Sinus Infection in Two Year Old

Sinus infection (also known as sinusitis) can affect anyone, including two year old toddlers. Fortunately, the problem rarely leads to serious complication. Many times, it is mild and often responds with home remedies and lifestyle measures – though in rare cases it may also be potential to become serious (for such case, there is usually an underlying condition behind the problem).

How do toddlers get sinus infection?

The sinuses are small, air-filled hollow cavities in the skull. They are classified into 4 main types according to where they are located. These include:

  1. Ethmoid (located behind the nose, between the eyes).
  2. Sphenoid (behind the nose, deep in the face).
  3. Frontal sinus (in the low-center of forehead).
  4. And maxillary (in the cheekbones).

These hollow spaces are lined with the same membranes (soft tissue) that line the mouth and nose. Normally, they are empty except for air and a thin layer of mucus.

In toddlers, the common cause of sinusitis is viral infection or common cold event. Other possible causes include infections of bacteria, fungus, or foreign bodies (for examples – a bead, a peanut, or a raisin pushed into the nose may lead to infection).

When the infection starts, the lining of the sinus gets swelled, blocking the mucus passage. As a result, the mucus doesn’t drain out normally and gets trapped. This build up of mucus can worsen the blockage. And if the mucus remains too long in the sinus, it can also be infected.

The inflammation can affect one or more sinuses. In toddlers, it is most commonly found in the ethmoid and maxillary sinuses, because sphenoid and frontal sinuses are still developing.

The problem can be acute or chronic. Acute means it lasts less than 4 weeks. And for chronic sinusitis, it can last for a couple of months (8 weeks or longer). The good news, sinusitis in toddlers is usually mild and not serious.

What are the symptoms?

Again, it’s common to find sinusitis that occurs after common cold. But common cold is not the only precursor to the condition. Toddlers with allergy may have the condition without being sick first.

The symptoms of sinusitis in toddlers can vary. But the main ones are as follows:

  1. Cold-like symptoms such as nasal congestion, fever, or tiredness.
  2. Runny nose with discharge that turns into yellow or green. The color discharge is the sign of the infection. But in a few cases, the discharge can be clear.
  3. Persistent cough (difficult to go away), which usually worsens at night.
  4. Swelling over the affected sinus, such as around the eyes.

These symptoms are usually not enough to diagnose the condition, because they can also resemble other conditions (such as ear infection, pneumonia, or bronchitis). But if your toddler has some of them without headache and they last longer than 7-10 days, this may signal sinus infection.

Headache is also common symptom of sinusitis. But in toddlers, frontal sinuses in the forehead are still developing (as noted before). So it is more likely to be associated with sinusitis in older children.

If you do worry about persistent, cold-like symptoms of your toddler – see a doctor for clearly diagnosis. Imaging test (such as CT scan) may be required to help identify the problem.

Is taking antibiotic right away necessary?

According to a guideline released by the American Academy of Pediatrics, the immediate use of antibiotic for acute sinusitis in toddlers is not necessary. Instead, watch-and-wait approach is more recommended to see the infection relieves and heal in time without antibiotic.

This option is aimed to avoid the risk of antibiotic resistance. In fact, there is a lot of overlap between acute sinusitis and common cold. And if antibiotic is given too soon, it may be mistakenly prescribed for some patients who’re not actually suffering from sinus infection caused by bacteria.

Still, antibiotic is one of the main treatments – especially true if bacterial infection is to blame. The next question, when should it be given?

Each case may vary. In general, antibiotic is recommended when the symptoms doesn’t improve within 10-13 days. But for toddlers who look sicker, it would be prescribed earlier – ask your doctor for more guidance!

Other treatment options include antihistamines and decongestants to help ease the nasal symptoms. Ibuprofen or acetaminophen may be prescribed to reduce sinus pain. Home remedy such as warm compress may help, too.

Over-the-counter cold medications should be avoided for sinusitis in toddlers. They will not help, and even may pose the risk of unwanted negative side effects.

If the infection is caused by virus, it usually will get better on its own. For such case, medication is usually not necessary.

Chronic sinusitis treatment is dependent on the underlying cause. It may be associated with particular underlying condition such as allergies, abnormality problem in the nasal passages (like deviated septum), or certain undiagnosed /untreated medical condition.


Compared with general population, toddlers and children are more vulnerable to have the disease. The good news, there are plenty of ways to reduce the risk and prevent the infection from coming back.

Even simple changes in your home environment can play a part. The following are easy checklists to help prevent sinus infection: