Blowing noses

The question was posed over here as to how to teach children to blow their nose. I thought it would make a great post here.

This is a tough lesson to teach children. Many times they will grab a tissue and just wipe, drop, and run. The wipe the tissue across their nose causing all that gross mucus to trail across their face, drop the tissue wherever (though we would like to see it land in the trash can, it doesn't always), and run off to play again.

So, how do we get them on track to fixing this problem? We start young. Very young. Begin-in-the-infant-room young.

If you are a follower of RIE (Magda Gerber) then you will know that we talk to children through everything. We talk to children through diaper changes (I'm taking your diaper off, now I'm going to wipe you, the wipe is a little cold, can you lift your legs up for me, thank you, let me help a bit, ...you get the idea). IF you do this, you will find very young children will actually give subtle signs that they understand. I have actually seen a 4 day infant respond to me when doing this as I was picking her up because from the day she was born I talked her through every diaper change.

This is to say that, if you talk them through a nose wipe every time, you will get a response sooner. With those young, non-mobile infants, we approach with a tissue, "Johnny, your nose is running, I'm going to wipe it now. Can you blow for me?" We follow this by blowing strongly through our nose while we gently wipe his nose.

Do they blow their nose? No. It's the idea of talking them through this process from the beginning to start making that connection. Sometimes, as they get a little older and begin to immitate those things we do, they will do this; but it's not to blow their nose, it's to get a reaction from us.

As they start toddling around, when they need their nose wiped, we first and foremost take it to them! This is important. If you make them drop what they are doing to come wipe their nose you are going to be in a bettle. Nose wiping is something that needs to be done and can be done anywhere. I have seen teachers get into a struggle with a child to walk them over to the tissue box. This consistently sets off a tantrum that lasts way too long and is fully the teacher's fault.

When you bring a tissue to a toddler, this is the process: "Sara, I need to wipe your nose. Here's the tissue." Place the tissue over the child's nose and (now this is an important part that seems small and insignificant, but it can make a huge difference to cooperation) make sure that the tissue is not over their line of sight. They will move their head around and seem to be struggling with you when all they are really trying to do is see.

So, place the tissue over their nose and say, "Can you blow?" Then take a deep breath yourself, close your mouth, and blow out your nose while physically moving your body (shoulders move down, head leans forward a bit, you know, like you are blowing really hard). This shows them in a very exagerated way what they are supposed to do.

Many times, at this age, they will end up blowing through their mouth. You can try about three times to get them to blow through their nose. This is more as practice rather than getting them to do this. They won't do it. But I alway repeat, "blow! And again! Again!" while I am repeating my motions. When we do this, they are picking up on what they are supposed to do. Sometimes it seems futile, but it IS making a difference.

As they get older, have them hold the tissue with your hand over theirs. You will know when they are ready for this because they will grab at the tissue when you approach them and tell them you are going to wipe their nose. It's a natural progression. Encourage this but know that they still need help.

Hold their hand gently over their nose. This is hand-over-hand training; just like we do hand-over-hand when they are pouring their milk at the table. We are guiding their hand into what to do: how hard to hold the tissue so that it is on the nose, but not so hard that they can't get anything out; where to hold the tissue so that it catches everything; how to squeeze the thumb and finger together to squeeze that mucus out and get it in the tissue. It's a complicated process, and, when they are ready, hand-over-hand works wonders.

While holding hand-over-hand, remember to tell them, "Blow!" and go through the physical cues again. At this point, they will soon get the blowing down. They really will! When they get the blowing down, have them keep blowing until you can't hear any mucus anymore.

I always follow up with, "See, now you can breathe so much better, right?" This shows them that there is a purpose to this nose wiping.

By the time they are 4, they can typically blow their nose all on their own. Yes, it's a FOUR YEAR PROCESS!!! Be patient!

Another note to make things easier: when those toddlers really fight off the nose wipe (which they will even when you follow this process) SHOW THEM the mucus after you wipe. After wiping open the tissue and say, "Look! That came from your nose! Let's get some more." This has a 99% success rate. The second wipe will be so much easier. Sure, there is that 1% that it doesn't help; but that's typical toddlerhood.

Make sure that you wash your hands after helping children wipe their noses. If they helped in the process, encourage them to do the same. Many times they don't want to because they are afraid to lose their toys. Take the toy with them or, if worse come to worse, bring over some hand sanitizer