Tuesday, August 23, 2011

Q&A: Can I Do Sinus Rinses on a Baby?

I'm going to start a Q&A feature on this blog. If you have a question you would like me to answer, please contact me through our contact page.

Question: 
A friend of mine recently asked me advice about doing sinus rinses on a six-month-old child who has CF. Here's what she wrote: This child has lots of allergies and will benefit greatly at some point with the sinus rinses. Can you tell me when you start sinus rinses with Peter and how did you teach him to do them?

Answer:
Disclaimer: I am not a doctor. Before starting sinus rinses, it's important to check with your child's doctor to make sure it's okay. NeilMed does not recommend sinus rinses on children younger than 4 years, but Peter's ENT had us start right away with sinus rinses when he was one.

Here's my experience:

You can do sinus rinses on babies. I'm pretty sure this CFer would be fine starting right away with approval of your doctor. Whenever the child is getting stuffy, it's a good time to do a sinus rinse. The child may not like them for the few moments you do them, but afterwards, they can breathe, and that little bit of discomfort is worth it.

I don't use nose suckers or other fancy nose gadgets. For a kid with sinus issues, they are basically useless. We make mucus in all parts of the sinuses, and no nasal spray, aspirator, or syringe or is going to clean them out as well as a sinus rinse.

NeilMed Sinus Rinse Saline Nasal Rinse, Premixed PacketsWe use the NeilMed sinus rinse bottle, available at nearly any pharmacy and also online. They do make a pediatric version which has a smaller hole in the top and holds less solution, but you have to order it online. I would start with the adult bottle since you can get it easily. If it is too big, you can order a pediatric size. You can get deals on the bottles if you fan them on Facebook.
The sinus rinse bottle kit comes with packets of sinus rinse mixtures. We also use a homemade solution that our ENT gave us, and sometimes use generic sinus rinse packets from the pharmacy. (Sometimes you have to ask where they are. My pharmacy keeps them behind the counter. No idea why.) 

Either way (with packets or homemade solutions), you can dilute it down a bit for a baby or someone who is more sensitive to the solution. We mix up the solution with distilled water (new research shows it's dangerous to use tap water.) How do you know if a solution is too strong? Try it on yourself! If your nose burns from the mixture, it's too strong. (And then wash and sterilize the bottle before you use it on the baby.) 

Here's how we got Peter to do his sinus rinses when he was little. You can also see a video of it here
  1. To avoid flailing arms, wrap the baby's chest and arms in a towel. 
  2. Lean them over the sink and squeeze the solution very gently into one nostril. The solution will come out the other nostril with mucus and snot. Repeat until the solution runs clear.
  3. Repeat on the other nostril.
  4. Tilt the baby from side to side and forward to get the remaining solution out.
  5. Wipe nose with tissue.
  6. Cheer and clap! Yay, they did it!
  7. Dump out remaining solution and wash bottle. (Hint: the black top can be removed from the tube. That makes cleaning a lot easier.)
  8. Wash and then sterilize the bottle (directions for sterilizing here:  http://www.neilmed.com/usa/directions.php)
As Peter got older, I taught him to blow out the rest of the solution into the sink or a tissue, and he doesn't need the towel now or tilting from side to side. Peter doesn't necessarily like "doing his nose," but I really feel it's as important as brushing his teeth, and he has not had to have sinus surgery since we started the rinses. We do sinus rinses 1-2 times a day, no matter what. We do more rinses when Peter is stuffy from a cold or allergies.

Here's a few pictures of Peter doing his sinus rinse by himself. He doesn't always do it alone, but he knows how, and we're so proud of him!





Finally, please tell your friend that if chronic sinusitis (constant nose and sinus infections) is a problem, they will probably benefit from seeing a pediatric ENT, especially one that is familiar with cystic fibrosis. Also, since the child has allergies, I would make sure they are under the care of an allergy specialist. (We CF families love our medical specialists!)

Thanks for the question!

Marchet, mom to Peter who has CF and chronic sinusitis

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