It can be very frightening when blood is flowing from your child’s nose. Nosebleeds are very common and rarely serious. They are usually caused by dry air (cold outside air/air conditioned air/dry heat) or by nose picking.
The inside of the nose has lots of blood vessels that are close to the surface so it’s easy for these blood vessels to be irritated or injured, resulting in a nosebleed.
Nosebleeds can occur during a cold or with allergy symptoms when the nasal tissue has become raw and inflamed. Other times nosebleeds happen after any injury to the face, perhaps after a fall. Rarely are nosebleeds caused by a serious medical problem.
Medications that are used as blood thinners can cause nosebleeds but these medications are seldom used in children.
Certain nasal sprays that contain steroids can have nosebleeds as a side effect. These nosebleeds are usually mild and resolve if the spray is discontinued for a week or two.
With the right care most nosebleeds stop on their own. Here’s what you should do:
- Have your child sit bending forward at the waist. Do not have them lie down or tilt their head back. This might cause them to swallow blood and can lead to nausea and vomiting since blood is very irritating to the GI tract.
- Grip the soft part of both nostrils at the bottom of the nose and apply pressure.
- Squeeze nose for at least 5 minutes. If you release the pressure before 5 minutes the bleeding may recur and you will need to hold for another 5 minutes.
- You may also apply a cold compress to the bridge of the nose. This will help the blood vessels to constrict and slow the bleeding.
If you follow these steps and your child’s nose continues to bleed, repeat all steps and apply pressure for up to 30 minutes. If the bleeding continues after this then emergency care is needed.
If your child’s nosebleeds are very frequent or prolonged there might be an underlying problem. There might be a large blood vessel near the surface of the nasal tissue. If this is the case the bleeding is often from only one side of the nose. In this case a referral to an Ear, Nose and Throat specialist might be needed. These specialists have the equipment to visualize the upper part of the nose to locate and treat the offending blood vessel.
Another less common problem causing prolonged frequent nosebleeds is a bleeding disorder called “Von Willebrand’s Disease”. In this case the bleeding should be from both nostrils and there might be a family history of nosebleeds or heavy periods in female relatives. This disorder can be diagnosed with a blood test, preferable at the time of the bleeding. Patients with this disorder are referred to a hematologist (blood doctor) for treatment and do very well with medication.
Here are some measures to try to prevent nosebleeds:
- Use a humidifier in the bedroom, especially in winter when the dry heat is turned on.
- Keep inside of nose moist using nasal saline spray or gel or applying Vaseline to inside of nose at bedtime.
- Avoid nose picking and keep fingernails short
Article written by Sue Gaston, M.D.