Nasal irrigation is indicated in children with breathing difficulties due to upper airway obstruction from secretions. It should be performed one hour before or after a feed or a meal if possible. There are two methods: the instillation method and the volumetric method.
15.1 Instillation technique (done by parents, at home)
– Wash hands.
– Lay the child on his back.
– Instil 2 to 4 drops of normal saline in each nostril when the child inhales.
– Raise the child (to a semi-seated position) and collect the secretions from the nose and mouth with a tissue.
– Wash hands.
15.2 Volumetric technique (done by care provider at an outpatient visit or in the hospital)
– Wash hands.
– Lay the child on his back, head slightly elevated.
– Placing one hand under his neck, turn his head to the right to treat the left nostril.
– Insert the dropper tip of the normal saline vial at the opening of the left nostril.
– Squeeze the vial when the child inhales.
– If the child coughs, stop the instillation and let him settle down for a few minutes.
– Check that the saline and secretions have drained via the right nostril.
– Raise the child’s head slightly so that the fluid can drain more easily.
– Collect the secretions.
– Repeat the procedure on the other side.
– Monitor the child for a few minutes after the procedure.
– Wash hands.