Caring for Your Child’s Nosebleed

Nosebleeds aren’t just the result of an unfortunate run-in with the playground bully. While a knock to the nose certainly can cause a bleed, nosebleeds usually occur when the protective lining of the nose is dry or irritated. Most often they are caused by picking, blowing too hard or breathing dry air.

Here are some other causes of nosebleeds:

• Colds and allergies can cause swelling and irritation inside the nose, which can sometimes cause bleeds.
• In colder months, your child is especially susceptible. Turning on the heat causes the moist lining of the nose to dry out, leaving the blood vessels in the nose vulnerable.
• Children with chronic illnesses who require extra oxygen or use medication that can dry out the inside of the nose are more susceptible to nosebleeds.

How to stop a nosebleed

Applying a few basic first-aid measures will usually quickly take care of the problem:

• Stay calm and keep the child calm. The sight of blood can be scary, but remember nosebleeds are often not serious and there is no cause for alarm. Reassure your child that she will be fine.
• Keep the child in an upright position with her head slightly forward. Do not tilt the child’s head back; this can cause her to choke on the blood or swallow blood which can lead to vomiting.
• Apply pressure. Most of the time, gently pinching the nostrils shut for 10 minutes will stop the bleeding. Keep the nostrils closed for the full 10 minutes. Try not to check and see if its working until the full time has elapsed. If the nose is still bleeding after 10 minutes, repeat this step.
• Do not put ice on the nose or neck. This will not stop the bleeding; it will only make the child uncomfortable.
• Wash the face gently afterward, but don’t scrub the nose area.
• Keep the inner nose moist  for the next few days. Use saline nasal spray, a cool mist humidifier or vaporizer in the bedroom. Discourage your child from picking his nose or blowing his nose too hard.

When nosebleeds need more attention

Rarely do nosebleeds require a visit to the doctor. However, if your child experiences the following, you should call his pediatrician:

• Has trouble breathing.
• Faints or looks pale and sweaty, or is unusually tired or weak.
• Has had some kind of head trauma.
• The bleeding doesn’t stop within 20 minutes.
• Has recurring nosebleeds. While children who have had a nosebleed are likely to have more over the next few days, recurring nosebleeds should be checked out by a doctor.
• Might have a broken nose due to injury.
• Might have a foreign object in the nose. Children often stick small objects up their noses (a favorite is peas). If your child’s nosebleed is accompanied by a foul-smelling yellowish-green discharge from one nostril, there is a good possibility there is something stuck up there.
• Has blood in his stool, urine, ears, throat or gums.
• Has abnormal skin bruising.

Contributed by: Patrick S. Pasquariello, MD