Why removing tonsils is not usually the answer for children who do not breathe easily

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Enlarged tonsils and adenoids are quite common in children, and may make breathing difficult. One way that this may manifest is as snoring and something known as sleep apnoea ” basically where breathing is so obstructed that it can stop for short periods during sleep. Surgical removal of tonsils and adenoids is a common strategy adopted by affected children. Like a lot of conventional medical care, tonsillectomy and adenoidectomy (or ‘T and A’ as it is known in the trade) is assumed to work, but does it?

In a recent edition of the Journal of Pediatrics, doctors at the University of Louisville, in Kentucky, USA, tested the breathing of children before and after T and A operations [1]. The long and short of it is that only about a quarter of children were significantly benefited by the procedure. This is a classic example of where a close look at our medical practices reveals just how limited the effectiveness of modern medicine can be.

I’m writing this, though, not to have (another) go at conventional medicine, but to explore why T and A’s aren’t that effective. If I were to use one word that I think explains this phenomenon, it would be DAIRY. Here’s why:

Sensitivity or intolerance to dairy products is common, and in children commonly causes mucus, enlargement of the tonsils and/or adenoids, and general ‘congestion’ in and around the ears, nose and throat. What this means is that surgically removing the tonsils and adenoids doesn’t necessarily clear the airways sufficiently to prevent obstruction and sleep apnoea. I’ve seen a legion of these kids in practice: the tonsils and adenoids may be gone but they usually still have symptoms like nasal congestion, post-nasal drip and a bit too much phlegm generally.

They may have other symptoms of food sensitivity to, such as dark circles under the eyes.

My advice to parents of these children is to get dairy products out of the diet, and see how they go. Almost always, they are a lot better without it. The same is true of children with enlarged tonsils and/or adenoids who are yet to go under the knife. Just coming off dairy products is usually all it takes to spare them from surgery.

It seems that not all dairy products are equally likely to cause problems. It is believed it is the protein molecules, such as casein, that cause the sorts of problems we’re discussing here. Butter contains hardly any protein, as is rarely a cause of food sensitivity. And yoghurt is generally better than milk, as the protein molecules are broken down as bit by the bacteria used to make yoghurt, which makes them less likely to provoke problems. Also, goat and sheep products are generally better tolerated than those that come from cows.

When I write about ability for dairy products to cause food sensitivity problems I not uncommonly have communication from the Dairy Council here in the UK who tell me how mistaken I am. I have also been asked for ‘proof’ for my contentions.

I’m not against science (some of you may have noticed that I draw from it quite a lot), but it has limits. One obvious limitation is that some treatments and approaches that might have merit have simply not been studied, and there is therefore no proof or evidence either way. Many researchers and doctors seem to take absence of evidence as evidence of absence, and believe that something only becomes valid once it has been ‘proven’. Curiously, these individuals often suddenly lower this bar for ‘accepted’ medical practice, most of which has never been proven to be of benefit at all [2].

And why many in the scientific community believe that health care should be ‘evidence-based’, does that mean that ‘experience’ has to go out of the window? Do I need some piece of research, for instance, to be able to suggest that drinking some water each day is to be recommended? And do I also need a study, for instance, to warn people against smashing themselves in the face with a polo mallet?

And I sometimes wonder why it is that when individuals demand the ‘evidence’, they so often make assertions as though they are fact, but which are not supported by any published ‘evidence’. This soft of double-standard and hypocrisy is rife in science and medicine.

The reason that I advise who are suffer from nasal and upper airway congestion look to get dairy products out of their diet is because, in my experience, this often dramatically reduces and sometimes completely resolves their symptoms. And I will not be desisting in recommending other approaches that have not been studied but I find highly useful in practice.

And to those who would ask me to ‘prove’ the benefits of the advice I give, I say Prove it ain’t so.


1. Tauman R, et al. Persistence of obstructive sleep apnea syndrome in children after adenotonsillectomy. J Pediatr. 2006;149(6):803-8.

2. http://www.clinicalevidence.com/ceweb/about/knowledge.jsp

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