The nose has seven bony air-filled chambers (sinuses) that help to warm and humidify the air passing through it. When your child has sinus congestion, he or she will have a sensation of fullness, pressure, or pain on the face in an area overlying a sinus. Most children can't accurately report sinus symptoms before 5 years old.
With sinus congestion:
It is helpful if a healthcare provider has diagnosed your child with sinus congestion one or more times in the past. This condition tends to be recurrent.
Sinus congestion occurs when the sinus openings are blocked and normal sinus secretions build up and cause a sensation of pressure and fullness. Sinus congestion occurs mainly with colds and nasal allergies.
Sinus congestion usually goes away on its own. Without treatment, the sinuses usually open after about a week. The main complication occurs when bacteria multiply within the blocked sinus, causing a sinus infection (sinusitis). This leads to fever and increased pain. Sometimes the overlying skin (around the eyelids or cheeks) becomes red or swollen. This type of sinusitis needs antibiotics and happens in about 5% of colds.
Frequent throat-clearing of postnasal secretions usually leads to a sore throat.
Use warm water or saline nose drops or spray followed by suction or nose blowing to wash dried mucus or pus out of the nose. Do these nasal washes at least 4 times a day or whenever your child can't breathe through the nose. If the air in your home is dry, run a humidifier.
If the sinus still seems blocked after the nasal washes, you may use long-acting decongestant nose drops or sprays if your child is over age 12 years. These are nonprescription items. Ask your pharmacist to recommend a brand. The usual dose for teens is 2 drops or sprays per side, twice a day.
Before you use nose drops or a spray, your child should clear his nose by sniffing or nasal suction. The openings to the sinuses are on the outer side of the nasal passages. Point the nasal spray in this direction. To deliver nose drops to the sinuses, put them in while your child is lying on a bed with his head tipped back and turned to one side.
Use nose drops or a spray routinely for the first 2 or 3 days of treatment. Then don't use them again unless the sinus congestion or pain recurs. The drops or spray must be stopped after 5 days to prevent rebound swelling.
Your child may take acetaminophen or ibuprofen to relieve pain until the sinus is opened. Putting a cold pack over the sinus for 20 minutes may also help to relieve pain.
If your child also has hay fever, give him his allergy medicine.
Encourage your child to drink adequate fluids to prevent dehydration. This will also thin out the nasal secretions.
Sinus infections are not contagious. Your child can return to school or child care when he is feeling better and the fever is gone.
Jumping into the water feet first can cause sinusitis of the frontal sinuses and should be avoided unless the nose is pinched. Swimming does not worsen sinusitis, but deep diving should be avoided unless your child wears nose plugs.
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