There is a common myth that says sinusitis only affects adults. But we all know that a baby’s immune system is so vulnerable, and this increases their chance of having infections, including sinusitis. Although true sinusitis is rare to happen in babies because of their immature sinuses. What actually happens is that a cold is accompanied by congestion, which often looks like the symptoms of sinusitis in infants.
So, do babies get sinus infections? The short answer is yes, but it’s unlikely to happen as it is in older children and adults.
Most of the time, symptoms that may seem like a sinus infection are actually caused by a simple viral cold or mucus buildup, issues that can often be safely managed at home with gentle tools like a newborn nasal aspirator and proper care techniques.
Understanding Infant Anatomy: Why True Sinusitis is Rare in Babies
True sinusitis is rare in babies because they are born with small sinuses, and most of the major cavities, such as the frontal sinuses, are not yet fully developed until later in their childhood. The frontal sinuses don’t develop until around age 7, and the sphenoid sinuses develop even later.
And because sinus infections usually happen when fluid gets trapped in larger sinus cavities, the underdeveloped sinuses in infants make them less prone to bacterial sinusitis. Most of the time, nasal congestion is caused by viral infections or environmental irritants.
The Primary Cause: Differentiating Colds from Actual Infections
Babies often get colds, sometimes up to 8-10 times each year. Its symptoms can be very similar to sinus infections, but there are a few differences:
- A common cold typically lasts for 5 to 10 days. If the baby has a sinus infection, the symptoms of a cold will last for more than 10 days without any signs of improvement.
- The nasal discharge in colds is watery in the beginning and turns thicker, while in a sinus infection, the discharge is yellowish.
- A cold may cause a low-grade fever and can last for a day or two. In a sinus infection, the fever is persistent and lasts for 4 days or more.
- Colds can also include a cough, especially at night. Sinus infection signs include swelling or dark circles around the eyes, which can be really visible in the morning. It is also accompanied by bad breath and irritability.
Watch out for the timeline of the symptoms, because this is one of the biggest indicators. If your baby’s runny nose and congestion don’t improve or get worse after 10 days, it may be a sinus infection.
Infant Mucus: Why Viral Congestion Mimics Sinusitis Symptoms
Babies naturally produce more mucus than older children and adults, and their small nasal passages make even small amounts of congestion feel overwhelming. During a viral cold, the mucus becomes thick as the body is fighting the infection, causing symptoms that can easily look like sinusitis.
Because babies can’t blow their noses, mucus builds up more quickly, which results in noisy breathing, fussiness, and difficulty feeding or sleeping, signs that most parents often mistake for a sinus infection.
Additionally, since babies spend most of their time lying down, the mucus tends to pool in the back of the throat and create a lingering cough, especially at night. This postnasal drip, when combined with prolonged congestion, can mimic what older children experience with sinusitis. But in reality, most of these symptoms are just the body’s normal response to a viral infection rather than the true sinusitis.
Recognizing the Key Indicators of a Potential Bacterial Infection
According to the American Academy of Pediatrics, cold symptoms such as nasal discharge and a cough that lasts more than ten days without improvement indicate a sinus infection. The following symptoms may indicate a sinus infection in your baby:
- Nasal congestion or a cold that lasts for more than 10 to 14 days
- Green-yellow discharge from the nose for more than 4 days
- A bad bout of coughing in the daytime that becomes worse at night
- Swelling around the nose and eyes
- Dark circles around the eyes
- Increased irritability
- Post-nasal drip seen as a cough, sore throat, vomiting, nausea, and bad breath
- Low-grade fever for at least four days in a row
Identifying Risk Factors That Predispose Infants to Sinus Issues
According to doctors, there are no specific causes for sinus infection in babies other than Upper Respiratory Tract Infections (URTI). It is believed that sinusitis usually progresses from a cold and allergies. Some possible causes of sinus infections in babies are:
- Exposure to someone with a sinus infection
- Large adenoids (tissue behind the nose)
- Being exposed to smoke and environmental pollutants
- Lack of regular vaccinations
- Malnutrition or poor diet
- Poor hygiene
- Dehydration
- Tooth infection
- Unclean air
When to Seek Pediatric Assessment for Persistent Congestion
When your baby has a thick nasal discharge for more than a week, and the symptoms are not improving with saline drops and a newborn nasal aspirator, you must contact your pediatrician immediately.
- Swelling or redness around the eyes
- A fever above 100.4 degrees Fahrenheit lasting more than 2 days
- Persistent thick green or yellow nasal discharge continuing for more than 10-14 days
- Signs of dehydration, such as fewer wet diapers
- Trouble breathing
- Unusual fussiness, lethargy, or refusal to feed
If you think something doesn’t feel right, it’s always best to get your baby checked by a professional.
Safe Home Management Strategies for Clearing Infant Mucus
It is very common for babies to produce mucus all the time. Even a tiny amount of it can cause the nose to feel clogged. There are safe at-home remedies you can do to clear your baby’s mucus, like saline drops and a newborn nasal aspirator.
Saline drops can be very beneficial if your baby’s mucus is too thick and the boogers are too hard to remove. They aid in reducing stuffiness and decongest the nostrils. Use only a small amount as their nose is much smaller compared to adults.v Here’s how to us1e1 1i1t:
- Lay your baby on their back.
- Using the nose dropper, put 3 to 4 drops into each nostril of your baby. Be careful as the nose drops may make your little one sneeze.
- After giving saline drops, position your baby with their head back for about a minute to allow the saline to thin the mucus. Then, suction with a bulb syringe.
- Wash the dropper and bulb syringe each time after use. Throw away unused saline.
- Do not use any other type of medicine nose drops, unless prescribed by the doctor.
A newborn nasal aspirator often comes with a spray, which can soften the mucus by spraying it with saline, and then suction it out. Here’s how you can use this device:
- Lay your baby on a flat, safe surface with their head slightly tilted back.
- If needed, apply saline drops first.
- Attach the soft tip of the nasal aspirator and power on the device.
- Gently insert the tip into your baby’s nostril.
- Use suction briefly.
- Clean all parts after use to maintain hygiene.
Treatment Approaches: When Antibiotics or Further Testing Are Needed
Sinus infections are acute and last for less than 4 weeks, subacute that lasts for 4 to 8 weeks, chronic that lasts for 8 weeks or longer and recurrent. It may be caused by bacteria or virus or exposure to smoke.
Here are the important facts you should know:
- Most sinus infections improve without any antibiotics. Studies have shown that over 80% of them resolve on their own.
- The American Academy of Pediatrics suggest a “watch-and-wait” approach. If your baby is not severely ill, doctors may wait up to 3 days while monitoring symptoms before prescribing antibiotics.
- Antibiotics do not help sinus infections caused by viruses or irritants such as smoke or pollution.
- Mild cases often improve without medication. At-home care, like saline drops, humidifiers, and a newborn nasal aspirator, helps relieve symptoms.
Antibiotics may be needed when:
- Nasal discharge is thick and colored and persists for 10 days or more
- Symptoms worsen after initially improving
- The infant has had a persistent fever for 3-4 days
- The child appears significantly ill or in pain
Not all sinus infections need antibiotics. Most resolve with home remedies and time. Avoid requesting antibiotics unnecessarily and instead trust your pediatrician’s judgment.
If symptoms are severe, unusually long, or keep returning, your doctor may recommend additional testing or refer your child to an ENT specialist.