Doctors’ Notes

Nosebleeds

Nosebleeds can be scary for both parents and children. They are, however, very common and rarely seroius.

Facts

Nosebleeds in children usually occur between 2 to 10 years of age. Some preschoolers have several a week. This is neither abnormal nor worrisome. Nosebleeds in infants, however, are unusual and require evaluation in our office.

Though most nosebleeds in children are spontaneous and occur infrequently, some children may experience more frequent, recurrent nosebleeds. 90% of nose bleeds in children originate in the front part of the nose. If blood flows down from the back of the nose into the mouth and throat, your child may swallow it, which may cause her to vomit.

Causes

There are many causes of nosebleeds, most of which aren’t serious. Beginning with the most common, they include colds, allergies, and nose-picking. A cold or allergy causes swelling and irritation inside the nose and can lead the nose to bleed. Often a child gets nosebleeds from trauma such as picking his nose, putting something into it, blowing it too hard, getting hit in the nose by a ball or other object, or from a fall. Another common cause of nosebleeds is dry air in the home; the lining of your child’s nose may dry out, making it more likely to bleed.

Much less common causes of nosebleeds are exposure to toxic fumes, anatomical problems inside the nose, abnormal growths inside the nose, or a clotting disorder. If there is an abnormal growth in your child’s nose, it ‘s usually a polyp, which is benign and can be easily treated. If your child may have nosebleeds if she has a chronic disease that may require oxygen or on other medications that can dry out the nose.

Treatment

There are many misconceptions about how to treat nosebleeds. Follow these easy steps and you’ll do great:

Remain calm. A nosebleed can be frightening, but is rarely serious.

Keep your child in a sitting or standing positions.

Tilt his head slightly forward. Have him gently blow his nose if he is old enough.

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 can do this himself.Don’t release the nose during this time to see if it is still bleeding.

Release the pressure after ten minutes and wait, keeping your child quiet.

If the bleeding hasn’t stopped, repeat this step. If after ten more minutes of pressure the bleeding hasn’t stopped, call your pediatrician or go to the nearest emergency department.

Don’t…

Panic. You’ll just scare your child.

Have him lie down or tilt back his head.

Stuff tissues, gauze, or any other material into your child’s nose to stop the bleeding.

Call Us If…

You think your child may have lost too much blood. (But keep in mind that the blood coming from the nose always looks like a lot.)

The bleeding is coming only from your child’s mouth, or he’s coughing or vomiting blood or brown material that looks like coffee grounds.

Your child is unusually pale or sweaty.

911 if unresponsive.

She has a lot of nosebleeds, along with a chronically stuffy nose. This may mean she has a small, easily broken blood vessel in the nose or on the surface of the lining of the nose, or a growth in the nasal passages. If a blood vessel is causing the problem, we may cauterize that blood vessel to stop the bleeding.

Prevention

If your child gets a lot of nosebleeds, you can use saline nasal sprays every day. Doing so may be particularly helpful if your house is dry. Use of a humidifier or vaporizer will also help prevent nasal drying. And, of course, tell your child not to pick his nose.

As always, if your child is not getting relief from these helpful tips, or if you want to talk about your child’s nosebleeds further, call the office any time for an appointment.

Dr. Ditte Karlovits joined Kids Plus in 2012.