When and how to perform nasal washes for children?

The nasal washes frequent are often torture for the child. Knowing how and when to do them is important. It is a simple technique that consists of applying a saline solution through the nose in order to eliminate mucus.

When are they useful?

If we are based on the premise that young children do not know how to blow their nose, it is normal that when their nose is full of mucus, they breathe with difficulty. In addition, since they do not know how to breathe through their mouth, the nasal mucus is especially annoying and can make it difficult for them to sleep and eat. Therefore, Nasal wash is "the tissue" to help babies relieve them of runny nose. Its frequency, if we rely on common sense, is clear: as many times as you need it and if the mucus bothers you.

How is a nasal wash performed?

There are several systems to do the nasal washes In children. All methods are valid as long as they are done properly. One method is not better than the other. The choice will depend on the parents' preference and which one they deal with best. We have devices in the form of nasal spray with different forces depending on the child's age and single-dose preparations that have a specific adapter to do the washing.

The best way to wash is to lay the child on his side without tilting his head back. You have to hold it firmly because you don't usually like it very much and pour the saline solution through the hole at the top, without hesitation. Once the liquid has entered, it can be incorporated or seated to promote the expulsion of mucus. This same operation is repeated in the other nostril, turning the head to the opposite side.

Physiological, hypertonic or “sea water” serum?

On the market there are several types of saline solutions to perform nasal washing: physiological, hypertonic or sea water. In reality, they have a similar efficacy and are differentiated by the concentration of salt in the solution (between 0.9 to 2.3%). It seems that the higher the salt concentration, the better the mucus washes away by the force of osmosis, but this is not yet fully proven. Keep in mind that we should not use hypertonic solutions in children under six months.

Is it necessary to use a nasal aspirator?

It is very common to hear parents in the office say “with some satisfaction” the amount of snot that they have sucked from their little one. In pharmacies they sell nasal aspirators of various types, the most popular are those that are pear or hose-shaped. They are helpful, but should be used very sparingly. Caregivers must be told that frequent aspiration is not a good habit, as it can dry out or injure the nasal mucosa, inflame it and cause just the opposite effect to what we are looking for: generate more mucus, worsening the problem. Always consult with him.

Aspiration, also, if done with great enthusiasm, can cause unpleasant sensations in the ear. So it is better to limit its use to a maximum of once or twice a day and only in the case of the presence of a lot of mucus that is seen, but is not eliminated after washing, limiting the suction pressure.

Some recommendations

• Buy physiological saline or small-size seawater, thus avoiding the use of the same device cold after cold and contamination by germs.
• Each member of the family should use a different device to avoid contagion.
• Nasal washing should not be performed with the child lying on his back since there is a risk of pushing the mucus towards the ear, favoring the development of. Hence the importance of washing with the head on one side.
• Ideally, wash before sleeping and before feeding babies.
• Do not wash if the baby is comfortable or does not have snot. That means you don't need them.
• It is usually enough to apply between 1.5-2 ml in each nostril in young children and a maximum of 5 ml in older ones.
• The sensation will be less unpleasant if the serum is at room temperature, that is, never cold.
• If the nose is very clogged, you can add a little serum, massage to loosen the mucus and repeat the instillation of serum.
• If the child is older, he can do the washing himself.
• It is normal for the child to cough or sneeze after washing.
• There is no need to worry if some of the mucus is swallowed.

• Nasal washing is "the tissue" to help babies relieve them of runny nose. Its frequency will be: as many times as you need it and if the mucus bothers you.
• There are several systems for doing nasal washes in children. All methods are valid as long as they are done properly.
• It seems that the higher the salt concentration, the better it drags the mucus away by the force of osmosis, but this is not yet fully proven.

Pediatric Specialist