Abstract
Intervention
Mother’s kiss or parent’s kiss.
Indication
Children aged 2–5 years have the highest incidence of nasal foreign bodies (NFBs), with some studies suggesting a greater prevalence in boys. NFBs may be inorganic items (e.g. 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’ (Figure 1).
The mother’s 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)
Grading
NHMRC Level 1 evidence.
Footnotes
Acknowledgement
Article reprinted with permission from The Royal Australian College of General Practitioners.
The HANDI Group is made up of Paul Glasziou, Ben Ewald, Dan Ewald, Kim Bennell, Marie Pirotta, Peter Greenberg, Sally Green, Tammy Hoffman, Jan Radford, John Benett David King and Raquel Newman.