pneumothorax from mother’s kiss?

29 May

Recently heard someone mention they stopped using the Mother’s Kiss technique for nasal foreign bodies due to risk of pneumothorax.  

QUICK REVIEW OF MOTHER’S KISS TECHNIQUE:

  • parent places 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
  • hopefully, nasal foreign body (and some snot–messy) comes flying out

 

While this idea makes sense as a possibility (sudden positive pressure from mom without a release valve–though its not usually a perfect seal–might pop a lung in theory), wondered if there’s any data out there that addressed this theoretical risk.
PUBMED SEARCH:

yielded not a ton. pretty much this:

Efficacy and safety of the “mother’s kiss” technique: a systematic review of case reports and case series, by Cook S, et al.

review of 8 articles

overall success rate: 59.9% (91/152)

No adverse effects were reported.

“a ruptured tympanic membrane or pneumothorax resulting from this technique has never been reported” (article published Nov 2012)

  • glottis is closed during the technique, so there is little risk of barotrauma to the lungs
  • the pressure used is low, comparable with that generated during sneezing (about 60 mm Hg)

possible confounder: reporting bias (Positive results tend to be published more frequently than negative results)

 

BOTTOM LINE:

according to the data we have, mother’s kiss seems safe.  worth keeping in the toolbox.

 

References: article; pic 1; pic 2

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