Nasal Saline Irrigations

Asthma is often accompanied by inflammation of the nasal passages and sinuses. Mucus draining down the throat can act as a trigger for wheezing. Nasal saline irrigations help keep the nose, sinus passages, and throat clear of mucus that may trigger asthma. They also may prevent sinus infections. How nasal saline irrigations are done depends on the age and comfort level of the child.

Instructions for Infants

The equipment you need:

• bulb syringe or nasal saline rinse bottle
• saline solution (see recipe at end of text)
• plastic dropper
• rubbing alcohol.

Put 10 to 20 drops (0.6 to 1 ml) of normal saline in each nostril. Use a bulb syringe to suction out the mucus and saline. Repeat the procedure if necessary.

It is important to clean the bulb syringe daily. To clean it, draw hot soapy water into the syringe, shake, and squeeze. Rinse the bulb syringe thoroughly with clear tap water, water then draw rubbing alcohol into the syringe, shake, and squeeze. Rinse thoroughly with clear tap water and store the syringe with the tip down to drain completely.

Instructions for Young Children

If your child is able to blow his or her nose but needs some coaching and help, use the following method.

The equipment you need:

• nasal spray bottle
• saline solution
• tissues.

Partially fill the nasal spray bottle with normal saline. Gently squeeze the solution into one nostril. Have your child sniff and blow his nose. Repeat with the other nostril.

Instructions for Older Children:

Children who do not need help can try one of the following methods.

• Method 1: Bend over a sink. Place some saline solution into the palm of the hand. Sniff the solution into one nostril and then blow the nose gently. Repeat with the other nostril.
• Method 2: Fill a bulb syringe or nasal saline rinse bottle with solution. Lean over a sink with the head tilted slightly forward and the chin tilted slightly toward the chest. Insert the syringe tip just inside one nostril and gently squeeze the bulb, releasing the solution into the nose until the saline solution comes out of the other nostril. The amount of solution draining down the back of the throat is reduced by leaning forward. Blow the nose gently and repeat the process with the other nostril.

Recipe for Normal Saline Solution

Normal saline solution is salt mixed with water. It is called normal because it is a strength (0.9% saline) that is similar to tears, blood, and other body fluids. It is also called isotonic saline. Normal saline solution is soothing. Other kinds of saline solutions (hypertonic or hypotonic) may cause irritation.

It is very important to use fresh saline solution because bacteria can grow in saline and bacteria can cause infections. If you are buying a saline solution, buy individual-use packs only. It is cheaper and often more convenient to make a fresh supply of saline every day.

To make your own saline solution:
Mix 8 ounces of tap water (1 measuring cup) with 1/4 to 1/2 teaspoon of non-iodized table salt and a pinch of baking soda.

Keep the saline in a bottle or glass for a maximum of 24 hours. Then throw the solution away, wash the container, and make a new solution.

NOTE: Use nasal irrigations before using nasal spray medicines. It is best to wait 15 to 20 minutes after the nasal irrigation before using the nasal spray medicine, if possible.