Helping Children Wash Their Nose

The most effective way to wash a child's nose depends on the age of the child. Here are detailed instructions by age group, as well as links to nasal washing tips and other interesting information for parents.

Sophie, age 7, washing her nose

Watch Sophie, at age 4, wash her nose

References Supporting Nasal Washing In Children

Bothwell MR, Parsons DS: Pediatric Chronic Rhinosinusitis: A Step-Wise Approach to Medical and Surgical Management. Operative Techniques in Otolaryngology - Head and Neck Surgery 12,1:34-39, 2001.
"Three key elements summarize the normal physiology of the paranasal sinuses: the patency of the ostia, the function of the ciliary apparatus and, integral to the latter, the quality of secretions… General treatment measures are directed at establishing a more normal nasal environment through moisturization, humidification, and the reduction of swelling. Nasal irrigation with buffered hypertonic saline…”

Grossan M: Irrigation of the Child’s Nose. Clinical Pediatrics 13,3:229-231, 1974.
“Treatment by nasal irrigation is indicated for chronic purulent sinusitis, chronic adenoid infection, dacryocystorhinitis secondary to nasal infection, and chronic rhinitis. Often stubborn otitis media or serous otitis will not improve until after the nasal pus is removed”.

Manning SC: Pediatric Sinusitis. Otolaryngologic Clinics of North America. 26,4:623-637, 1993.
"A gentle squirt of saline into each nostril once or twice daily can improve nasal function by mechanically removing sensitizing agents, by enhancing mucociliary transport via increased relative humidity, and by improving sinus drainage and ventilation via a mild vasoconstrictive effect. Compliance can be enhanced by using prepared pH-neutral solutions and by emphasizing to the parents that saline lavage represents a long-term hygiene strategy aimed at prevention of sinusitis, analogous to tooth brushing to prevent cavities".

Seaton T: Hypertonic Saline for Chronic Sinusitis. The Journal of Family Practice. 47,2:94-96.
“Clinical question: Are hypertonic saline nasal washes beneficial in the treatment of chronic sinusitis in children? …Recommendations for clinical practice: This study demonstrates some clinical benefit from the use of intranasal hypertonic saline washes… this treatment is inexpensive, safe, and generally well tolerated… It should be considered as adjunctive therapy in children with chronic sinusitis".

Talbot AR, Herr MH, Parsons DS. Mucociliary Clearance and Buffered Hypertonic Saline Solution. Laryngoscope. 107:500-503, 1997.
"Nasal irrigations have been used for centuries without any scientific data to determine efficacy. For 10 years, the senior author has used buffered hypertonic saline nasal irrigation for patients with acute/chronic sinusitis and for those having undergone sinus surgery. A simple study was undertaken… The outcome showed buffered hypertonic saline nasal irrigation to improve mucociliary transit times of saccharin, while buffered normal saline had no such effect… Buffered hypertonic saline is a mildly alkaline solution… Buffered hypertonic saline nasal irrigation is an important addition to the care of sinus disease".

Tomooka LT, Murphy C, Davidson TM: Clinical Study and literature Review of Nasal Irrigation. The Laryngoscope. 110:1189-1192, 2000.
“Results: Patients who used nasal irrigation for the treatment of sinonasal disease experienced statistically significant improvements in 23 of the 30 nasal symptoms queried. Improvement was also measured in the global assessment of health status using the Quality of Well-Being scale. Conclusions: Nasal irrigation is effective in improving symptoms and the health status of patients with sinonasal disease.”

Virant FS: A Guide to Therapeutic Interventions for Rhinosinusitis in Children. The Journal of Respiratory Diseases for Pediatricians. 4,1:8-14, 2002.
“Nasal irrigation with a buffered saline solution theoretically may improve mucus flow and provide a less satisfactory environment for bacteria.”

Pediatric Allergy Immunology 2003 Apr;14(2):140 in Pediatric Notes 2003 Jun 26;27(26):103)
“hypersaline nasal irrigation improves symptoms in children during allergy season;” 20 children with seasonal allergic rhinitis randomized to 3% saline 2.5 mL in each nostril tid for 6 weeks vs. no extra therapy, treatment group had significant decreases in total symptoms and use of antihistamines, benefits not seen until third week of therapy.

David Shoseyov, MD; Haim Blbl, MD; et al. Journal of Allergy and Clinical Immunology 1998; 101:602-5.
Treatment with hypertonic saline versus normal saline nasal wash of pediatric chronic sinusitis. “Hypertonic Saline three times a day for 1 month improves the clinical and radiologic status among children with Chronic Sinusitis. The treatment is tolerable, inexpensive, and effective.”