Nasal Salt Water Washes: 10 Tips for successful use

Dr. Momma shares ten tips for the successful use of nasal salt water washes in the management of allergies and chronic sinus disease.

Nasal salt water washes stand as an extremely useful method to improve symptoms cause by a runny, congested nose. My previous post detailed  how the nasal salt water washes are beneficial. Regardless of the cause of nasal swelling and mucous production, cleansing with nasal salt water (saline) relieves symptoms and helps to prevent progression of the disease.

Since my first post was published, I received numerous questions about the best practices for the successful use of nasal salt water washes. As mentioned, there is no one way to achieve success. The upcoming list details some helpful tips.

10 Tips for successful  use of nasal salt (saline) water washes.

1. Infant positioning

Most parents in my office describe using nasal salt water washes while their infants lie on their backs, sometimes swaddled in a blanket. Well, this position allows the water to shoot directly to the back of the nose and into the throat causing choking and gagging.

Infants should be in a sitting position. Any technique is fine, but I found it easiest to position my own infant on my lap with her back to my chest, then crossed my legs over hers to keep them from flailing. One of my arms crossed her body to hold both of her arms which allowed me to rinse her nose with better control. Again, remember to watch your chin to avoid getting an angry head-butt!

2. Everyone else positioning!

Children and adults should use nasal salt water washes in the shower or over the sink. Many children reflexively tilt their chins in the air, but this encourages the salty solution to travel into the throat. One of the best positions for saline washes is to lean over the sink and allow the wash to go in nostrils and run back out.

3. Amount of force

I emphasize the need for rinsing, cleansing or washing. I do not mean scrubbing by aggressively forcing liquids into the nose.  Some people use devices similar to a water pick. That’s a lot of force. If you love it, then go for it, but it is causing repeated trauma to already inflamed tissues.

Whether you use a traditional over the counter squirt bottle, a pressurized aerosol can or a Netipot, I recommend a gentle continuous stream or an intermittent pulsating wash. Alternating nostrils allows saline to run out and remove a layer of contaminants. The take home point: harder and faster washes are not better.

4. Water temperature

Cold water is typically used and is absolutely acceptable. But let’s be honest, who wants ice cube water in your nose? Nobody. Room temperature is the next most common temperature used. My previous post discussed the benefits of warm water which increases effective cleansing.

5. Volume matters

Remember to use enough volume to wash the nose and not just moisten the tissues  This means more than 1-2 squirts. For infants 3 squirts each nostril is typically useful while young children often need 5-6 squirts. Older children may use a 4 oz bottle of saline, while the adult nasal saline wash bottle holds 8 oz.

6. Burning: Fix #1

If  the saline wash burns your inflamed nasal tissues, you may consider trying a variety of over the counter products to find one that has a preservative that is not irritating

7. Burning: Fix #2

If all over the counter saline causes burning, you may consider making your own nasal salt water with 8 oz of water, 1 tsp pure salt (rock salt, pickling salt NOT table salt!) and 1/2 tsp baking soda. The baking soda and lack of preservatives reduces the burning sensation.

8. Cleaning and Care for saline devices

Be sure to thoroughly clean your spray bottles daily to avoid build up of bacteria and mold which could be flushed up into the nose during the next use.

9. Stronger solutions and additives

My inner science nerd is going to slip out for a little bit here! Our body fluids are salty, and most saline mixes are created to be equal to our body salt content.

When salt mixtures are the same concentration as the salt naturally occurring in our bodies, the liquid is called ISOTONIC (EYE-so-TAWN-ick).

When additional salt is added to the saline solution, the amount of salt becomes greater than our body’s salt concentration. These mixtures are called HYPERTONIC (HIPE-ur-TAWN-ick). Some physicians recommend these stronger saline solutions because the extra salt helps reduce nasal congestion more because it causes additional fluid from the swollen nasal tissue to leak into the nose….in an attempt to dilute the hypertonic mixture. (Remember wayyyyy back in chemistry class: OSMOSIS?)

Physicians may also recommend adding antibiotics, anti-fungal medications, or Alkalol for additional nasal care.

10. Frequency of use

Some people only needs nasal salt water washes when they are sick. Chronically ill patients with severe allergies or chronic sinus infections greatly benefit from more routine usage. By the time an infection has set it, it is too late and recovery is slower. Many of these patients use the washes as a nightly maintenance.

Nasal salt washes often bring major improvements to the quality of life for allergy sufferers. Hopefully these tips will allow you to gain the most benefit possible from your washes.

*These are opinions of Dr. Momma. Discuss your specific treatments with your physician*


Dr. Momma shares ten tips for the successful use of nasal salt water washes in the management of allergies and chronic sinus disease.



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