Perform hand hygiene. Trim fingernails. Position the infant supine or held securely by a parent.

If mucopurulent discharge is expressed, gentle cleaning with warm water or saline on a gauze pad should follow massage. 5. Clinical Evidence and Efficacy 5.1 Spontaneous Resolution Rates Multiple observational studies demonstrate that over 80% of congenital NLDO resolves by 12 months of age. The role of massage specifically—versus observation alone—has been debated.

Identify the medial canthus. The lacrimal sac is palpated as a small, firm nodule just medial to the inner canthal tendon.

A landmark RCT by Kushner (1982) and a later meta-analysis by Petris and Liu (2017) found that .