Sinusitis in special cases (pregnancy, children, elderly)

Sinusitis needs a little extra care in pregnancy, in children and in older adults, mainly because of medicine safety and different warning signs.

Pregnancy

• Hormone changes can swell the nasal lining (pregnancy rhinitis), making blockage and sinus problems more common.
• Safe self-care: saline rinse or spray, steam, warm compresses, extra fluids, rest and sleeping with the head raised.
• Paracetamol is generally preferred for pain and fever. Avoid ibuprofen and other NSAIDs unless a doctor agrees.
• Many decongestant tablets and some herbal products are not advised. Ask a doctor before using any medicine or herb.
• Steroid nasal sprays and some antibiotics may be considered by the doctor when needed.
• See a doctor for fever, severe facial pain, or symptoms lasting more than 10 days.

Children

• Most children with a cold have a runny nose for 7 to 10 days. Suspect sinusitis if symptoms last more than 10 days without improvement, if there is a high fever with thick discharge for 3 days, or if they worsen after improving.
• Use saline drops or spray, fluids and rest. Do not use steam, which can cause burns, and do not put oils or herbs in a child's nose.
• Avoid cough and cold medicines in young children, and never give aspirin.
• Do not give honey to babies under 12 months.
• Seek urgent care for swelling around the eyes, a stiff neck, drowsiness, or a baby who is feeding poorly or has a high fever.