Children's nasal cavities are narrow and their mucous membranes are delicate, making them prone to nasal congestion and runny nose during colds or allergy seasons. Nasal irrigation with saline solution is widely recommended as an adjunct to other care methods due to its high safety and ease of use. However, parents still need to pay attention to the details of the procedure and contraindications to avoid risks caused by improper use.
Scientific Principles and Safety of Nasal Irrigation with Saline Solution
Saline solution (0.9% sodium chloride solution) has a similar osmotic pressure to human body fluids. Through physical flushing, it achieves a triple effect:
Clearing pathogens and allergens: It dilutes and drains viscous secretions, reducing the retention of irritants such as bacteria, viruses, and pollen in the nasal cavity. For example, children with allergic rhinitis experience significant relief from nasal itching and sneezing after irrigation.
Reducing mucosal swelling: The moist environment promotes ciliary movement, accelerates the drainage of inflammatory secretions, and relieves nasal congestion caused by mucosal edema.
Maintaining the nasal cavity microecology: Isotonic solutions do not disrupt the pH balance of the mucosa, avoiding cell dehydration caused by hypertonic saline (>3%) or mucosal swelling caused by hypotonic saline.
Studies show that daily saline irrigation 1-2 times can reduce the risk of acute otitis media in children, especially suitable for children with postnasal drip. However, it should be noted that infants under 6 months of age, due to their underdeveloped swallowing function, should use nasal drops instead of irrigation under the guidance of a doctor.
Key Steps for Safe Operation and Equipment Selection
Equipment Classification and Applicable Scenarios
Pressure Nasal Irrigator: Water is generated by squeezing the bottle, providing strong cleaning power but causing noticeable choking sensation. Suitable for children over 3 years old who can cooperate. During operation, the nozzle should be pointed towards the nostrils to avoid direct spraying onto the nasal septum, which could cause bleeding.
Atomized Nasal Spray: Atomizes saline into tiny particles, resulting in high compliance. Suitable for infants and young children who resist irrigation. Medical-grade products with uniform aerosol and no irritation should be selected.
Nasal Drops: Suitable for infants under 6 months old. Administer 2-3 drops to each nostril each time, gently pressing the nostrils to promote absorption.
Operating Procedures (Five-Step Method)
Environmental Preparation: Maintain a quiet room with a temperature of 20-25℃, avoiding cold air stimulation.
Positioning Adjustment:
Sitting Position: The child should lean forward 30°, with their chin close to their chest, and a towel placed underneath to catch the waste liquid.
Side-Lying Position: The infant should be held in the parent's lap, with their head fixed to prevent movement.
Rinsing Procedure: Use gentle pressure when squeezing the nasal irrigator; the water instillation time in one nostril should not exceed 5 seconds.
During rinsing, instruct the child to breathe through their mouth and not to swallow the liquid to prevent retrograde infection.
Nose Blowing Technique: After rinsing, have the child gently blow one nostril at a time to avoid pressure imbalance caused by blowing both nostrils simultaneously.
Instrument Disinfection: Disassemble and clean the instrument after each use, boiling in water for 5 minutes or wiping with 75% alcohol.
Risk Control and Contraindication Identification
Potential Risks and Responses
Ear Discomfort: Excessive irrigation pressure or tilting the head back may cause fluid to enter the Eustachian tube, leading to ear pain and a feeling of fullness. If such symptoms occur, stop immediately and observe for 24 hours. If symptoms do not improve, seek medical attention.
Nosebleeds: Often caused by inserting the nozzle too deeply or using excessively concentrated saline solution (>3%). Room temperature (20℃) or lukewarm (37℃) saline solution is recommended to avoid hot or cold stimuli.
Mucosal Irritation: A few children are sensitive to the pH of the saline solution; physiological seawater spray with added glycerin or buffer can be used.
Absolute Contraindications
Acute Otitis Media: Irrigation may worsen the spread of infection.
Active Episode of Nasal Bleeding: Contraindicated in patients with coagulation disorders or recent nasal surgery.
Upper Airway Foreign Body: If a nasal foreign body is suspected, endoscopic confirmation is necessary first.
Individualized Adjustments in Special Circumstances
Comorbid Asthma: Respiratory function should be assessed before irrigation to avoid irritation that could trigger bronchospasm. It is recommended to use nasal corticosteroid spray prophylactically two weeks before seasonal flare-ups.
Nasal septum deviation: Irrigation is less effective in cases of severe deviation, requiring surgical correction.
Postoperative care: Low-pressure nasal spray should be used under a doctor's guidance for two weeks after adenoidectomy.
Nasal irrigation with saline solution is a safe option for children's nasal care, but it must strictly adhere to the "three appropriate principles": suitable population, appropriate concentration, and appropriate operation. Parents should regularly observe their child's reaction after irrigation. If persistent headache, bloody discharge, or no improvement in symptoms occur, prompt medical attention is necessary to rule out complications such as sinusitis. Through standardized operation and individualized adjustments, saline irrigation can effectively relieve nasal discomfort in children, building the first line of defense for their respiratory health.
