badly enough to miss school, or when big tonsils and adenoids make them snore loudly with pauses in their breathing at night. Large tonsils on their own, without these problems, are not a reason to operate.
Book tonsillectomy, from ₦250,000Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
What tonsils and adenoids do
Tonsils sit at the back of the throat, and adenoids sit higher up, behind the nose. Both are part of the body's defence against germs and are naturally large in young children, often shrinking as they get older. Children can live healthy lives without them, but that does not mean every child should have them removed.
The NHS notes that most tonsillitis is caused by viruses, and that taking tonsils out is usually only done for severe tonsillitis that keeps coming back.
Good reasons to consider surgery
- Repeated severe tonsillitis: several proper episodes a year, over more than one year, each with fever, painful swallowing and missed school, and not just a scratchy throat
- Snoring with gasps or pauses in breathing at night, restless sleep, mouth breathing, bedwetting that has come back, or daytime tiredness and poor concentration. This is sleep-disordered breathing, and adenotonsillectomy often helps
- A quinsy, which is a collection of pus beside the tonsil, especially if it has happened more than once
- Tonsils so large they make swallowing or eating difficult, or affect growth
When surgery is not the answer
A child who has the odd sore throat, or whose tonsils look big but who sleeps and eats well, does not need surgery. Tonsillectomy does not stop colds, coughs or catarrh, and it is not a cure for bad breath on its own. Many children grow out of frequent tonsillitis with time.
Before deciding, keep a simple diary: dates, temperature, days off school, and whether a doctor saw the child. Taking a short phone video of the child's sleep, if they snore, is very useful to the specialist.
Adenoids: sometimes the real problem
If the main trouble is a blocked nose, mouth breathing, snoring or repeated ear problems, the adenoids may be the issue. Removing the adenoids can be done alone or together with the tonsils, or with grommets for glue ear. The specialist decides this after examining the child, sometimes with a nose camera or an X-ray.
Risks to weigh
The main risk is bleeding, which can happen on the day or up to about two weeks later. Any bleeding from the mouth after a tonsillectomy means going to the hospital straight away. Recovery is painful for one to two weeks, and the child needs time off school.
Children with sickle cell disease, a bleeding disorder, or a heart condition need extra planning before surgery. Tell the specialist at the first visit.
Get help urgently if
Take your child to emergency care if they:
- Cannot swallow saliva and are drooling
- Have difficulty breathing or noisy breathing when awake
- Have swelling on one side of the throat, or cannot open their mouth fully
- Are very drowsy, floppy, or not drinking at all
What it costs on Mezo
Day case. Home the same afternoon.
Common questions
My child's tonsils are very big. Should they come out?
Not just because they look big. Size alone matters only if it causes problems, such as snoring with pauses in breathing or difficulty swallowing.
Will removing tonsils weaken my child's immunity?
Mainstream evidence does not show that children become generally sicker after tonsillectomy. Other parts of the immune system carry on the work.
What is the best age for tonsillectomy?
There is no single best age. It depends on how much the problem affects the child now. Very young children need more careful planning, which the surgeon will discuss.
How much is tonsillectomy for a child in Lagos?
On Mezo tonsillectomy starts from ₦250,000. A specialist examines your child first, then you get a written all-in quote and pay online.
Can antibiotics prevent tonsillitis coming back?
Long courses of antibiotics are not a routine way to prevent tonsillitis. Most sore throats are viral and antibiotics do not help them. A doctor decides when an antibiotic is needed for a particular episode.
The procedures
Related health guides
More patient guides
Sources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Tonsillitis. NHS. Patient information.
- Adenoidectomy. NHS. Patient information.
- Sore throat (acute): antimicrobial prescribing. National Institute for Health and Care Excellence (NICE). Clinical guideline.
Links last checked 22 October 2026.
Medical disclaimer: This guide is general information and does not replace advice from your own doctor. Where your centre's instructions differ from this guide, follow theirs.