Out, damn’d snot

“Out, damn’d snot! out, I say!—One; two: why, then ’tis time to do’t.—Hell is murky.—Fie, my lord, fie, a soldier, and afeard? What need we fear who knows it, when none can call our pow’r to accompt?—Yet who would have thought the child to have had so much snot in him?”

Macbeth Act 5, scene 1, 26–40. Adapted.

One of the joys of being a pediatrician is that I can still make jokes about snot. I get all serious sometimes during the physical exam, asking a six year old to turn up their nose for a careful look. Then I make a concerned “Hmmmmm noise”—you know, create some comedic tension—then, a pause, followed by one of my best one-liners: “Ewww! Boogers!”

It cracks them up. Really.

Shannon asked me to write about whether the fancy-pants new high-tech nasal aspirators are any better than the old fashioned ones at de-snotting kids. The truth is, I have no idea. But there are plenty of other booger-tidbits I’d be happy to share—so join me for what promises to be the most revolting post of 2009, a journey of mucus and fun!

Snot is nasal mucus, made by specialized cells lining the nose, sinuses, and the entire respiratory tree. It’s mostly water, plus specialized proteins called mucins that help create its wonderfully sticky character. Mucus also contains disease-fighting antibodies and chemicals that can tear apart infectious particles. Not only does it help prevent and treat infections, but it also keeps the nasal linings happy and moist, and humidifies inhaled air. Its sticky surface traps pollens, infectious particles, and airborne pollutants, sort of like built-in fly paper. Under ordinary circumstances, a person makes—and swallows– about a quart of it a day.

The most common “chief complaint” for visits to a pediatric office is nasal congestion, most often caused by an upper respiratory infection, or “the common cold.” The snot, especially early on in the cold when it’s clear and watery, is loaded with infectious viral particles. That’s why colds are so common: they make your nose runny and irritated, so you rub it, then touch a doorknob, and then the virus can easily spread to the rest of the family and everyone else in the classroom. Towards the end of a cold, snot will get thick and dark and lovely yellow-green (especially the stuff in that first morning tissue.) By then, the mucus isn’t infectious anymore. Rather than being loaded with virus, it’s filled with dead and dying infection-fighting cells and sloughed debris from your nose. It’s a misconception (unfortunately perpetuated by many doctors, I know) that green snot at the end of a cold means that there’s some kind of infection that needs antibiotics. ‘Taint true, though if thick persistent all-day mucus lasts longer than 10-14 days at the end of a cold, you might have a sinus infection brewing. It’s the duration of symptoms that helps distinguish a cold from sinusitis, not the color of the boogers. And no, you don’t need to bring in a sample for your pediatrician to examine. Really. Thanks.

Excessive snot could be caused by other things. Allergies can make your nose run, though more commonly allergies cause swelling of the lining of the nose, causing a congested feeling without much actual extra mucus. When you cry or have irritated, teary eyes, the tears drain into your nose through little ducts, which makes your nose run too. And a three year old who shoves a lego up her nose is going to get one heck of a snotty discharge in a few days. About once a year I see a toddler with a “cold”—but a cold that oddly enough only leads to nasal discharge from one nostril. If your child has two nostrils, but only one of them is runny, take a look up there. You might just find a toy you thought was missing.

Too much snot causes a few problems. In the short-run, it might make it hard for your child to get comfortable, and can interfere with sleep. More importantly, nasal mucus that just sits there in the nasal cavity is a warm and inviting media for bacteria, and can eventually lead to secondary bacterial infections like ear infections and sinusitis. So both for symptom relief and for the prevention of these infections, it’s a good idea to at least try to get the boogers out of there.

What about cold medicines? The short answer: they don’t work. Some contain antihistamines that may make your child sleepy—that’s not a bad thing, as long as it’s safe—but none actually decrease mucus accumulation . Topical decongestants like Afrin do work, but are potentially addictive and shouldn’t routinely be used in children.

