If the sinuses become congested and inflamed following a cold, flu or chronic catarrh, this can predispose to a sinus infection, either viral or bacterial. The resultant pain and swelling around the nose and eyes, as well as headaches and even toothache, can be quite distressing for children. Nasal congestion, sinusitis, postnasal drip and the irritating cough that can accompany it respond well to herbal treatment and dietary changes.

Chronic sinusitis can also be related to overproduction of mucus in an attempt by the body to cleanse itself of toxins that are not being adequately eliminated elsewhere. Lack of fresh air and exercise, constipation and insufficient fluid intake and urination can all be contributory factors.

Sinusitis can also be caused by atmospheric pollution such as passive smoking. Alternatively blockage and infection in the sinuses can be related to over-production of mucus due to food intolerance, most often to cow’s milk and milk products.

Atopic diseases such as rhinitis are a common feature of cow’s milk allergy.

A diet that reduces mucus, avoiding milk, sugar, wheat and excess red meats, and includes plenty of fresh fruit and vegetables, seeds, and essential fatty acids is recommended. The Hay diet is often helpful in clearing chronic catarrh. It involves avoidance of combining proteins with carbohydrates and acid fruits with carbohydrates in the same meal. Once the sinusitis clears normal eating can gradually be resumed.

Treatment of sinusitis

• For sluggish bowels dandelion root, liquorice, psyllium (Plantago psyllium) or linseed (Linum usitarissimum) are all helpful. Syrup of figs, cooked prunes and apricots will also stimulate bowel function.

• Herbs such as yarrow, limeflowers (Tilia europaea), ginger, catnip (Nepeta cataria), peppermint, chamomile, lavender, hyssop (Hyssopus off.), thyme, lemon balm and basil taken as hot teas stimulate the circulation to the periphery and increase sweating and thereby elimination of toxins through the pores.

• Herbs rich in volatile oils not only stimulate the linings of the sinuses, helping to loosen and shift the mucus, but also have antimicrobial properties that help to resolve the accompanying infection in the sinuses. These include aniseed (Pimpinella anisum), chamomile, fennel (Foeniculum vulgare), rose, ginger, hyssop (Hyssopus off.), lavender, peppermint, rosemary and thyme. These are best taken as hot infusions (sweetened with honey / liquorice / apple concentrate if desired) three times a day. They can be taken singly or in mixtures, blended to suit the child’s taste.

• Essential oils of the same herbs along with pine, lemon and eucalyptus can be used for steam inhalations and to make nose drops. As well as the antimicrobial properties of the oils, many constituents in the oils such as chamazulene in chamomile have potent anti-inflammatory actions. For a steam inhalation a few drops of oil can be added to a bowl of hot boiled water, using a towel over the child’s head to stop the volatile oils and steam from escaping. This can be done morning and night. To make nose drops add 1-2 drops of the chosen essential oils per 5 ml of base oil such as sesame oil, warm the oil and massage the facial area around the sinuses and insert 2 drops into each nostril morning and night.

• Once the mucus starts to loosen and drain, the sinusitis should clear fairly quickly. If not, astringent herbs like agrimony (Agrimonia eupatoria), elderflowers, marigold, rose petals, eye-bright (Euphrasia off.) and golden rod (Solidago virgaurea), as well as demulcent herbs like marshmallow (Althea off.), comfrey leaf (Symphy-tum off.), mullein and Iceland moss (Cetraria islandica) can be given internally as infusions to soothe the irritated mucous membranes.

• For a particularly persistent sinus infection combined with general tiredness, irritability and malaise, immune-enhancing and antimicrobial remedies including echinacea, myrrh (Commiphora molmol), turmeric, chamomile, garlic or wild indigo (Baptisia tintoria) are indicated.

• Drinks of hot lemon and honey, elderberry and blackcurrant juice will also help to loosen the mucus congestion while supplements of vitamin C, zinc, garlic and cod liver oil will help to build resistance to infection.

Ayurvedic approach

Sinusitis is most likely to be a Kapha problem with involvement of Pitta and will be aggravated by Kapha foods (particularly cold drinks, dairy produce) and cold, damp Kapha weather. However the other doshas can also be involved.

Vata type: there will be signs of Vata imbalance such as wind, constipation, restless sleep, low weight, scanty mucus, sinus pain and headaches.

Pitta type: there will be signs of Pitta imbalance such as heat, yellow phlegm, tendency to fever, inflammatory problems and irritability.

Kapha type: there will be signs of Kapha imbalance such as lethargy, feeling of heaviness, foggy-mindedness, laziness, excess saliva, loss of sense of smell and thick mucus.

Ayurvedic treatment

For general treatment use fresh ginger tea or freshly grated ginger pulp with a teaspoon of honey 2-3 times a day to help to raise digestive fire, clear toxins and reduce excess Kapha.

• For Vata: ginger, bala, astragalus (Astragalus membranaceus), garlic, pippali, basil, angelica (Angelica archangelica), are suitable. Trikulu, and Sitopaladi are useful formulae.

• For Pitta: mullein, bala, mint, guduchi, amalaki, chamomile, neem, and turmeric.

• For Kapha: calamus, neem, turmeric, ginger, pippali, basil, fenugreek (Trigonella foenum-graecum), garlic and onions. Sitopaladi and Trikatu are useful formulae.

Salt water made from adding ½ tsp of sea salt to a cup of warm water can be drawn (or poured using a netty pot) up into one nostril and eliminated through the other and then repeated on the other side. This rather unpleasant form of treatment, suitable for older children, is excellent. Nasal drops using the same saline solution is preferable for younger children. Two or three drops in both nostrils am and pm.