Diet after Tonsillectomy – Important Care Instructions

Diet after Tonsillectomy Important Care Instructions

A tonsillectomy is a surgery to remove your tonsils.

After a tonsillectomy surgery you should eat foods that are easy to swallow and gentle on the throat.

This makes recovery easier.

The recommended guidelines for the Diet after Tonsillectomy is ideally for 1–2 weeks or until any pain from the surgery is completely gone.

After the first 24 hours:

• You may only eat soft foods.
• You may drink any liquid except citrus juices. For example, do not drink orange juice.
• Do not eat foods that are hard or that have a hard crust.
• Do not eat hot, spicy, or highly seasoned foods.

While you are on this diet:

• Cut foods into small pieces and chew them well.
• Drink several glasses of warm water daily.
• Consider drinking a liquid nutritional supplement, such as a liquid nutrition drink. Your health care provider can give you recommendations.

What do I need to know about this Diet after Tonsillectomy ?

In the first 24 hours after surgery, here are the guidelines for Diet after Tonsillectomy:

• Do not eat any food.
• Do not drink citrus juices or liquids that are cloudy.
• You may drink liquids that are clear, such as water, chicken broth, apple juice, and lemon-lime soda that has been set out to remove the carbonation.

What is the recommended Diet after Tonsillectomy?

• Clear fluids like water, cordial, iceblock are ideal for your child immediately post tonsillectomy for the first two hours.
• Followed by non carbonated fluids like milk, ice-cream and custard if your child is able to take the fluids
• Children may refuse to drink fluids after the surgery because of throat pain but they must be encouraged to drink regularly (half a cup every hour) to avoid dehydration. Dehydration can lead to increased pain and also increase the chance of bleeding.
• Two hours after returning to the ward your child can eat regular meals. During the first eight hours after surgery your child may eat without too much discomfort due to the local anaesthetic used in the surgery.
• It is important to maintain your child’s fluid intake at home to prevent dehydration. Your child should also resume their normal diet as soon possible, although he/ she will probably be fussy about food at first. Any food is better than none in the first few days. Some foods (hot and/or spicy, acidic) may cause discomfort when eating so should be avoided for a few weeks.
• Chewing gum or chewy lollies will increase saliva production and help to reduce jaw stiffness.

Things to Note

• Its very common that most of the children show very minimal interest in food for up to a week.
• Usually a little Discomfort is expected when swallowing food.
• It is highly recommended that you keep your child Hydrated. This is extremely important!
• Foods to Encourage: juices (except for drinks that are high in citrus like lemon, lime, and grapefruit).
• Also Encourage: jello and popsicles or ice chips. These not only help in hydration but sooth the throat.
• Avoid: milk products such as pudding, yogurt, and ice cream for the first 24 hours.
• Also stay away from sports drinks like Gatorade, which dry the throat up. Pedialyte is okay.
• Stay away from foods like chips and crackers which can scratch the back of the throat until you see your doctor for the follow up appointment.

The 3 Fruits you need to avoid for your child post tonsillectomy

1. Citrus fruits – Citrus fruits and juices are painful to swallow. The surgical site can be irritated by the acid in these fruits. This acid can even cause a burning or stinging sensation which might last for several days or weeks.
2. Pineapple – Pineapple may irritate the surgical site
3. Mangoes – may also irritate the site of tonsillectomy.

The 7 Recommended Vegetables for your child post tonsillectomy

The best and most important source of minerals and vitamins are the vegetables. Though your child might not like the vegetables always, vegetables can be a prepared in a way to soothe the pain post surgery.

Here are the best vegetables for your child.

1. Pumpkin – easy to eat along with the other pureed vegetables
2. Sweet Potato – alongside other pureed vegetables in the mashed potatoes
3. Mashed Potato – also can be mixed with the full cream milk to make it much smoother
4. Broccoli
5. Carrot
6. Peas
7. Cauliflower

The 8 Recommended Fruits for your child post tonsillectomy

1. Pear – Well stewed or baked fruit 
2. Berries – You can prepare a smoothie with milk and berries for your child with sensitive throat post tonsillectomy
3. Peaches or papaya
4. Watermelon without seeds
5. Canned fruit
6. Pureed fruit –Can be brought from the Stores
7. Apples
8. Bananas

Which foods can I eat after Tonsillectomy?

Grains

Soft bread. Soggy waffles or French toast without crust and soaked in syrup. Pancakes. Oatmeal or other creamy cereal. Soggy, cold cereal. Pasta noodles.

Vegetables

Cooked vegetables. Mashed potatoes.

Fruits

Applesauce. Bananas. Canned fruit. Watermelon without seeds.

Meats and Other Protein Sources

Hot dogs. Hamburger. Tender, moist meat. Tuna. Scrambled or poached eggs.

Dairy

Milk. Smooth yogurt. Cottage cheese. Processed cheeses.

Beverages

Milk. Juices without seeds. Soda without carbonation.

Sweets and Desserts

Custard. Pudding. Ice cream. Malts. Shakes. Popsicles.

Other

Soup. Macaroni and cheese. Smooth nut butter, such as smooth peanut butter. Smooth peanut butter and jelly sandwiches without crust.