So a more creative approach is needed. Traditional, effective advice includes giving the child extra fluids, humidifying the air, and sitting in a steamy bathroom. These will all keep the mucus nice and runny rather than thick and sticky. You can also put a few drops of saline solution in the nostrils, or even better use a nasal saline irrigator to wash out the boogies. Loose, watery mucus can also be sucked out with a traditional bulb aspirator.

You say you want something fancy, something high-tech, something to casually whip out to the oooohs and aaaaahs of the envious playgroup crowd? This electronic marvel boasts twelve different tunes it can play to distract your honey while her nose is sucked out. (Got to be at least 12. Junior would certainly complain if the same tedious song were played during each episode of nose-sucking. I’m surprised there isn’t a built-in MP3 player.) Or the Nosefrida, manufactured in Sweden, which apparently lets you inflate your baby’s head much like a carnival balloon. I can’t believe I’m raising three kids without it!

I have no experience with these newer nose-suckers, so please, if you get one, post a review. Anyone who posts gets double points if you include a photo—of the kid, not the snot. I really can live without seeing that!

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23 Comments on “Out, damn’d snot”

  1. Holly Says:

    Thanks Dr. Roy, for a particularly disgusting, but informative, topic. 🙂

    I did get “sucked” into buying a Nosefrida. If you can get past the concept of it, it’s not a bad invention – easier to clean, in my opinion, than those nose bulbs.


  2. Beth Olsson Says:

    I have to say, life was greatly improved in our home when our kids learned to blow their noses.


  3. Nicole Says:

    My 10 month old has very heavy black snot?! I have three children and have never seen this before.. is there cause for concern???


  4. Dr. Roy Says:

    Nicole, black snot usually means there’s been a nosebleed. Old blood turns black or dark brown. I would take a 10 month with this into the pediatrician for an exam.


  5. Beth Says:

    I just stumbled on your site. We have toddler twins who have struggled with the “lingering” upper respiratory viruses (and then sinusitis, ear infections, conjunctivitis, wheezing and on and on). The Nosefrida sucks SO much more snot out. They hate it, of course, and have to be held down, but it works light years better (and was faster) than the bulbs. The bulbs are still fine for small issues, but the really constant runny stuff is better removed by the nosefrida. It’s our new go-to baby shower gift- gets a good laugh, but it’s great.

    Liked by 1 person

  6. Dee Says:

    So helpful!! Thanks


  7. Celeste Says:

    I always thought green snot was bad and clear snot was good. This article was so enlightening! Now I understand why my kid seems to feel better but his snot is turning thicker and green. Life makes sense now 🙂


  8. […] My new personal pediatrician says: […]


  9. kara Says:

    Don’t knock the nose-frida till you’ve used it–and followed the directions. It works 100% better than nose bulbs. I swear by it and give it at every baby showe.


  10. Shaina Sheppard Says:

    We have a 2.5 yr old and a 2 mo old. I swear by the Nosefrida for congestion. Agreed, it does seem a bit gross to “suck” the snot out of your child’s nose, but there’s a filter so no particles ever actually make it that far to you (I’d be impressed with someone’s lung capacity and IRV if they were able to generate enough suction to get it more than halfway up the tube). Simple and extremely useful, with or without saline drops. I’ve left the bulb at the hospital and never looked back. You’ll be shocked by the size of the boogers you get, but the result is a kid that can breathe…translating into sleep for all!

    I’m starting to eye the Windi…only since my 2mo old’s gas causes him to kick, arch and cry and wake him from sleep, all with mommy avoiding milk too! An exhausted infant isn’t fun for anyone.


  11. vlo226@yahoo.com Says:

    My baby just got his first cold, and when the Nose Frida arrived in the mail ( bless you, too, Amazon Prime), it was the best night we’ve had in a week. The Nose Frida sucks out so much more, and you can see how much you’ve gotten out.


