What Can I Do About My Child’s Chronic Nosebleeds?

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Starting with your child’s preschool years and continuing into adolescence and the teenage years, he/she is almost certain to have at least one nosebleed, perhaps even several. (Some children have several a week.) Although nosebleeds can be alarming and yes, messy, we at Westchester Health Pediatrics want you to know that they are neither abnormal nor dangerous. We’ve seen plenty of nosebleeds through the years and we’re ready to help you and your child when they happen.

Causes of nosebleeds

A wide range of factors can cause nosebleeds, most of which are not serious. These include:

  1. Colds and allergies: A cold or allergy causes swelling and irritation inside the nose and may lead to spontaneous bleeding.
  2. Trauma: A child can get a nosebleed from picking his/her nose, or putting something into it, or just blowing it too hard. A nosebleed can also result from being hit in the nose by a ball or other object, or from falling hitting the nose.
  3. Low humidity or irritating fumes: If your house is very dry, or if you live in a dry climate, the lining of your child’s nose may dry out, making it more likely to bleed. In addition, if he/she is frequently exposed to toxic fumes, this can cause nosebleeds.
  4. Anatomical problems: Any abnormal structure inside the nose can lead to crusting and bleeding.
  5. Abnormal growths: Abnormal tissue growing in the nose may cause bleeding. Although most of these growths (usually polyps) are benign, they still should be evaluated promptly by your child’s pediatrician.
  6. Abnormal blood clotting: Anything that interferes with blood clotting can lead to nosebleeds. Medications, even common ones like aspirin, can alter the body’s blood-clotting mechanism just enough to cause bleeding. Blood diseases, such as hemophilia or platelet disorders, also can provoke nosebleeds.
  7. Chronic illness: A child with a long-term illness, or who requires extra oxygen or other medication that can dry out or affect the lining of the nose, is likely to have nosebleeds.

The best way to treat nosebleeds

In our many years of treating young patients, we’ve all heard our share of misconceptions and folktales about how to treat nosebleeds. To set the record straight, we’ve compiled this list of dos and don’ts.

Do:

  1. Remain calm. A nosebleed can be scary, for you and your child, but is rarely serious.
  2. Keep your child in a sitting or standing position. Tilt the head slightly forward and have your child gently blow his/her nose if old enough.
  3. Pinch the lower half of your child’s nose (the soft part) between your thumb and finger and hold it firmly for a full ten minutes. If your child is old enough, he/she can do this him/herself. Do not release the nose to see if it is still bleeding. After ten minutes, release the pressure and wait, keeping your child quiet. If the bleeding has not stopped, repeat this step. If after ten more minutes of pressure, the bleeding has still not stopped, call your pediatrician or go to the nearest emergency department.

Don’t:

  1. Panic. This will just scare your child more.
  2. Have your child lie down or tilt back the head.
  3. Stuff tissues, gauze or any other material into your child’s nose to stop the bleeding.

Call your pediatrician if:

  1. You think your child may have lost too much blood. (Keep in mind that blood coming out of the nose always looks like a lot.)
  1. Blood is coming from your child’s mouth, or he/she is coughing up or vomiting blood or brown material that looks like coffee grounds.
  1. Your child is unusually pale or sweaty or is not responsive. Call your pediatrician immediately in this case and take your child straight to the emergency room.
  1. Your child has a lot of nosebleeds, along with a chronically stuffy nose. This may signal a broken blood vessel in the nose or on the surface of the lining of the nose, or a growth in the nasal passages.

What you can do to prevent your child’s nosebleeds

If your child is prone to a lot of nosebleeds:

  1. Keep the inside of the nose moist. Nasal dryness can cause nosebleeds. An over the counter nasal saline spray or gel may be used daily as often as needed.
  2. Use a vaporizer or humidifier. Your child’s nostrils might be dry because the air in your house is dry. A humidifier or vaporizer will help maintain your home’s humidity at a level high enough to prevent nasal drying.
  3. Don’t smoke. Smoking (including secondhand smoke) can irritate the inside of the nose and dry it out.
  4. Don’t pick the nose. Also, don’t blow or rub it too hard. If your child is getting nosebleeds, keep his/her fingernails short and discourage him/her from picking his/her nose.
  5. Don’t use allergy nose sprays too often. These can also dry out the nose. In some cases, certain medications can cause nosebleeds or make them worse so discuss all medications with your child’s doctor.

Concerned about your child’s nosebleeds? Come see us.

If your child is experiencing a lot of nosebleeds, please come in and see one of our Westchester Health Pediatrics pediatricians. Together, we’ll figure out the best treatment and prevention plan to get your child back on track without nosebleeds. Whenever, wherever you need us, we’re here for you.

Make an apptBy Heather Magnan, MD, a Westchester Health Pediatrics pediatrician.

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About the Author: ML Ball