Pediatric Sinus Rinse Review
||Qadara Moore, PA-C
About the author: Qadara Moore, PA-C and is a physician assistant practicing with ProHealth Physicians Express Care in Manchester, CT. She have been practicing as a PA for 10 years with a background in family practice, hospitalist medicine, and pediatrics. She currently practice in an urgent care setting with patients ranging from age 4 and up, where she see a large amount of pediatric patients.
Upper respiratory infections (URIs) and rhinosinusitis are common presenting conditions in the pediatric population and 5-10 percent of children with a URI develop acute rhinosinusitis. Children with acute rhinosinusitis often have cough, purulent nasal discharge, nasal airway obstruction, post nasal drip, facial pain or headache, fever, and irritability. Additionally, children can develop problems with sleep, which can in turn affect school performance, and can result in missed school days. Allergy and sinus disease is a major interest for me, as I personally was a child who suffered from severe allergic rhinitis and frequent sinus infections. I absolutely love Pediatric Sinus Rinse!! It does a great job of “draining the swamp”, by way of large volume saline irrigation, additionally nasal swelling is improved, thereby significantly helping to reduce symptoms. One point that parents often point out is that their children tend to sleep better with using this product. Nasal saline sprays are helpful with reducing nasal mucosal swelling, but as there is minimal volume they do nothing for removing copious amounts of nasal discharge or flushing the sinuses. In clinical practice, my pediatric patients that have used sinus rinse have experienced varying degrees of symptomatic relief. As such, in addition to prescribing nasal steroids, non-steroidal anti-inflammatory medications (NSAIDs), and antibiotics when indicated, pediatric Sinus Rinse is one product that I regularly recommend to my pediatric patients to improve their symptoms.
3 Simple things to improve your child’s cold symptoms
||Sarah Osborne, CPNP
About the author: Sarah is a PNCB Certified Pediatric Nurse Practitioner at One Health Pediatric Center in Owensboro Kentucky, and mother of five. She holds a Bachelor’s degree in Science and Nursing from the University of Kentucky and her Master’s Degree in Science and Nursing from Vanderbilt University. Pediatrics is her passion.
As a Pediatric Nurse Practitioner, and a mom, I see a lot of snotty noses. The number one question I get in my office this time of year is “what can I do for my child’s runny nose and cough?” Unfortunately, no one has discovered a cure for the common cold, or the “Upper Respiratory Infection (URI)” as it is referred to in medical terms. These viral illnesses are something our bodies just have to fight, and none of the over-the-counter cough and cold syrups are recommended for children under 8 since research has not been able to show them effective. The best thing we can do when a virus gets ahold of us or our little ones is treat the symptoms and let their immune system fight the virus.
So how do we best do that you ask? Several things can help. I tell all my patients there are three big things that improve cold symptoms for a child. These are:
1. Saline and suction
2. Cool mist humidifier
3. Elevate the head of the bed
These three things in addition to encouraging lots of fluids, and getting plenty of rest will help the most with that dreaded runny or stuffy nose. Why do they work? Because helping to keep that mucous thin and moving is the biggest thing you can do to help get over a cold in children. A few drops of saline (such as Neilmed’s NasaDrops® Saline on the Go) in the nose and a good suction bulb (such as Neilmed’s Naspira® or Nasabulb®) can help get all that mucous out of little noses so that children can eat, drink, and sleep better. Removing the drainage from their noses can also help prevent it from sitting in their sinuses and allowing bacteria to grow causing sinus infections (sinusitis) or ear infections.
A humidifier also works to help keep all that congestion thin and moving. At night, a child is drinking less and their mucous can get thick and dry, making it difficult to breathe through their nose. It can also collect in the back of their throats causing them to cough and lose sleep overnight. In children over one year old, honey or a vapor rub may also help, but the humidifier helps keep their noses from getting so dry and allows for better drainage.
Elevating the head of the bed by adding an extra pillow in older children, or putting a pillow or rolled towel under a crib mattress to elevate the entire mattress in smaller children can also help keep that mucous from collecting in their noses and the backs of their throats at night.
My Child Has a Nose Bleed, What Should I Do?
||Lynda Visher, D.O
Board Certified Otolaryngologist
About the author: Dr. Visher, is a Board Certified Otolaryngologist, with a special interest in making people feel better practices in Dallas Texas for 22 years.
It’s a scary thing to see a child with a nose bleed, especially when it doesn’t stop. Of course, the child needs to see a doctor but in the meantime, what is a parent to do? First stop the bleeding. The child should sit down and try to relax. Pinch the nose shut and put an ice bag on the bridge of the nose. When the bleeding stops, put in nasal saline gel to keep the area moist so it doesn’t crust over.
