Secretions and suctioning: General knowledge

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If a child has excess secretions, they may need to be suctioned using a suction machine. Learn more about the different types of suctioning and why a child might need it.

Key points

  • Your child may need suctioning if they are not able to clear secretions (mucus) from their airways by blowing their nose or coughing.
  • Most children who need suctioning need to be suctioned three or four times a day.
  • The main types of suctioning are nasal (in the nose), oral (mouth), nasopharyngeal and oropharyngeal (throat), and deep suctioning.

What are secretions?

Secretions (mucus) are normally produced in the nose, mouth and trachea (windpipe). Secretions are usually clear or white.

A change in the colour, amount, consistency or smell of secretions may be the first sign that your child is getting sick or that something else is wrong.

The following are different types of secretions that your child may have and their common causes.

Secretion characteristicsPotential causes
  • Not enough humidity
  • Dehydration
  • Chest physiotherapy has just been performed

Yellow or green

Foul smelling

Increased production

  • Infection
Red-streaked or bloody
  • Infection
  • Not enough humidity in the secretions
  • Bleeding from gums from infection or trauma (e.g. after brushing or flossing teeth), nose
Frothy pink
  • Fluid build-up in the lungs
  • Old blood
  • Infection

Important: If you notice a change in the colour, amount, smell or consistency of your child's secretions, contact your health-care team immediately.

What is suctioning?

Suctioning involves removing excess secretions from the nasal cavity (in the nose), mouth, throat and trachea. It is usually done with a device called a suction machine.

Why do I need to suction my child's airway?

You need to suction your child's airway because your child needs help to clear secretions that they cannot clear on their own through coughing or blowing their nose. This will help your child breathe more easily.

When do I need to suction my child?

Most children who need suctioning need to be suctioned at least three or four times a day. In particular, your child needs to be suctioned when:

  • their cough is more frequent or sounds more congested than usual
  • they are having trouble breathing or their breath sounds are harsh
  • you can hear a gurgling noise while your child is breathing
  • you suspect aspiration (your child has inhaled food and/or liquid)

What are the different types of suctioning?

There are four ways to suction your child's airway:

Upper respiratory tractThe upper respiratory tract, showing the nasal cavity, oral cavity, pharynx, epiglottis, larynx, esophagus and vocal cords.
Lower respiratory tractThe lower respiratory tract, showing the trachea (windpipe) bronchioles, bronchi, lungs and alveoli.

Nasal suctioning

With nasal suctioning, a catheter or small tip catheter is passed into the nostril. This is helpful when secretions are visible in the nose or you suspect that secretions are blocking the nasal passage.

Oral suctioning

For oral suctioning, a hard-plastic tip with a handle called a Yankauer is usually used to suction secretions in the mouth. Oral suctioning is useful when your child is unable to remove secretions by coughing (for example, they have a weak cough) or they are drooling because they cannot swallow.

Suctioning depths This image shows the correct suctioning depth for nasal, nasopharyngeal and oropharyngeal suctioning. You will be shown how to measure this by your child's health-care provider.

Nasopharyngeal and oropharyngeal suctioning

A suction catheter (a thin, clear, soft plastic tube preferably with depth markings on it) is inserted to a predetermined depth through the nose (nasopharyngeal) or mouth (oropharyngeal) to the back of the throat. This type of suctioning is useful when secretions are pooled at the back of the throat and your child does not have the ability to cough them up or swallow them.

Deep suctioning

Deep suctioning lets you remove mucus from your child’s airway. This method is usually done with an artificial airway such as a tracheostomy tube. It removes mucus between the end of the tube and the carina (the part where the trachea splits into the bronchi, the tubes that go into the lungs). Deep suctioning is often done in urgent situations when secretions are unable to be removed by the other methods and the child is in distress.

Last updated: February 20th 2020