Nosebleeds can be very common – with most children experiencing at least one during their early years. Some younger children can even have several per week! This is not dangerous or uncommon, but any bleeding can be scary. Nosebleeds can even cause vomiting, if the blood flows down into your child’s mouth and throat and they swallow a large amount of it.
Causes
Most of the numerous causes of nosebleeds are not serious. Starting with the most common:
- Colds & Allergies – Colds and allergies cause swelling and irritation inside the nose and can lead to spontaneous bleeding.
- Trauma – Nosebleeds can occur when the nose is hit or scratched such as nose picking, putting something in the nose, blowing the nose too hard, being hit in the face by a ball or other object, or falling and hitting the nose.
- Low Humidity or Irritating Fumes – If the air in your home or climate is very dry, your child’s nose lining may dry out and become more susceptible to bleeding. Also, if they are frequently exposed to toxic fumes such as cigarette smoke, bleach, or ammonia, that may cause nosebleeds as well.
- Anatomical Problems – If your child’s nose has any abnormal structure, this can lead to crusting and bleeding.
- Abnormal Growths – Growths in the nose can cause bleeding. Most of theses growths (such as polyps) are benign (not cancerous), but they still should be treated immediately.
- Abnormal Blood Clotting – Some medications, such as ibuprofen, can interfere with normal blood clotting which can lead to nosebleeds. There are also blood diseases, such as hemophilia, that can provoke and worsen nosebleeds.
- Chronic Illness – Children with long-term illnesses, or those who may require extra oxygen or other medications that can dry out the lining of the nose, are more likely to have nosebleeds.
Treatment
There are a lot of misconceptions and old wives tales about how to treat a nosebleed. Here are a few Dos & Don’ts:
Do:
- Stay calm – nosebleeds are scary, but very rarely dangerous.
- Keep your child upright and tilt their head slightly forward.
- Pinch the soft bottom part of your child’s nose and hold it firmly for at least 10 minutes. If your child is older, they can do this part themselves. Don’t release the nose during these 10 minutes to see if it has stopped bleeding. Stopping the pressure can interfere with the forming of the clot that will stop the bleeding.
- Release pressure after 10 minutes and wait. Make sure your child stays quiet and still. If the bleeding hasn’t stopped, hold pressure again. If another 10 minutes passes and the bleeding hasn’t stopped, keep holding pressure and call your pediatrician or go to the emergency room.
Don’t:
- Don’t panic! This can scare your child and make things worse.
- Don’t let them lay down or tilt their head backwards.
- Don’t stuff anything in the nose to stop the bleeding such as tissues, gauze, etc.
Call your pediatrician if:
- You think your child has lost too much blood or keeps bleeding heavily after applying pressure. (Remember, blood coming from the nose always looks like a lot!)
- The bleeding is also coming from your child’s mouth, or they’re coughing or vomiting up blood or brown material that looks like coffee grounds.
- Your child is abnormally pale and sweaty. In this case, call your pediatrician right away and arrange for your child to go to the emergency room. Call 911 anytime your child is unresponsive.
- Your child has chronic nose bleeds along with a chronically stuffy nose that never seems to go away. This could be a sign of a small, easily broken blood vessel in their nose, on the surface of the lining of their nose, or a growth in their nasal passage.
If a blood vessel is causing the problem, your pediatrician may treat that area with a chemical substance (silver nitrate) to stop the bleeding.
Prevention
If your child deals with chronic nosebleeds, ask your pediatrician about using saline (saltwater) nose drops every day and/or using a small amount of petroleum jelly in each nostril at night to help prevent them from getting too dry if you live in a dry climate. A humidifier or vaporizer can also maintain your home’s humidity enough to prevent nasal drying. Remind your child not to pick their nose!
If you child has more than 5 nosebleeds per year, or the bleeding lasts more than 10 minutes, your pediatrician may refer you to a pediatric ENT (ear, nose, and throat doctor) to test for a bleeding disorder.