Wednesday 24 July 2019

Dear Dr Nina: 'Are drops for children safe? My six-year-old has complained of stinging eyes since treatment'

Saline drops are considered safe to use by all ages
Saline drops are considered safe to use by all ages

Nina Byrnes

Question: Are saline nasal drops for children really safe? I gave them to my six-year-old daughter recently and they caused her eyes to tear up on and off for about an hour afterwards. She also complained of stinging eyes. I had also been treating my baby with the drops and now I am worried.

Dr Nina replies:  Saline drops are considered safe to use by all ages. They are most commonly used to help decongest the nose making breathing easier. It may be that your daughter had a cold or concurrent rhinitis at the time you administered the drops. It would be very unusual to be allergic or react to saline drops. This is a fluid that is designed to provide the least possible irritation to the membranes lining our bodies.

It is important to ensure that the drops are in date and that any unused drops are discarded within one month of opening. Each bottle should only be used on one person. Many have an applicator tip that is placed just inside the nostril and bacteria could gather on this and transfer to another person. Always clean the bottle tip after using. When administering the drops, tilt the head back or lie down, place the bottle at a right angle to the nasal passage.

The sinus pathway goes towards the back of the head, not the top. Breath normally after placing the drops. Snorting strongly means the drops end up in the throat not the nose where they were intended. The eye and nose are connected by the nasolacrimal duct - this brings tears from the eye to the back of the nose. Medication administered into the eye can travel down the back of the nose but gravity and other factors make it extremely unlikely that it can travel the other way.

It may be that you daughter has rhinitis. This causes a sensation of blocked nose, congestion and can cause sneezing, itchy eyes and nasal drip. Other symptoms include reduced taste, red eyes, mouth breathing, snoring, reduced sleep and fatigue. Most associate rhinitis with summer grasses and pollens but symptoms can occur seasonally for some or all year round or others. Common triggers in winter months are house dust mite, moulds, fungal spores, and animal dander. Rhinitis occurs in about 20pc of the population and it affects all ages. It is more common in those with a personal or family history of asthma or eczema.

Medication can help. Saline rinses may clear the nose but steroid nasal sprays are essentially the mainstay of treatment for rhinitis whenever it occurs. They act locally in the nasal passages so absorption into the body is minimal. They help reduce swelling in the nasal passages thus reducing congestion and blockage. Steroid nasal sprays are generally considered safe and they can be used on an on-going basis if required. They are licensed for use in a six- year-old. Anti-allergy eye drops may help with itchy running eyes. Anti-histamine tablets are another option. If your daughter continues to get runny, sore eyes a visit to your GP is a good idea.

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