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Kids Health Info

How to use ear drops, nasal sprays and sinus rinses

  • Go to ear drops Go to nasal sprays Go to sinus rinses

    Key points

    • There are many different medicines to help ear and nose conditions.
    • You can buy some ear and nose medicines over the counter, but stronger medicines need a doctor’s prescription.
    • You should speak to a health professional before giving your child any ear or nose medicines.
    • Always read medicine labels and follow the instructions for use.
    • If your child’s condition does not get better, speak to their doctor or a pharmacist.

    What are ear and nose medicines?

    If your child has a condition relating to their ears or nose, a doctor or pharmacist may suggest they use medicines to help. These are called ear and nose or ‘nasal’ medicines.

    Most common ear and nose medicines

    Three of the most common ear and nose medicines are ear drops, nasal sprays and sinus rinses. You can buy some products over the counter, while you will need a prescription for others.

    It is best to speak with a health professional before giving your child any ear or nose medicines. They will check if your child has any allergies before prescribing or suggesting suitable products.

    Ear drops

    What are ear drops, and what do they do?

    Ear drops are liquid medicines put into the ear. There are many types of ear drops; they each do different things depending on the condition.

    Some common ear drops are:

    • Antibiotic ear drops: Help treat ear infections.
    • Steroid ear drops: Help reduce inflammation (redness, heat, swelling or pain).
    • Antiseptic ear drops: Help dry out any moisture stuck in the ear, which can lead to an infection.
    • Ear wax drops: Help remove ear wax build-up.

    How to use ear drops

    1. Please check with your pharmacist and the product information for any medicine specific instructions.
    1. Wash your hands with warm, soapy water.
    1. Ensure your child is in a comfortable position and the treating ear is within reach. You can either:
      • tilt their head back and to one side
      • lay them on their side with the treating ear facing up.
      If your child is young, you may want to wrap them in a light blanket to keep their arms still.
    1. You may want to warm the drops in your hand to make it more comfortable when applying into the ear.
    1. Shake the ear drop bottle and check the expiry date. Most ear drops have a 28-day expiry – do not use them if they have expired.
    1. Remove the bottle cap.
    1. Gently pull your child’s ear up and backwards to open the ear canal. For children aged younger than 3 years, pull backwards then downwards.
    1. Squeeze the bottle to release the required number of drops into the ear canal. Rest your wrist on the child’s cheek to keep your hand steady.
    1. After giving the drops, gently press the area at the front of the ear over the hole. Pressing helps move the drops deeper into the ear.
    1. If possible, keep your child in this position for a few minutes so the drops can absorb inside the ear.
    1. If your child needs drops in the other ear, turn them over so the other ear faces up or tilt their head the other way. Then, repeat steps five to eight.
    1. Put the cap back on the bottle and store it in a cool, dark space according to the label.
    1. Wash your hands again with warm, soapy water.

    Things to remember about ear drops

    • Watch for any signs of an allergic reaction, such as a rash, after using ear drops. If your child does react, stop using the drops until you speak with a doctor.
    • If your child’s ear condition stays the same or worsens after using the drops, speak with a doctor.

    Nasal sprays

    What are nasal sprays, and what do they do?

    Nasal sprays are liquid medicines sprayed into the nose. They help with nasal problems, such as a blocked nose (congestion), allergies and inflammation. The most common types of nasal sprays are steroids and decongestants.

    Steroid nasal sprays

    • Help reduce inflammation in the nose and nasal passage.
    • Reduce the amount of mucus the body makes.
    • Used for hay fever and allergies, nasal polyps, sinusitis, post-operative care and obstructive sleep apnoea (OSA).

    Decongestant nasal sprays

    • Restrict blood vessels in the nose and nasal passage.
    • Help ease the feeling of a blocked nose (congestion) and the amount of mucus the body makes.
    • Used for cold and flu symptoms, hay fever, allergies and sinusitis.
    • Strictly only for short-term use, as directed by a doctor.

    How to use a nasal spray

    1. Please check with your pharmacist and the product information for any medicine specific instructions.
    1. Wash your hands with warm, soapy water.
    1. Ask your child to blow their nose. You could also get them to use a saline spray to clear their nasal passage.

      Girl-with-brown-skin-and-black-curly-hair-in-purple-top-blowing-nose

    1. Ensure your child is sitting down; you can stand or squat in front of them. Then, ask them to look down like they are reading a book. This position will keep the medicine in their nose and stop it from going down their throat.

      Girl-with-brown-skin-and-black-curly-hair-in-purple-top-looking-down
    1. Shake the nasal spray bottle and check the expiry date. Do not use it if it has expired.
    1. If the bottle has not been used before or for some time, prime it by spraying it into the air a few times until a fine mist comes out.
    1. Hold the bottle in the opposite hand to the nostril you spray into. For example, use the left hand to spray into the right nostril and the right hand to spray into the left nostril.

      Girl-with-brown-skin-and-black-curly-hair-in-purple-top-holding-nasal-spray-with-left-handGirl-with-brown-skin-and-black-curly-hair-in-purple-top-using-nasal-spray-in-right-nostril
    1. Insert the nozzle tip into the nose (make sure not to push it too far up) and angle it towards the outer edge of the nose. Avoid spraying straight upwards.
    1. Ask your child to continue breathing gently through their nose as normal. Once ready, press to release one spray into the nostril. Then, ask them to breathe out through the mouth.