The items listed above may not be a complete list of recommended foods or beverages. Ask your dietitian for more options.

Which foods to be avoided after Tonsillectomy?

Grains

Toast. Crispy waffles. Crunchy, cold cereal. Crackers. Pretzels. Popcorn. Chips. Any grain that is dry, hard, or has a hard crust.

Vegetables

Any raw vegetables.

Fruits

All citrus fruits. Most fresh fruits, including oranges, apples, and melon.

Cereals

Crunchy cold cereal

Meats and Other Protein Sources

Tough, dry meat. Poultry. Fish. Nuts. Crunchy peanut butter or other crunchy nut butters.

Beverages

Citrus juices (such as orange juice or lemonade). Any soda or carbonated beverage with bubbles.

Sweets and Desserts

Cookies. Any dessert that contains nuts, seeds, or coconut.

Other

Fried foods. Grilled cheese sandwiches.

• crackers  
• pretzels  
• chips  
• popcorn  
• nuts

You may start small amounts of soft foods when your child drinks well after surgery.

Your child can eat soft foods for around fifteen days.

• Soft foods include yogurt, cooked cereal, cooked pasta, soft fruit, cooked vegetables, mashed potatoes, soups, pudding, ice cream and smoothies.

• Avoid foods that are crunchy or have sharp edges (such as chips). These foods can scrape the scabs in the back of the throat and make them bleed.

• Avoid red popsicles or foods with red dye that can look like blood in the mouth or throat.

Interesting Current Research Facts about the role of diet in post tonsillectomy children

Study 1

A study conducted comprising of 150 children to identify the influence of dietary advice in post-tonsillectomy recovery. These 150 children due to undergo tonsillectomy were prospectively randomized to 1 of 3 diets:

These diet patterns are mainly rough food, mainly soft food, and no advice except to eat regularly.

The parameters recorded daily in these children are pain levels, Food consumption and intake of the analgesia.

1 and 2 weeks after surgery, the Tonsillar fossa slough and secondary haemorrhage were evaluated .

Results evaluated in 137 children.

There were no significant differences between the diets regarding post-operative pain, analgesic required, healing rates or secondary haemorrhage.

So Specific post-tonsillectomy dietary advice need not be given, other than to encourage regular eating.

Study 2

Another study conducted in the ENT department of the Avicenne military hospital in Marrakech assessed the benefits of a diet which is restricted to fluids and soft foods, and evaluated the complications like hemorrhage and post-tonsillectomy pain.

Its a comparative retrospective study conducted in 182 children who underwent a tonsillectomy during the period from 2013 to 2017.

These children were divided into two groups

The first children group being given a restricted diet, the second children group were instructed to resume a normal diet.

The findings of this study is that there was zero risk of bleeding and there was no worsening of the pain post tonsillectomy in the the second children group who were instructed to resume a normal diet.

There is a likely possibility that the kind of diet advised post tonsillectomy may affect the rate of bleeding/haemorrhage post-tonsillectomy.

Study 3

One more study conducted by the systematic review of the published literature assessed and analysed if and how the different types of diets post tonsillectomy were associated with differences in the rate of bleeding/haemorrhage post-tonsillectomy in the children.

This study also helped to form an evidence base to inform individual otorhinolaryngologists practice and for future guideline development.

1039 children were included in this study with 545 of them following a restricted/non-additive diet after tonsillectomy and 494 children following an unrestricted/additive diet.

The average reported rate of bleeding/haemorrhage in the restricted diet groups was 2.3% and 0.8% in children in the unrestricted diet groups.

This study proved that the different types of diets followed after tonsillectomy in children does not affect the rate of bleeding/haemorrhage following tonsillectomy.

Thereby the Guidelines advise that the Clinicians necessarily need not change the dietary advice following tonsillectomy surgery in children.

Study 4

Another study conducted in 103 children showed that consuming cold liquids and cold foods after tonsillectomy did not have a significant effect on post tonsillectomy pain in these children.

According to the findings in this study, it is not rational to advise the mother or the child about the temperature of fluids and foods consumed post tonsillectomy.

Study 5

A comparative retrospective study conducted in 182 patients, who underwent a tonsillectomy in the ENT department of the Avicenne military hospital in Marrakech, during the period from 2013 to 2017.

These patients were divided into two groups,

The first group of patients subjected to a restricted diet

The second group of patients were instructed to resume a normal diet.

This last diet, in the light of our study and the data in the literature, exposes little or no risk of bleeding and does not worsen the pain in post tonsillectomy.

A systematic review study was conducted of Embase, Medline, the Cumulative Index to Nursing and Allied Health Literature and PsycInfo, to November 2014. The objective of the study is to determine if there is evidence that post-tonsillectomy dietary advice affects post-operative morbidity.

Seventeen articles were included; their heterogeneous nature prevented meta-analysis. Of these, all three small, randomised studies showed no statistical difference in morbidity between restricted and non-restricted diets.

The results of the study showed that Most post-tonsillectomy dietary advice is based on historical anecdotes and not rigorous scientific testing. The existing small-scale, randomised studies show no statistical difference in morbidity between non-restricted and restricted diets.