A foreign object lodged in a child’s nose is a common scenario, particularly for children between the ages of two and five who often insert small items like beads, food, or toy parts. Recognizing the issue can range from the child admitting the insertion to a parent noticing subtle symptoms like discharge from only one nostril. Navigating this situation safely requires a calm approach and an understanding of appropriate removal techniques and when to seek professional help.
Immediate Steps Before Attempting Removal
The initial response should focus on controlling the environment and the child’s reaction. Remaining calm is important, as children often mirror their caregiver’s distress, and anxiety can lead to deeper inhalation that pushes the object further into the nasal passage. Encourage the child to breathe through their mouth to prevent sniffing or deep inhalation, which risks aspirating the object. Assess the situation visually using a flashlight to determine the object’s visibility and type, but avoid any probing at this stage. Determine immediately if the object is a button battery, a magnet, or an item that expands when wet, as these require immediate emergency attention and should not be managed at home. If the child is old enough, instruct them to gently try blowing the object out of the affected nostril, emphasizing that the blow should be gentle, like blowing out a single candle.
Safe Home Techniques for Object Removal
If the object is not hazardous and the child is cooperative, the first-line removal method is positive pressure. The “Parent’s Kiss” technique is highly recommended, as it is effective in approximately 60% of cases and is less traumatic than instrumental removal. To perform this, the parent should first explain they are going to give a “big kiss” to encourage cooperation.
The parent places their mouth completely over the child’s open mouth, creating a firm seal similar to mouth-to-mouth resuscitation. The unaffected nostril must be sealed closed using a finger. A short, sharp puff of air is then delivered into the child’s mouth, creating positive pressure that often expels the object through the blocked nostril.
If the child can follow instructions, a gentle nose-blowing technique can be attempted by blocking the unaffected nostril and asking the child to blow out. Tweezers should only be used if the object is large, easily visible, and securely graspable right at the nostril opening. Attempting to use tweezers on a small or deep object can push it further back, increasing the risk of aspiration or tissue injury. Avoid using tools like cotton swabs or bobby pins, as they can cause significant damage to the nasal lining.
When to Immediately Seek Professional Medical Help
Certain objects and scenarios require an immediate trip to the emergency department, bypassing all home removal attempts. A button battery is a medical emergency if placed in the nose. The moist environment triggers an electrochemical reaction that can cause severe chemical burns and tissue necrosis in as little as one to two hours. Paired magnets in the nasal cavity also require urgent removal, as they can attract each other across the nasal septum, damaging the tissue between the nostrils. Medical help is necessary if the child is experiencing difficulty breathing, which could indicate the object is obstructing the airway or is lodged deep. Stop immediately and seek medical care if the object is not visible, remains lodged after one or two gentle removal attempts, or if any bleeding occurs. Repeated attempts at home can cause swelling, making professional removal more difficult and increasing the chance of infection.
Monitoring and Follow-Up Care
After successful removal, monitoring the child for signs of irritation or infection is necessary. The delicate nasal lining may be scratched, and temporary symptoms like a runny nose or slight bleeding may occur. Watch for persistent, localized symptoms, especially a foul-smelling, purulent discharge from only the affected nostril, which indicates a retained foreign body or a secondary bacterial infection. A fever, increased facial swelling, or significant pain around the nose or cheekbones also suggest a developing infection that requires a medical evaluation. Even if removal seemed successful, a follow-up appointment with a pediatrician is prudent, particularly if the object was lodged for a prolonged time. The doctor can assess the nasal passage for damage to the septum or lining and determine if antibiotics are needed.