For many kids, getting their tonsils taken out is a rite of passage, but new guidelines may make it less common. Despite the frequency of tonsillectomies, over 500,000 per year, until now there haven't been national guidelines on when and if a child should get tonsils removed.

 According to the guidelines only children with seven severe throat infections in one year or five a year for two straight years make the best candidates for the surgery.

 Professor of pediatrics at Temple University's School of Medicine Glenn Isaacson supports the recommendations.  He said it's a great surgery but only when done for the right reasons. “Most children have sore throat for a year or two if their lives, and then it disappears on its own,” he said.   “So the operation, for most people, is not beneficial and has risk and discomfort.”

 He said one in 20 children will have significant bleeding and have to return to the hospital after the operation.

Tonsillectomy is the third most common surgery for children behind circumcision and ear tubes.

 Jerry Schreibstein is with the American Academy of Otolaryngology which published the guidelines. He said throat infections are only one reason why children may need their tonsils removed. The guide also highlights lesser-known reasons why tonsils become an issue. “There are those children who don't have infections but have large tonsils that cause obstructive breathing at night,” he said  “Snoring, mouth breathing, and sometimes even sleep apnea that benefit from tonsillectomy as well.”

 The guideline authors hope to reduce the number of inappropriate tonsillectomies.