How to Properly Clean Your Child's Nose — Step-by-Step Guide

Why nasal hygiene is important in children

The nose has the fundamental role of filtering, humidifying, and warming inspired air. In children, the nasal cavities are narrower and the mucosa is more sensitive. When secretions accumulate, they block airflow, create a favourable environment for infections, and can cause complications such as otitis or sinusitis.

Regular nasal hygiene with saline solution (physiological saline or hypertonic solution) is recommended by ENT medical societies as a basic measure in:

• The common cold and viral infections
• Allergic rhinitis
• Prevention of otitis and sinusitis
• Nasal obstruction of any cause
• Pre- and post-operative period (for example, after adenoidectomy)

What solutions can you use

Isotonic saline solution (0.9% physiological saline)

This is the gentlest option, suitable for daily use, including in newborns. It is available in pharmacies as single-dose vials (5 ml ampoules) or nasal spray. It does not irritate the mucosa and can be used as often as needed.

Hypertonic saline solution (2-3%)

It has a stronger decongestant effect because it draws water from the inflamed mucosa, reducing oedema. It is useful during periods of cold or significant congestion, but is not recommended for continuous use, as it can dry out the mucosa over time. It is usually used 2-3 times a day for short periods (5-7 days).

Do not use tap water for nasal irrigation. Use only sterile saline solutions from the pharmacy or boiled and cooled water with non-iodised salt (9 grams per litre of water).

Technique for infants (0-3 months) — Drops and nasal aspirator

In very young babies, large-volume irrigation is not recommended. The correct technique involves:

Step 1 — Preparation

• Wash your hands with soap and water
• Prepare the physiological saline ampoules (at room temperature) and a clean nasal aspirator
• Place the baby on their back, with the head slightly tilted to one side

Step 2 — Instilling the saline solution

• Instil 2-3 drops of physiological saline into the upper nostril (the one facing up)
• Wait a few seconds for the solution to liquefy the secretions
• Gently turn the head to the other side and repeat in the other nostril

Step 3 — Aspirating the secretions

• Use a nasal aspirator (bulb type, tube type, or electric) to gently extract the secretions
• Insert the tip of the aspirator only at the entrance of the nostril, without pushing it deep
• Aspirate gently, without excessive force
• Clean the aspirator after each use

Recommended frequency

In infants, nasal hygiene is performed before meals (to facilitate breastfeeding) and before sleep. During periods of cold, it can be performed 4-6 times a day, or whenever you notice the baby is having breathing difficulties.

Technique for older children (over 2 years) — Volume nasal irrigation

In children who cooperate, you can switch to larger volume nasal irrigation, which is much more effective in completely cleaning the nasal cavities.

Step 1 — Preparation

• Use a nasal irrigation device such as a squeeze bottle, a 10-20 ml syringe without needle, or a neti pot adapted for children
• Fill with saline solution at body temperature (approximately 37 degrees Celsius) — cold water causes discomfort
• Position the child in front of the sink, with the head slightly tilted forward and to one side

Step 2 — Irrigation

• Insert the tip of the device into the upper nostril
• The child should breathe through their mouth and not swallow
• Instil the solution with gentle and constant pressure — it will flow through the opposite nostril, carrying the secretions
• Repeat on the other side

Step 3 — After irrigation

• The child should gently blow their nose, one nostril at a time, without blowing too hard (excessive pressure can push secretions into the Eustachian tube)
• Wash and dry the irrigation device after each use

Common mistakes to avoid

• Blowing the nose too hard — can cause otitis by pushing secretions into the middle ear
• Using tap water — risk of irritation and, very rarely, infections
• Solution too cold or too hot — causes discomfort and refusal by the child
• Forcing the child — turn nasal hygiene into a calm ritual, not a struggle
• Using vasoconstrictor drops without medical recommendation — in young children they are contraindicated or should only be used for very short periods (maximum 3-5 days)

When nasal hygiene is not enough

If nasal obstruction persists despite regular nasal hygiene, or if you notice frequent nosebleeds, purulent discharge, or worsening symptoms, it is recommended to consult an ENT specialist. A chronic nasal obstruction may have causes that require further investigation, such as hypertrophic adenoid vegetations or allergic rhinitis.

Consulting an ENT specialist is particularly important if the child presents with persistent snoring, mouth breathing, or sleep disturbances.