Sinusitis in infants

Overview

Sinusitis is swelling and inflammation of the sinuses — the small, air-filled spaces inside the bones of the face. In infants, these sinuses are tiny and not fully developed, but they can still become infected. It usually happens after a child has a cold and can make them very uncomfortable.

Sinusitis is less common in infants than in older children and adults because their sinuses are not fully formed. However, it can still occur, especially after a cold.

It mainly affects infants and young children, especially those who attend daycare or are around people with colds. Babies under 6 months are less likely to get it, but it can happen.

Symptoms

Common symptoms

• Nasal congestion (stuffy nose)
• Thick, yellow or green nasal discharge
• Cough, especially at night
• Fever (temperature over 100.4°F or 38°C)
• Irritability or fussiness
• Difficulty feeding due to stuffy nose

Symptoms in children

• Pulling at ears (may signal ear pressure)
• Poor sleep or waking often
• Less interest in playing
• Bad breath (halitosis)

Causes

Main causes

• Viral infections, like the common cold
• Bacterial infection (less common, usually after a viral cold)

Risk factors

• Attending daycare or being around many people
• Exposure to tobacco smoke
• Bottle feeding while lying down
• Weak immune system

When to see a doctor

See a doctor urgently if:

• Any sign of breathing trouble
• Swelling around the eye or forehead
• Baby seems very sick, not feeding, or unusually sleepy

Book a routine appointment if:

• Cold symptoms that last longer than 10 days
• Thick yellow or green nasal discharge for more than a week
• Fever that does not go away after 3 days

Diagnosis

A doctor will ask about symptoms and examine your baby. They will look in the nose, ears, and throat, and may feel the face gently. In most cases, no tests are needed.

Tests that may be done

• Nasal swab (to check for bacteria or virus, if infection is severe)
• X-ray or CT scan (rarely needed, only if complications are suspected)

What to expect at your appointment

The doctor will explain the likely cause and give advice on home care. If it seems bacterial, they may prescribe antibiotics. You will be told when to come back or what to watch for.

Treatment

Treatment for infant sinusitis focuses on easing symptoms and letting the body heal. Most cases are viral and do not need antibiotics. For bacterial infections, a doctor will prescribe medicine.

Self-care at home

• Use a cool-mist humidifier in the baby's room to moisten the air
• Give plenty of breast milk or formula to keep the baby hydrated
• Gently suction nasal mucus with a bulb syringe or nasal aspirator
• Use saline (salt water) drops to loosen mucus before feeding or sleeping
• Keep the baby upright when awake to help breathing

Medical treatments

If a bacterial infection is diagnosed, the doctor may recommend an antibiotic. It is important to give the full course as prescribed. Do not give over-the-counter cold or cough medicines to infants without a doctor's advice. Pain relief such as infant paracetamol or ibuprofen may be suggested by your healthcare provider for fever or discomfort.

When is surgery considered?

Surgery is very rarely needed for infant sinusitis. It may only be considered if there is a complication like an abscess or if sinus infections keep coming back despite treatment.

Living with this condition

Caring for an infant with sinusitis means helping them breathe and feed comfortably. Suctioning the nose before feeds and sleep can make a big difference. Keep the baby away from smoke and strong fumes.

Lifestyle tips

• Avoid exposure to cigarette smoke or other air irritants
• Keep the baby's sleeping area clean and dust-free
• Wash your hands often to prevent spreading germs

Diet and exercise

For infants, the best nutrition is breast milk or formula. Offer extra feeds to prevent dehydration. No special diet is needed. Movement is not a concern, but let the baby rest as needed.

Mental health and emotional wellbeing

Having a sick baby can be stressful for parents or caregivers. It is common to feel worried or tired. Talk to your partner, family, or friends. Take breaks when you can. Remember that most babies recover well.

Prevention

It is not always possible to prevent sinusitis, but you can reduce the risk. Teach everyone in the home to wash hands often. Keep the baby away from people with colds. Breastfeeding may help strengthen the baby's immune system.

Vaccines

Keeping up with routine childhood vaccines, including the flu vaccine (for children 6 months and older), can help prevent some illnesses that lead to sinusitis.

Screening programmes

There is no routine screening for sinusitis in infants. It is diagnosed when symptoms appear.

Complications

If left untreated

• Ear infection (otitis media)
• Swelling or infection around the eye (periorbital cellulitis)
• Rarely, spread of infection to the brain or blood (meningitis or sepsis)

Long-term outlook

With proper care, most infants with sinusitis recover completely without problems. If you follow your doctor's advice and watch for warning signs, the outlook is excellent.

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