A sinus infection, or sinusitis, occurs when the air-filled cavities around the nasal passages become inflamed. These infections can affect individuals of all ages, including infants. Though their anatomy is developing, babies’ sinuses are present and susceptible to infection.
Sinus Development and Susceptibility
Children’s sinuses develop progressively, influencing their susceptibility to infections. The maxillary sinuses, in the cheeks, and the ethmoid sinuses, between the eyes, are present at birth. Maxillary sinuses grow significantly in the first year, and ethmoid sinuses continue to grow through childhood. This early presence means infants can develop infections in these cavities.
Frontal sinuses, in the forehead, develop between ages 2 and 8, continuing to grow until after puberty. Consequently, frontal sinus infections are less common in very young children but become more prevalent as children approach school age. Sphenoid sinuses, deep behind the nose, develop from age 2 to 5 and are fully developed by adolescence. The gradual development of these air-filled spaces means children can experience sinus infections at any age, with the location often correlating with which sinuses are more developed.
Recognizing Sinus Infection in Children
Identifying a sinus infection in children can be challenging, as symptoms often resemble those of a common cold. A key indicator is the duration and progression of symptoms. If cold-like symptoms, such as nasal discharge or a cough, persist for more than 10 to 14 days without improvement, a sinus infection might be present. The nasal discharge can be thick and may be clear, yellow, or green.
Younger children might exhibit a persistent nighttime cough or an occasional daytime cough. Other signs in infants and toddlers can include irritability, bad breath, or even mild swelling around the eyes, which might be more noticeable in the morning. Older children may report headaches or facial pain, particularly around the cheeks or forehead, though headaches are less common in children under five years old. Facial tenderness or resistance to touch around the nose and cheeks can also signal discomfort.
Causes and When to Seek Medical Attention
Sinus infections in children often begin after a viral upper respiratory infection, like a common cold. The inflammation caused by the virus can block sinus openings, trapping mucus and creating an environment for bacterial growth. While many sinus infections are viral and resolve on their own, some can become bacterial. Allergies can also contribute to sinusitis by causing inflammation and increased mucus production, which can block the sinuses. Other factors like structural abnormalities or enlarged adenoids can also impede sinus drainage, increasing infection risk.
Parents should seek medical attention if symptoms worsen or persist for an extended period. A cold lasting over 10 days without improvement, or one that worsens after seven days, warrants a doctor’s visit. High fever with nasal discharge lasting three to four days, or severe headache, are also concerning signs. Immediate medical evaluation is required for red flags such as:
- Swelling or redness around the eyes that lasts all day
- Severe headache with neck pain
- Persistent vomiting
- Increased irritability
Treatment and Management
Managing sinus infections in children often begins with supportive home care to alleviate symptoms and encourage drainage. Ensuring adequate hydration helps thin mucus, and using a humidifier can keep nasal passages moist. Saline nasal sprays or washes are effective for clearing congestion and flushing out mucus from the nasal passages. Applying warm compresses to the face can also help reduce pain and pressure.
Antibiotics are generally reserved for bacterial sinus infections and are not effective for viral cases. A healthcare provider might prescribe antibiotics if a bacterial infection is suspected, often after observing symptoms for a few days to see if they resolve naturally. For sinusitis linked to allergies, antihistamines or other allergy medications may be recommended to reduce inflammation. In some instances, for persistent or recurrent infections, a doctor might suggest further evaluation by a specialist to consider other interventions.