Symptom Definition

  • Increased size of a lymph node in the neck, armpit or groin.
  • Usually larger than the corresponding node on the other side of the body.
  • Normal nodes are usually less than ½ inch across (size of pea or baked bean).


  • Nodes with a viral infection are usually ½ to 1 inch across.
  • Nodes with a bacterial infection are usually longer than 1 inch across (size of a quarter).

See More Appropriate Topic (instead of this one) If

  • Swollen node is in the neck and sore throat is the main symptom, see SORE THROAT.


Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick.
  • Node in the neck causes difficulty with breathing, swallowing or drinking.
  • Fever above 104°F (40°C).  
  • Overlying skin is red.  
  • Rapid increase in size of node over several hours.

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

  • You think your child needs to be seen.
  • 1 or more inches in size by measurement.  
  • Very tender to the touch.  
  • In the neck and also has a sore throat.
  • Interferes with moving the neck, arm or leg.  
  • Fever lasts longer than 3 days.

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns.
  • Large nodes at multiple locations.  
  • Cause of the swollen node is unknown.  
  • Age under 1 month old.

Parent Care at Home If

  • Mildly swollen lymph node and you don't think your child needs to be seen.


  1. Reassurance for Normal Nodes:  If you have discovered a pea-sized or bean-sized node (smaller than ½ inch), this is a normal lymph node.  Don't look for lymph nodes, because you can always find some (especially in the neck and groin).
  2. Reassurance for Swollen Nodes from a Viral Infection:  Viral throat infections and colds can cause lymph nodes in the neck to double in size.  Slight enlargement and mild tenderness means the lymph node is fighting the infection and doing a good job.
  3. Fever or Pain Medicine:  Give acetaminophen (e.g. Tylenol) or ibuprofen as needed for fever above 102°F (39°C) or pain.  Otherwise no treatment is needed.
  4. Avoid Squeezing:  Don't squeeze lymph nodes because it may keep them from shrinking back to normal size.  Tell your child not to fidget with them.
  5. Contagiousness:  Swollen lymph nodes are not contagious.
  6. Expected Course:  After the infection is gone, the nodes slowly return to normal size over 2 to 4 weeks.  However, they won't ever completely disappear.
  7. Call Your Doctor If:
    • Node enlarges to larger than 1 inch in size.
    • Node larger than ½ inch persists for more than 1 month.
    • Your child becomes worse or develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Pediatric HouseCalls Online. Copyright © 2000-2004 Barton Schmitt, M.D. FAAP

Reviewed 8/2004

Revised 7/2002

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