Author : Marta Brito, Hospital da Luz Lisboa physiotherapist Pediatric respiratory physiotherapy , mistakenly known as respiratory gymnastics or respiratory kinesiotherapy, is one of the therapies for respiratory problems in babies. We know that respiratory infections are the most disorders in babies up to 2 years of age. Hence the importance of respiratory physiotherapy, which helps and promotes airway clearance , facilitates ventilation , and improves gas exchange , thus allowing the symptoms relief. Respiratory physiotherapy intervention is, therefore, recommended whenever the baby has nasal obstruction , cough , sputum , secretion accumulation and difficulty expelling it. And also when there are respiratory sounds . What therapists do is to use manual techniques, that enable to mobilize and eliminate such secretions. But there are procedures that can help prevent those situations and may be applied at home by the parents, such as nasal rinsing with saline solution and syringe . It is important to familiarize the baby early on with this technique and introduce it in the daily routine, especially in those months where respiratory infections are most common. Nasal rinsing is even more important for babies and children that do not know how to blow their nose, their nostrils becoming obstructed, which hampers breathing and the process of feeding, moreover, fostering respiratory infections. For this technique, it is necessary: Saline solution, in single-dose containers or larger containers (and in this case, also a receptacle for the saline solution); Individual use syringe; Syringe adaptor; Hand towel. The saline should be at room temperature to avoid the irritation of the nasal mucosa. If necessary, the saline can be previously heated before performing the technique. The towel is used to wrap the baby, to keep him more restrained and safer during the nasal rinsing. The baby should be set in the sitting position, with the torso slightly leaned forward and the head tilted to the opposite side to that where the saline solution will be instilled. This position prevents the baby from choking and the saline and mucus from reaching the ear, thus avoiding otitis, as the duct connecting the nose and the ear is more horizontal in babies under 2 years old. The saline instillation should not be done too quickly, but in a continuous way, watching its outflow through the opposite nostril, to allow a rinsing by dragging out the mucus, which contains the impurities, viruses or even bacteria. The same procedure is to be applied to the other nostril. The process should be repeated until the nose of the baby is cleared. This procedure has no limit number of repetitions and the amount of saline solution to be instilled is variable. Up to the first year of age, an amount of 5 mL of saline should be administered. After one and a half years, up to 10 mL of saline can be administered. It is important for parents to be attentive to the behaviour of the baby : Prostration and irritability; Decreased appetite; Alterations in the sleep pattern. These situations are often related with respiratory difficulty . In the sessions of respiratory physiotherapy, parents always receive wide information on the best strategies to apply, to prevent the respiratory disease in the baby and to manage its symptoms. More about Physical Medicine and Rehabilitation at the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