  12. Jessica Says:

    My stepson has excess of hard boogers all day every day. We live in Colorado so it is really dry & everyone refers to them as rock boogers. He has alot of nose hair for a 5 year old & a hard time blowing it out. We use a tweezers sometimes to pull them out & wipes its disgusting! Is there a preventative for this type of thing? Do you think he has constant allergies? Its been this way for 3 years. Thanks


  13. tlen Says:


    Use Simply Saline and get a Nosefida. Easy peasy.


  14. Rachael Says:

    Haha this got me chuckling. I know it’s an old post but hey ho lol! My 1 year old is coming out of the throws of a cold and I didn’t use either a bulb or this other gadget people are talking about, I simply used a nasal saline spray, good old tissues and vicks or olbas oil in hot steamy water to keep the air moist.


  15. Yemen Says:

    Hi Doctor Roy,

    I’m a respiratory therapist so i found this very funny. Your patients must love you to pieces. We could definitely use more peds like you in the field. I have a concern I’m hoping you can help me with also. I have a 2 year old with unusually sticky mucus in his nose. I literally have to pin him down 6-8 times a day to get it out so he can breathe and prevent infections. He’s had a mild episode of RSV at a couple months of age and had a influenza A after he turned a year old which lasted a good 4 months in his system until they prescribed Tamiflu. His x-ray at that time revealed cardiomegaly that was resolved after his flu symptoms went away. As a clinician i thought maybe the long period of time with the flu and congestion caused pulmonary hypertension that overworked the right side of his heart to cause this. As a mother no answer was good enough and I was scared to death. Now I fear the thought of winter But even during the summer he has this accumulation of thick sticky mucus that gets really hard within minutes. His ped says i shouldn’t worry but that’s not going to happen. it’s quite unusual and he’s too young to test for asthma. I don’t even want to think about CF, and he’s well hydrated all the time.

    I’m so sorry for the long post and so much detail. I’m confused and worried for my child. Can you please help?

    Thank you


  16. Dr. Roy Says:

    Yemen, even untreated influenza won’t last 4 months in a child with a normal immune system. I don’t think that part of the explanation rings true.

    There are many causes of overly-thick mucus, or mucus that is difficult to clear. You mentioned one -CF – that should be tested; immotile cilia, too. A specialist like a ped ENT or pulmonologist may help with the eval. Best of luck!

    Liked by 1 person

  17. Jen Says:

    is there anything particularly wrong with sucking the snot out of their noses? like with your mouth (other than it being fairly gross?) Ive read about parents doing this in a pinch


  18. Dr. Roy Says:

    Jen, other than the hygeine/yuck factor, I’m sure nose sucking is safe and effective. Not sure it’s for everyone, tho…


  19. Sarah W. Says:

    Amusing article! My 16 mo old just sounds like she needs to blow her nose or snort it up and swallow all day. The pile of snot that comes out during a shower is unreal. It’s like the snot replaces itself as quickly as I suck it out. (I completely recommend the nose Frieda!) I just saw videos of people spraying water(saline?) up a child’s nostril to push the snot out the other one. Is this a safe thing to do? It sounds more traumatizing than pinning her down to aspirate, but she just seems so uncomfortable trying to eat and sleep while clogged up.


  20. Nat Says:

    Ive woke up this mornig with black in my snot and mucus and my son has the same!
    We are just getting over a Bug and also a cold, he has a throat infection and is on antibiotics for it and seen as there was some going to be left over i took a bit of it as my throat was sore also!
    Would that have anything to do with it? Im a bit worried.


  21. Jenn Says:

    The Baby Vac http://www.babyvac.co.za is the best device we bought 5.5 years ago! We have had one ear infection between two kids in 5.5 yrs. thank you for your post; I had to refresh my memory on mucus duration.


  22. ReadMeri Says:

    Loved your post Doc. Nice work.



    The nose sucker is amazing. A life saver.


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