Tips for Securing the Cannula in Infants and Children

If you care for an infant or small child who needs oxygen treatment, you know how hard it is to keep a nasal cannula in place.

Without something to secure the cannula, most young children will pull it off, chew on it, etc. On the one hand, you need a solution that is strong enough to keep the nasal cannula securely in place. On the other hand, a newborns skin is incredibly delicate and sensitive, so the solution has to be mild. What is the caregiver of a young child with lung disease to do?

What is a nasal cannula? 

A nasal cannula is a thin, clear tube with two smaller tubes, called prongs, that are placed one in each nostril. The other end of the nasal cannula is connected to an oxygen delivery device, such as an oxygen tank or oxygen concentrator. If you have ever visited an adult in a hospital, you have likely seen the patient wearing an adult nasal cannula. Nasal cannulae (plural of cannula) are extremely common in the neonatal intensive care units because premature newborns almost always have underdeveloped or “weak” lungs and require additional oxygen. A portion of children need oxygen treatments all the time, so they leave the hospital with an oxygen delivery system and nasal cannulae.

The importance of oxygen therapy

If a child has a prescription for oxygen, this means supplemental oxygen therapy is an important part of their overall treatment program. In most children with severe cases of lung or heart disease, having additional oxygen can mean the difference between living life at home and winding up back in the PICU or NICU. Thus, it is very important to keep the oxygen flowing as directed. Unfortunately, this can be a tremendous burden on parents and other caregivers, since it is usually their responsibility to make sure the oxygen nasal cannula stays in place. 

Security versus safety

If you have not discovered it already, securing a nasal cannula to the face and head of an infant or toddler is challenging. The cannula often becomes a toy, an irritant, or just simply the target of randomly moving hands. Only using soft gauze to secure the cannula almost never works and if it works, it does not work for very long. Given the importance of continuous, supplemental oxygen for the child’s health and well-being, caregivers must find a way to secure nasal cannulae in place that tiny hands cannot dislodge. 

Heavy tapes, straps, or other bindings can certainly secure the cannula. However these attachments are almost always too uncomfortable for young children to bear, even painful. Children may not grow accustomed to wearing these cumbersome adhesives and devices. 

The other major problem with most bindings and adhesives is that they can irritate newborn skin. Certain bindings and tapes make it more likely that the young child will develop a rash or, over time, a fungal (yeast) infection on the face. Not only is this uncomfortable and potentially painful for the infant, but it also means that the binding will have to be removed until the skin heals. If this occurs, the child is at risk of not getting the extra oxygen he or she needs. In some ways, choosing a securement method that is too strong for an infant or toddler is worse than choosing one that is not strong enough.

Hy-Tape secures the cannula safely and securely

Those who care for young children in need of supplemental oxygen have learned through trial-and-error and word-of-mouth that Hy-Tape offers the ideal combination of safety and security for securing a nasal cannula. Hy-Tape—which almost everyone simply calls “pink tape”—uses a zinc oxide-based adhesive. This latex-free adhesive is gentle and even soothing on delicate skin. 

Pink tape is strong enough to hold a nasal cannula in place, and can hold its own against the busiest of tiny hands. Yet when it is time for Hy-Tape to come off, mom can remove it without burning or tearing the skin. Hy-Tape is washable and waterproof, so baby can take a bath while wearing oxygen, if needed. Pink tape makes dressings occlusive, and can stand up to secretions like saliva, spit up, and the random bit of baby food that didn’t quite make it into baby’s mouth.

Hy-Tape stays secure over several days, which means you don’t have to keep applying and reapplying the tape. In fact, the Children’s Interstitial Lung Disease Foundation suggests using Hy-Tape specifically to secure the nasal cannula because it is “perfect for extended wear use.”

How to secure a nasal cannula on an infant or toddler using Hy-Tape

Make sure your healthcare provider prescribes or orders the correct nasal cannula for your infant or toddler. Simply using an age or weight-based guide may not ensure the right fit. When in doubt, ask a medical professional.

Each of the nasal tubes (prongs) should fit comfortably within a nostril. The tubes should not take up the entire area of the nostril, however. In other words, there should be room for air to pass through the nose when the nasal cannula is in place. Place the nasal prongs in the baby’s nose and extend the tubes behind the baby’s head. Gently tighten the tubes together so it encircles the child’s head snugly—but not tightly. Once in place, place a piece of Hy-Tape on either side of the baby’s face at the upper cheek or temple, right in front the ears. Check to see that nasal cannula is securely fastened by very gently tugging the tubing near the nose. If you need to place additional pieces of tape, identify areas that are not covered with hair, i.e., not the scalp. 

If you are the caregiver of a child who needs supplemental oxygen through a nasal cannula, visit our website to request a free sample. Purchase a Three Pack of Hy-Tape.

“We’ve used Hy-Tape for years to hold the cannula to our daughter’s face. It is great and doesn’t irritate her skin. I remember years ago ordering the free sample and have spread the word to the other lung moms in the Children’s Interstitial Lung Disease group. Thanks for such a great product.”

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