Nosebleeds in Children
Nosebleeds can be impressive and scary to children and to their parents, but very rarely are they serious or a sign of underlying illness. The inside of the nose is delicate and bleeds easily. Bleeding from the nose is quick and copious, and often looks worse than it actually is. And because a young child will often swallow some blood, which is very irritating to the stomach, it is not unusual for a child with a nosebleed to vomit blood.
Why do children’s noses bleed?
Anything that dries, damages or irritates the lining of the nose can cause a nosebleed. Some common causes of nosebleeds are:
- Low humidity
- High altitudes
- Repeated or forceful nose blowing
- Picking of the nose
- Bleeding abnormalities (nosebleeds alone do not signify bleeding issues)
What you can do if your child has a nosebleed:
Follow these steps to stop the bleeding:
- Stay calm. Your child will take his/her cue from you.
- Have your child sit up and lean slightly forward
- Firmly pinch the soft part of your child’s nose (just below the bone between the eyes) for 10 minutes. Do not release pressure to check until 10 minutes have passed. If bleeding has not stopped at the end of the 10 minutes, resume pressure for another 10 minutes. Once again check. If bleeding still has not stopped resume pressure for one last interval of 10 minutes.
- If possible, apply a cold compress or ice to the area where you are applying pressure.
- Encourage your child to breathe through his/her mouth even after the nosebleed has stopped.
- Ask your child not to blow his/her nose, and try to minimize very active behavior for 12 hours to prevent immediate re-bleeding.
How to prevent future nosebleeds
- Increase the humidity in your child’s bedroom with a cool mist vaporizer or a humidifier.
- Lower the temperature of the heater at night. Heat dries the air, and dry air can lead to nosebleeds.
- Moisturize the inside of your child’s nose:
- A nasal saline spray, used 2-3 times a day, will help keep the nose moist and clear of mucus, leading to less picking and blowing of the nose, minimizing drying and irritation of the nasal membranes.
- Use a q-tip or the tip of your finger to apply Vaseline or Aquaphor ointment just inside your child’s nostrils each morning and evening.
- Encourage your child to keep his/her fingers out of his/her nose.
If despite these steps your child continues to have frequent or severe nosebleeds your child’s pediatrician may recommend a visit to an Ear Nose Throat specialist for cauterization of the irritated blood vessels inside the nose. You should call the doctor during normal business hours to explore your options.
Call or see a doctor immediately if:
- The bleeding lasts longer than 30 min despite pressure and cold compresses.
- An injury has occurred and your child’s nose is deformed or off center.
- Your child is pale, sweaty, or is not responding appropriately.
- Your child is complaining of a severe headache.
- Your child has blood in his/her urine or stool, has bleeding from his/her gums, or has extreme bruising on his/her body.
- You feel that this is not just a simple nosebleed and that something is not right with your child. Remember, no one knows your child like you do!
-Monique Araya, MD, FAAP
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