Nasal washes for children

Is nasal discharge a bad thing?

Yes. Imagine a world without nasal discharge — a very beautiful world.

Snot, no matter what colour it is, is a big troublemaker for children and adults alike.

It is especially problematic in young children, as it can block the upper airways and make feeding difficult (because the nostrils are blocked and the child struggles to breastfeed or bottle-feed). It also makes it harder for air to enter the airways, and when the mucus slides backwards — especially at night — it can cause a productive cough.

This is why I have dedicated an entire chapter to the baby with a runny nose.

Is nasal discharge an illness?

No.

Nasal discharge is released from the mucous membranes of the nose as a reaction to a certain stimulus. In children, this is mostly caused by viruses, and in older individuals, it can also result from allergies (find out more about allergic rhinitis in the link here).

So, does it make sense to try and stop nasal discharge?

Yes. If there were a good and effective medication for snot in babies and children, then of course we would all be better off without nasal discharge.

But I’m not sure such a medication exists — especially not for babies under the age of two.

So, does it make sense to try and pull the discharge out of the nose, or in other words, to perform nasal washes?

If there were a tool that could pull the discharge out without causing any discomfort or complications—and could bring about a stable change in the child’s discharge (in such a way that it wouldn’t all reaccumulate within five minutes)—then great.

Excellent – then nasal washes are a good thing, right?

Wait, be patient my friends. Continue reading below.

What are nasal washes and what is a sinus flush?

Nasal wash – the use of a specific type of pump that simply pulls the discharge out of the child’s nose. This is typically used in babies with blocked noses.
Sinus flush/nasal irrigation – many people do this for different age groups, and the idea is to push water (usually salt water) into one nostril and have it come out the other. Some of these pumps require the parent’s mouth to create suction so that the discharge collects in a small cup.

So, what is so bad about these nasal washes?

Three things:

1. It simply doesn’t help – even if it feels like you’ve cleared the baby’s nose for five minutes (which I agree can be a relief), you’ve actually provoked the mucous membrane to produce even more mucus—up to seven times as much—in the next few minutes. There is no medical literature supporting the effectiveness of nasal washes in babies or children.
2. Injury to the mucous membrane – pushing water into the nose under pressure, or using suction, can injure the baby’s mucous membrane—even microscopically. This affects its function and may worsen symptoms.
3. Introduction of infections – the pumps you use, whether manual or vacuum-based, are not sterile. The tubes inserted into your child’s nose are also not sterile. So, as a result, you’re potentially introducing viruses, bacteria, or fungi into the child’s nasal passages. Yes, this has led to infections in the past.

So, what is the difference between this and the suction that is done on babies in the hospital – isn’t it the same thing?

The suction we sometimes perform on babies in the hospital is done using a suction pump that is connected to the wall and does not require anyone’s mouth. The tube used is sterile, and the procedure is carried out by experienced nurses.

And I’ll tell you a secret: I’m not even sure that hospital suction is helpful either, but it is a common practice.

Wait, Dr. Efi, can you explain it again – what is wrong with nasal washes?

When you perform a nasal wash, you may injure the mucous membrane of the nose and introduce infections into an area that is already sensitive. It simply doesn’t help your child in a meaningful or lasting way.

But my neighbour’s aunt swears that she does it to her child every time they have a runny nose and that it works wonders?

I am aware of the videos on social media about children who had nasal washes and could suddenly breathe after five years of suffering from nasal discharge.

I also saw that viral video of the Japanese mom who splashed holy water into one of her baby’s nostrils and got tons of nasty discharge out of the other.

I know that people on social media will say I know nothing and that sinus washes are a miracle.

And I understand how difficult it is for pediatricians to sit in front of parents who haven’t slept all night and say, “There’s nothing we can offer.”

But please, don’t do this to your child.

Are there specific cases where you would recommend nasal/sinus washes for a child?

Listen, everything in life is about moderation.

If you can’t fall asleep without giving your otherwise healthy child a gentle nasal rinse, then go ahead—just make sure to sterilize the device before every use. And while you’re at it, explain to me how you’re sterilizing a plastic device.

Have chronic sinusitis (even though the sinuses are underdeveloped in children)? Are you otherwise 100% healthy and have been told by your ENT specialist that nasal washes are necessary? Then do what you’re told.

But if you have a sick baby or a child who is immunocompromised, do not insert tubes into their nose.

And if you haven’t started doing nasal washes and you’re not convinced—just forget they exist.

I have a number of other addictions to suggest to you.