    1. After spraying, ask your child to look downwards and pinch the end of their nose. Tell them not to sniff too hard or blow their nose – this is to keep the medicine inside the nose. You can wipe any liquid that drips out with a tissue. They should not be able to taste the spray.

      Girl-with-brown-skin-and-black-curly-hair-in-purple-top-looking-down
    1. Repeat this process with the other nostril if required.

      Girl-with-brown-skin-and-black-curly-hair-in-purple-top-holding-nasal-spray-with-right-hand Girl-with-brown-skin-and-black-curly-hair-in-purple-top-using-nasal-spray-in-right-nostril
    1. Clean the bottle nozzle with soapy water, dry it with a clean tissue, and then put the cap back on.
    1. Wash your hands again after use with warm, soapy water.

    Things to remember about nasal sprays

    • You may need to prime a new nasal spray bottle by spraying it into the air up to 10 times before a fine mist comes out. If you have not used the spray in over two weeks, you may need to reprime by spraying it into the air twice.
    • Do not try to unblock the nasal applicator by inserting a pin or another sharp object, as this will damage the applicator and change the amount of medicine that comes out. It can also transfer germs into the applicator.
    • If you forget to give a dose, skip the missed dose and wait for your child’s regular dose. Do not double doses to make up for missed doses.

    Sinus rinse

    What is a sinus rinse, and what does it do?

    A sinus rinse can flush out the nose and sinus cavities. It uses no active medicine – only salt water – so it is gentle on the nose.

    Sinus rinses are commonly used for:

    • Colds and sinusitis: to clear mucus and bacteria, and reduce inflammation in the nose and sinus cavities, helping to unblock the nose and ease facial pressure.
    • Hay fever and allergies: to wash away excess mucus, pollens, dust, pet dander and other allergy triggers to help symptoms like a blocked nose or sneezing.
    • CPAP users: to help thin mucus and relieve nasal and sinus congestion caused by CPAP devices.
    • Post-operative care: to wash away mucus and dried blood from the nose and sinuses after surgery.
    • Postnasal drip: to wash away excess mucus that may cause a dry cough.

    How to use a sinus rinse

    Older children may want to do this themselves if they feel comfortable.

    1. Boil water and let it cool to room temperature. Add the advised amount of water according to the product information to the sinus rinse bottle.
    1. Add the contents of one sinus rinse sachet into the bottle. Then, screw the straw and cap firmly onto the bottle.
    1. Put your finger over the hole in the bottle cap and shake for 30 seconds or until all the sachet powder has dissolved. Once dissolved, use the mixture immediately.
    1. Ask your child to stand over a sink or in the shower, then get them to lean forward and tilt their head so their chin is as close to their chest as possible.
    1. Insert the tip of the bottle cap gently into one of your child’s nostrils until it makes a tight seal.
    1. Ask your child to breathe through their mouth while you gently squeeze the bottle. This will slowly push the water into their nostril. Keep squeezing until the solution drains from their other nostril or their mouth.
    1. Repeat this process until about half of the solution in the bottle is left. Take breaks as required.
    1. Follow steps five and six on the other nostril until the bottle is empty.
    1. Ask your child to gently blow their nose to remove any excess fluid and mucus.
    1. Clean the bottle, cap, and straw with soapy water and dry them before putting them back together. This will kill any unwanted bacteria and keep them safe for next time.

    Things to remember about sinus rinses

    • Try not to apply too much pressure when squeezing the bottle, as this may cause the ears to block.
    • Make sure your child’s mouth is open and they continue breathing normally while you squeeze the bottle.
    • Avoid using a sinus rinse the hour before your child’s bedtime. The saltwater may drain from their sinuses into their throat, causing discomfort, which we want to avoid.

    Storing ENT medicines

    • Do not use ear drops, nasal sprays or sinus rinse materials – including the sachets or bottle – if they look damaged or tampered with.
    • Do not use any ear or nose medicines after their marked expiry date.
    • Replace the sinus rinse bottle after three months of use.
    • Always read the medicine labels and follow the instructions for use. If your child’s condition does not get better, speak to a health professional.
    • Store ear and nose medicines below 30°C away from heat and direct sunlight.

    Common questions about ear and nose medicines

    Can kids use nasal spray?

    Most nasal sprays are safe for children to use. However, some have large nozzles that may not fit in little nostrils, so it is best to speak with a health professional to find the best products for children.

    Do nasal sprays have long-term side effects?

    This may vary depending on which nasal spray is being used and whether it is being used correctly. Generally, non-medicated nasal sprays such as saline should not have any long-term side effects. For medicated nasal sprays, speak with your pharmacist for more information.

    Is it okay for my child to use nasal spray on their own?

    If your child is old enough and feels confident, they can use nasal spray on themselves. However, it may be best for you to help them ensure they get the right amount of medicine.

    For more information

    Developed by The Royal Children’s Hospital Pharmacy department. We acknowledge the input of RCH consumers and carers.

    Reviewed June 2025

    Please always seek the most recent advice from a registered and practising clinician.


Disclaimer

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.