My 7-year-old daughter has been diagnosed with strep throat four times in six months. Should we consider having her tonsils removed?

Answers from Jay L. Hoecker, M.D.

If a child has six or more severe throat infections in one year, his or her doctor might suggest surgery to remove the tonsils (tonsillectomy). To be considered severe, each throat infection must meet at least one of the following conditions:

  • Oral temperature of at least 101 F (38 C)
  • Enlarged and tender lymph nodes in the neck
  • White spots on the tonsils
  • Positive test for strep throat

Children can still get strep throat after having their tonsils removed. But for some children with recurring strep throat, tonsillectomy reduces the frequency and severity of strep throat infections.

However, many children tend to stop having recurring strep throat as they get older. The decision to remove a child's tonsils must be weighed against the risks of anesthesia and bleeding, as well as the missed school days to recover from the procedure.

Tonsillectomy is an elective surgery except in three situations, all of which are relatively rare: cancer of the tonsil, bleeding of the tonsil and airway obstruction by the tonsils.

Aug. 13, 2014