By Dr. Benjamin Moresco
The Children’s Hospital of San Antonio
Baylor College of Medicine, Third Year Resident (PGY3)
Please note: the model used below is a specially designed manikin used by medical professionals to practice and demonstrate procedures.
Cold and flu season, fall allergies, and children getting settled back into school (and sharing lots of germs with each other) create the perfect combination for little ones to get stuffy noses. Runny noses are one thing, but even worse is the nasal congestion and sinus pain that can accompany a cold. What can parents and caregivers do at home to relieve a stopped-up nose and painful sinus pressure?
What you may not know is that many children who visit the Emergency Room (ER) during the fall and winter could have been cared for at home. In addition to the handy dandy bulb-syringe, there are some newer options available for families to help clear the nose and mouth of mucus. Be sure to remember two very important things: keep your child well hydrated and always use nasal saline before you suction.
A dehydrated child will have thick, hard-to-suction mucus. What many families find during a sudden illness with their children is that they lose their appetite. We find this most commonly among babies who rely on formula or breast milk for their calories. In this situation, you can think about alternate forms of oral hydrating solutions such as Pedialyte® (always check with your pediatrician before starting Pedialyte or if you are worried your child is not drinking enough or making enough wet diapers). These solutions can help to thin those thickened secretions and make them easier to suction.
Nasal saline sometimes gets mixed reviews from parents, but in practice it works wonders to relieve nasal congestion. It works by thinning the mucus, but it also can have a decongestive or anti-inflammatory effect on the nose. In this case, however, more does not mean better and you should only use one or two drops in each nostril before every suction attempt. You can find more details in the attached videos in which I use a manikin in our Simulation Lab to demonstrate proper suctioning techniques.
We are going to talk about three different suction devices that you can buy at most drug stores. The best times to suction are before meals (not after eating unless you want vomiting) and before sleep and nap time.
For nasal saline, I found the Ayr brand (about $2-3) available at most grocery and drug stores. The Nose-Frida comes as a pack for $20 (including some nasal saline) or as an individual suction device for $15.
Here is a demonstration of the proper use of the bulb syringe:
And rather new to the market is the battery-operated nasal aspirator (sounds like a battery-operated toothbrush and plays music!) that costs about $20.
As a parting word, I’d like to talk about a couple of things that I frequently see in the ER. One is the use of Vicks-VapoRub or other camphor-containing products. Again, this is another case of which more is not always better. Camphor has no studied or proven effects on decongestion (it just makes you think you are decongested), should never be used in children younger than two years of age, and should only ever be applied to the chest (and maybe the neck). Where you get into trouble: it is toxic and should never be consumed; it can harm the eyes, nose, and mouth.
Humidifiers can be expensive, but sometimes an effective way of helping with congestion, especially at night. Just remember they need to be regularly cleaned (just like the nasal suction devices above) so that you aren’t introducing mold into your home. Good luck to you all on your suctioning quests and please don’t forget to reach out to your child’s pediatrician for help if you ever need.
If you need to identify a primary care pediatrician for your child, please visit www.chofsa.org/findadoc.
A great step-wise method by Cincinnati Children’s Hospital on how to use the Bulb Suction
Nose Frida Website
Graco NasalClear Battery Operated Nasal Aspirator