Reported by Lauren S. Hughes, MD
What do crayons, buttons and plastic toy parts have in common?
They all find their way up kids' noses.
And a little-known technique - called the "mother's kiss" - is a safe and effective way to remove nasal foreign objects, according to Dr. Stephanie Cook, general practitioner at Buxted Medical Center in East Sussex, U.K.
"It is actually neat and very safe," said Cook, lead author of a study published today in the Canadian Medical Association Journal. "In my opinion, the [mother's kiss] is under-used, not just in the ear, nose, and throat world, but in emergency departments and among general practitioners."
In the method, first used in the 1960s, the mother creates a seal by covering the child's mouth with her own, blocks the unaffected nostril with a finger and delivers a forceful breath with approximately the same amount of pressure generated in a sneeze. The goal is to blow the object out of the nose entirely or move it forward enough so that it is easier to extract. The procedure can be repeated multiple times.
Cook, who studied ear, nose, and throat medicine before pursuing training as a general practitioner, reviewed eight previous papers examining this non-invasive approach in children aged 1 to 8 years to determine its success rate and whether it leads to adverse effects. And 60 percent of the time, the technique was successful in dislodging beads, beans, and other small items.
No harmful side effects were reported, but Cook suggests taking the findings with somewhat of a grain of salt, as positive results are the ones that tend to be reported in the literature.
Dr. Henry Ou, associate professor in the department of otolaryngology at Seattle Children's Hospital, is skeptical.
"My gut feeling is that it would only work on a subset of foreign bodies, those that are particularly plugged so that you could get enough of a seal to generate enough force," he said. "My one fear is if parents try this at home or [do it] incorrectly, it could turn in to a true emergency if the foreign body is blown in to the airway… I would hate to see a stable situation turn in to an unstable one."
But Cook said the mother's kiss may help children avoid more invasive techniques, such as hooks, suction, balloon catheters, and special types of glue. More importantly, it may avoid the need for anesthesia during more-complicated removals.
"From a child's point-of-view, it seems to be well tolerated and accepted by parents who have tried it," she said.