Usually nose bleeds occur because the front part of the septum, the middle divide inside the nose, gets dry and irritated and scratched. This happens because of allergies, irritants, and infection. The nose bleeds and then tries to heal with a scab but when the scab dries out and falls off, it leads to recurrent bleeding. The scab falls off, it bleeds, another scab forms and falls off and bleeds again leading to recurrent nose bleeds. The treatment is to stop the cycle. Using nasal saline spray during the day keeps the lining of the nose moist and prevents a scab from developing. Have the child use the spray frequently during the day. I recommend having the child with help from the parent put 2 big sprays in each nose and spit out the mouth. This keeps the nose moist but also rinses out allergens and irritants and infectious agents that may be causing the problem. Use the nasal saline irrigation 4 times a day. At night so the child can sleep, use a nasal saline gel instead. Squirt the gel inside the nose so it covers the irritation and keeps the nose from drying out. Sometimes, an antibiotic prescribed by the doctor is needed to stop the recurrent nose bleed. If that’s the case, the doctor can order a special compound with antibiotic that is mixed with the saline. The NeilMed bottle can be used to instill the compound into the nose. Also, antibiotic ointment like mupirocin can be use inside the nose at night if infection persists.
A nose bleed can be scary, but can be managed and healed and prevented from reoccurring.
Contact Dr. Visher’s practice at email@example.com .
What are Allergens
||John E. Rooney, M.D., Ph.D., F.A.C.P., F.A.A.A.A.I
Board Certified in Allergy, Asthma and Immunology
Clinical Assistant Professor of Medicine – Hofstra North Shore LIJ School of Medicine
Associate Physician – ENT Associates of New York (www.nyents.com)
About the author: Medical Degree at Jefferson Medical College, Philadelphia, PA; Residency at Barnes Hospital Washington University, St. Louis, MO; Fellowship in Allergy & Immunology at the Long Island Jewish Medical Center (LIJ), New Hyde Park, NY. Board Certified. Affiliated with: North Shore LIJ; North Shore University Hospital
Allergens are ordinary proteins that are found naturally in the environment and which are, most of the time, completely harmless. However, in people who are sensitized, these ordinary proteins can produce some extraordinarily nasty symptoms. There is nothing inherently dangerous, for example, about ragweed. Many people could roll around naked in the stuff and be none the worse for wear (although perhaps somewhat embarrassed if caught). People who are allergic will unfortunately have quite a different experience. The tiny particles floating in the air will cause them to sneeze, itch and wheeze. Blocked noses and clogged sinuses will ensue. The immune system of an allergic person has decided, incorrectly, that ragweed pollen is a dangerous substance that must be fought off like an infectious bacterium. Many of the symptoms of allergy are therefore similar to those of a cold.
Trees, grasses and weeds all produce pollen which they release to the four winds so that their species can diversify and spread. Animals, even our beloved dogs and cats, produce enzyme proteins that get on their fur and are present in the air we breathe. And, of course, there are the hordes of invisible mites, molds and insects which exist around us every day. We unwittingly take in their waste products with every breath, and these, too, can be powerful allergens.
What can people do about this army of microparticles assaulting them at every turn? Not breathing does not seem practical. Some people afflicted by the misery of allergies will walk around wearing particle filtration masks, risking personal humiliation for the sake of symptom relief. But there is an easier, simpler solution. The human nose is designed brilliantly to filter the air we breathe. Inside and invisible to the casual observer are a multitude of twists and turns through which inhaled air must pass. These surfaces are covered with sticky mucus and fine hairs which beat constantly to remove offending particles like allergens. Unfortunately, even the best designed system can be overwhelmed.
Irrigating the nose with a salt water solution helps clear away the particles which, left unchecked, will cause allergies. The human body is composed largely of a 0.9% solution of sodium chloride in water, and rinsing with a nasal saline solution dramatically reduces the allergens to which one is exposed. I recommend that my patients spend a few minutes three times per day to rinse their allergies away.
Dr. Rooney is an Associate Physician at ENT Associates of NY (www.nyents.com) and an Assistant Professor of Clinical Medicine at Hofstra – North Shore LIJ School of Medicine.
Rinse Away Medicines
||Dr. J Modi, M.D.
Board Certified Pediatrician
About the author: Dr. Modi earned his Medical Degree from Pennsylvania State University, Hershey and completed his Pediatric Residency Program at Walter Reed Army Medical Center/National Naval Medical Center. He served as an Active Duty physician for the US Army. Dr. Modi is Board Certified in Pediatric Medicine and was recognized as one of the top five pediatric providers in the Navy.
As a pediatrician, I have the opportunity to advise and recommend. I am fortunate to have parents who really take my opinion as meaningful. My most favorite recommendation is saline rinse to the nose. It’s good for so many things. I recommend it for asthma, allergies, colds, sleep apnea, recurrent sinus infection and even better athletic performance. This recommendation always makes families skeptical. They are concerned about how it will feel. They are concerned that they may “drown.” They are concerned that the rinse will taste bad. The skeptics have valid concerns but it’s worth challenging. I tell them about the numerous studies detailing the benefits of saline rinse over medications. The skeptism really changes when I tell them that I personally have asthma and allergies. I was on over 4 different medications to include inhalers. With daily sinuses rinses during my allergy seasons, I only take my medications as needed. I wash away the pollen, and it has helped me wash away medications. I always end my conversation with- “just give it a try… after all, it’s just salt water in the nose. It’s got to be safer than all these medications that you want me to prescribe.”