You notice your child’s tonsils seems abnormally large. In fact, they seem to be touching. Is your child sick, or do they have something called “kissing tonsils?” What are tonsils? Tonsils are lymphoid tissue located in the back of the mouth, behind and above the tongue. They are part of the immune system, but their role is limited. Removal is considered when they are excessively enlarged and causing sleep apnea or difficulty swallowing. They are also removed when they are frequently infected. When are they considered kissing tonsils? Children often have large tonsils. Sometimes they’re so large they touch or overlap. These are called kissing tonsils. Why are my child’s tonsils so large? Tonsils naturally get larger as they fight off illness, but doctors aren’t entirely sure what causes chronically enlarged tonsils.Chronic infection, allergies, air pollution and secondhand smoke could be factors, though. Is my child sick if they have kissing tonsils? Many parents worry that their child has tonsillitis if they have kissing tonsils, but enlarged tonsils aren’t always infected. Infected tonsils are usually red, not pink. They are also painful and have white patches or drainage. However, even if they aren’t infected, kissing tonsils might still cause difficulty breathing, noisy breathing, snoring, or restless sleep. As a result, your child may also wet the bed, may develop behavioral changes such as ADHD, or perform poorly in school. Should my child have kissing tonsils removed? If your child has enlarged tonsils and is snoring, has restless sleep, has behavioral problems such as ADHD, or is pausing or gasping for air at night, they may have sleep apnea. A tonsillectomy may improve or cure these symptoms, CEENTA ENT doctor Nicholas Stowell, MD, said. A consultation with your child’s doctor will help determine if they need their tonsils removed. This blog is for informational purposes only. For specific medical questions, please consult your physician. Dr. Stowell practices in our Concord office. To make an appointment with him or any of CEENTA’s ENT doctors, call 704-295-3000. You can also schedule an appointment online or through myCEENTAchart.