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Swollen Lymph Nodes

Swollen lymph nodes — known medically as lymphadenopathy, and sometimes called “swollen glands” — are small, bean-shaped lumps you can feel under your child's skin, most often in the neck, behind the ears, under the jaw, in the armpits, or in the groin. In children, a little swelling is usually a sign that the body is doing its job and fighting off a common germ.

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If you believe your child is experiencing a life-threatening medical emergency, please call 911 or go to the nearest emergency room.

Common Causes in Children

Lymph nodes are part of the immune system. They act like tiny filters, trapping viruses and bacteria and helping infection-fighting cells do their work. When your child catches a cold, sore throat, or ear infection, the nodes nearby can fill with those cells and fluid and grow larger. Doctors call this “reactive” swelling, and it's the most common reason a parent notices a lump.

This is one of the most common findings in all of pediatrics, showing up in roughly 45% of otherwise healthy children. The large majority are harmless: In one large study, about two-thirds of cases had no specific cause and cleared on their own, and serious conditions accounted for well under 1 in 20.

A node that's soft, tender, movable, and about the size of a pea or bean is almost always the everyday, reactive kind. Here are the usual triggers:

  • Common colds and viral illnesses — This is the most common cause. Runny nose, cough, or a mild fever often comes with tender neck nodes that swell on both sides.

  • Sore throats and strep — Throat infections drain into the neck nodes. A bacterial infection like strep may cause one larger, tender node, often on just one side. 

  • Ear and sinus infections — nodes in front of or behind the ear can enlarge while the body clears the infection.

  • Skin infections, scratches, and bug bites — A cut or infected patch of skin can swell the nearest node (for example, a leg scrape swelling a node in the groin).

  • Cat-scratch disease — A scratch or bite from a young cat can cause a swollen, tender node days to weeks later. Tell your doctor about any new kitten in the house.

  • Mono and other whole-body viruses — Infectious mononucleosis or chickenpox can swell nodes in many areas at once, along with causing tiredness and fever.

  • Dental problems — A cavity or tooth infection can enlarge nodes along the jaw. 

How it shows up by age

  • Babies and infants — You may feel small nodes at the back of the scalp or neck, often from a mild scalp or ear irritation. New parents frequently notice these during bath time.

  • Toddlers and preschoolers — This is the peak age for reactive neck lumps, because little ones catch one virus after another as their immune systems learn. Frequent, come-and-go swelling is expected here.

  • School-age children — Sore throats, strep, and colds remain the usual causes.

  • Teens — Mono becomes more common and can cause widespread swelling with fatigue.

A quick note on teething

Many parents ask whether teething swells the glands. Teething can make the gums sore and cause drooling and fussiness, but it does not, by itself, cause true swollen lymph nodes. If your teething baby also has swollen glands, look for a separate cause such as a cold or ear infection, and check in with your pediatrician if you're unsure.

When to seek care

Seek emergency care

Call 911 or go to the nearest emergency room if your child has

• Trouble breathing, noisy breathing, or trouble swallowing or drinking.

• A swelling in the neck so large it seems to affect breathing, or that is quickly getting bigger.

• A stiff neck with high fever, severe headache, or a child who is very hard to wake.

• Skin over the node that is bright red or purple with a rapidly spreading area of redness.

Call your pediatrician

Book a visit or call your pediatrician's office if you notice

• A node that keeps growing, or is larger than about 1 inch (2.5 cm).

• Swelling that lasts longer than about 2 weeks without shrinking.

• A node that feels hard, is fixed in place (won't move under your fingers), or has an irregular shape.

• Redness, warmth, tenderness, or pus over the node.

• Fever lasting more than a few days, night sweats, unexplained weight loss, unusual bruising, or lasting tiredness.

• Any fever in a baby younger than 3 months. Call the same day.

• A swollen node just above the collarbone, which your doctor will always want to check.

Monitor and care at home

It's usually fine to care for your child at home when

• The node is soft, movable, and tender, and it appeared with a cold or sore throat.

• Your child is otherwise acting well — eating, drinking, and playing.

• Any fever is mild and improving.

• The swelling is slowly getting smaller over days to a couple of weeks.

When in doubt, it's always okay to call the clinic and ask.

At-home Care

For everyday reactive swelling that comes with a cold or sore throat, the goal is simply to keep your child comfortable while their body finishes the job. The nodes will shrink on their own once the illness passes, which can take a couple of weeks.

Comfort steps

1. Ease pain with a warm compress. Hold a clean, warm, damp washcloth gently over the sore node for about 10–15 minutes, a few times a day.

2. Keep fluids going. Offer plenty of water, milk, or soup to keep your child hydrated and comfortable.

3. Let them rest. Extra sleep helps the immune system do its work.

4. Never squeeze, poke, or try to drain a lump. This can push infection deeper or cause bleeding. Remind your child not to pick at it either.

5. Watch and note. Keep a simple mental (or phone) note of the node's size and how your child is acting, so you'll notice if it grows or lasts beyond 2 weeks.

Medicine for pain or fever

If the node is sore or your child has a fever, an over-the-counter pain reliever such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help. Always follow the dosing on the label for your child's weight and age.

Medication safety

  • Never give aspirin to children or teens. It is linked to Reye’s syndrome, a rare but serious illness.

  • Do not give ibuprofen to a baby younger than 6 months unless your doctor tells you to. Acetaminophen can be used earlier, but always confirm the dose for young infants with your pediatrician.

  • Don't combine two pain medicines at once unless your doctor has told you to.

  • Swollen glands don't need antibiotics unless a doctor finds a bacterial infection. If antibiotics are prescribed, finish the whole course, even after your child feels better.

FAQs answered by a pediatric expert

James Bakerink, MD

Answered by James Bakerink, MD

Pediatrics

My child has a small lump on their neck. Is it a swollen lymph node?
Can teething cause swollen lymph nodes in my baby?
How long will my child's swollen glands stay swollen?
My child has a swollen lymph node but no fever. Should I worry?
Why does my child always seem to have swollen lymph nodes?
When should I take my child to the doctor for a swollen node?
How can I ease my child's discomfort at home?
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When in doubt, schedule a visit

If something about your child's health just doesn't seem right, it's always best to consult your pediatrician.

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James Bakerink, MD

Clinically Reviewed By:

James Bakerink, MD

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Dr. James Bakerink, also known as "Dr. B," is a board-certified pediatrician with extensive experience in pediatrics, and he is dedicated to providing compassionate, collaborative care for children. Dr. Bakerink earned his medical degree from the University of Nevada School of Medicine in Reno, Nev. and completed his pediatric residency at the University of California, Davis. He later served as chief of pediatrics at Summerlin Hospital for several years. Dr. Bakerink continues to work in the Las Vegas Valley, caring for children of all ages and building trusted relationships with families while delivering thoughtful and compassionate care to patients from all walks of life. He is deeply committed to serving underserved children and has supported international medical service and charitable projects in Brazil, Africa, and Honduras. In addition to his clinical work, Dr. Bakerink shares his expertise with parents and caregivers as a contributor to the Zarminali Pediatrics website.