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Mother’s kiss: nasal foreign bodies


Children aged 2-5 years have the highest incidence of NFBs, with some studies suggesting a greater prevalence in boys


Intervention

Mother’s kiss or parent’s kiss.

Indication

Nasal foreign bodies (NFB), particularly in young children. NFBs may be inorganic items (eg. beads, stones or crayons) or food items.

The mother’s kiss technique is effective approximately 60% of the time, irrespective of the type of foreign body.

Even when not successful, the mother’s kiss technique may improve the visibility of the foreign body making removal by another technique easier.

Precautions

It is recommended that the parent have medical supervision to perform the technique.

  • A number of theoretical risks have been proposed, such as barotrauma to the tympanic membranes and lower airways. However, there has never been a reported incidence of tympanic membrane rupture or pneumothorax using the mother’s kiss
  • The main danger in removing a NFB by any technique is aspiration, particularly in a child who is uncooperative
  • If the NFB is suspected to be a disk battery, the child should be taken to the Emergency Department of the nearest hospital, due to the risk of tissue necrosis.

Adverse Effects

No adverse effects have been reported.

Description

Before starting the procedure, it is fully explained to the mother or trusted adult and the child is told they will be given a ‘big kiss’.

The mother, or other trusted adult:

  • places their mouth over the child’s open mouth, forming a firm seal as if about to perform mouth-to-mouth resuscitation
  • occludes the unaffected nostril with a finger
  • blows until they feel resistance caused by the closure of the child’s glottis
  • gives a sharp exhalation to deliver a short puff of air into the child’s mouth (which passes through the nasopharynx, out through the unoccluded nostril)

If successful the foreign body is expelled. If necessary, the procedure can be repeated a number of times.

The Mother's Kiss manouver

Grading

NHMRC Level 1 evidence

References

Consumer Resources

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