[PARTIALLY TRUE] Could the purported ‘mother’s kiss’ technique be used to remove a nasal foreign body for children?

Screenshot of the Facebook post

The Claim and Our Verdict

• The claim: A Facebook post published Aug. 19, 2021, claims that one can remove a nasal foreign body for children by blowing into the patient’s mouth and simultaneously occluding the contralateral nostril. This method is purported to be called “mother’s kiss,” according to the post.
• Fact-checking:
  • According to relevant research articles and case reports, nasal foreign bodies can be removed by a number of techniques. A safe and effective option is to remove a nasal foreign body for children by blowing into his/her mouth and occluding the unaffected nostril. Although this technique could be effective, it may still fail sometimes.
  • Cheng Kam Wah, director of first aidtraining at Hong Kong St. John Ambulance Association responded to our inquiry that this technique could fail because it will increase the chance of vomiting when the air enters the stomach through the esophagus. He suggested timely medical treatment if there is a foreign body in children’s nasal cavities with no danger of asphyxiation.
  • The technique may help expel the foreign bodies from the nasal cavities of children, but according to the results of a research review, the failure rate is about 40%. In addition, this technique may lead to other adverse effects. Generally speaking, the claim is too absolute and does not mention the failure rate and risks, which may mislead the readers.
• Our ruling: Therefore, we rate the claim as PARTIALLY TRUE.

News Brief

A Facebook post published Aug. 19, 2021, claims that former Hong Kong actress May Kwong, who has three children, said that her youngest daughter put a small bead in her nose while playing and they called for the ambulance. Fortunately, her daughter was safe in the end. She shared the technique taught by the doctor—to remove a nasal foreign body by blowing into the child’s mouth with a finger occluding the unaffected nostril.

As of the issuance of this report, the post had been shared 60 times, and had received 24 comments and 368 likes or reactions.

Fact-checking

Keyword searches found the following articles about how to deal with the foreign bodies in the nasal cavities of children. According to an article published in November 2008 in the medical journal Pediatric Emergency Care, titled “Nasal Foreign Body Removal in Children,” nasal foreign bodies in children are often managed in the pediatric emergency department. The child is usually between 2 and 4 years old, and the foreign body is most commonly a plastic toy or bead. The author claims that nasal foreign bodies are removed by a number of techniques. Positive-pressure expulsion is accomplished by orally applied pressure via a parent’s mouth or an Ambu bag or by nasally applied pressure via a catheter or an oxygen source. The object can be washed out with nasally applied saline. Direct mechanical extraction is possible with a variety of tools, including forceps, hooks, or balloon-tipped catheters. Each technique comes with its own risks and benefits. The technique discussed in the claim belongs to the category of positive-pressure expulsion.

Another article, titled “Efficacy and safety of the ‘mother’s kiss’ technique: a systematic review of case reports and case series,” published on Nov. 20, 2012 in Canadian Medical Association Journal, introduced the mother’s kiss technique—the mother, or other trusted adult, places her/his mouth over the child’s open mouth, forming a firm seal as if about to perform mouth-to-mouth resuscitation. While occluding the unaffected nostril with a finger, the adult then blows until they feel the resistance caused by closure of the child’s glottis, at which point the adult gives a sharp exhalation to deliver a short puff of air into the child’s mouth. This puff of air passes through the nasopharynx, out through the unobstructed nostril and, if successful, results in the expulsion of the foreign body. With a systematic review of 8 relevant studies, the author found that the overall success rate for all of the case series was 59.9% (91/152). No adverse effects were reported. The paper claims that evidence from case reports and case series suggests the mother’s kiss technique is a useful and safe first-line option for the removal of foreign bodies from the nasal cavities of children. Therefore, this technique is effective, but its failure rate is still about 40%.

Cheng Kam Wah, director of first aid training of Hong Kong St. John Ambulance Association, responded to our inquiry on Sept. 6, 2021. He said it is feasible to remove the nasal foreign body from children by blowing air into the mouth and nose, but different techniques should be used to deal with different emergencies. For the “mother’s kiss” technique mentioned above, he explained, “the technique works in theory, but may fail in reality, because the air may enter the airway or esophagus. It might cause vomiting when the air enters the stomach through the esophagus. The patient can still breathe with only one nasal cavity obstructed, so there is no immediate danger of asphyxiation.” He suggested that the parents should first calm the patient down and teach him/her to breathe with his/her mouth, leaving the foreign body untouched, and then seek medical treatment in time.

In conclusion, the technique of “mother’s kiss”—nasal foreign body removal in children by blowing into the patient’s mouth with a finger occluding the unaffected nostril in an emergency, works in theory but it may fail in reality. Under normal circumstances, if the foreign body occludes only one nasal cavity and there is no danger of asphyxiation, the parents should seek medical treatment in time. The claim is too absolute and does not mention the failure rate and risks of “mother’s kiss” technique, which may mislead the readers.