Thankfully, for most children, nosebleeds (aka epistaxis) are a benign and self-limited condition caused by a cold, allergies or excessively dry air. A little help from the common habit of nose picking amongst our youngest set typically sets things in motion.
- Dry/windy conditions: Winter is a common trigger for nosebleeds. Indoor air is typically dry and causes the mucosal lining in the nose to dry out and hence leave those tiny capillaries in the nose prone to bleeding.
- Cold/allergies: Anything that causing the mucosa to become inflamed and irritated will increase the chance of bleeding. Repeated upper airway infections and/or seasonal allergies do this and leave a child prone to nosebleeds.
- Trauma: Nose picking is a common nosebleed trigger as are mild facial traumas such as a ball to the face.
- Foreign body: Young children have been known to stick a thing or two in their noses. If this is the case (think a small bead) your child may only bleed from one side and it may be accompanied by persistent foul smelling discharge.
- Other unusual causes are medications, a chronic illness, a blood clotting disorder or a nasal tumor.
Treatment (what to do)
- Stay calm and know that you can handle it.
- Have your child sit on your lap or right next to you and apply firm pressure to the soft part of her nose, not the bony part.
- Make sure she sits with her head tilted slightly forward, not back. This way she won’t swallow any blood which could cause her to vomit and/or feel particularly nauseous.
- Maintain pressure for 10 minutes before letting go. If nose is still bleeding, apply pressure for another 10 minutes. Most nosebleeds stop within this time frame. If not, seek medical attention.
- If your child is prone to nosebleeds whenever a cold hits or when the air gets cold and dry, try running a cool mist humidifier in the room he sleeps in. This will help keep the nasal mucosa moist instead of dry and irritated.
- Discourage nose picking and keep those little nails nice and trimmed.
- Apply an antibiotic ointment or Vaseline around and inside the nasal opening.
- Use normal saline nose drops 1-2 times per day to keep nose moist and clear away mucus and congestion.
When to worry
- Nosebleed in a child less than 2 years old. In this age group, nosebleeds can indicate a foreign body, intentional injury or medical issue.
- A nosebleed that does not respond well to applied pressure as described above.
- A nosebleed in conjunction with significant head trauma.
- Nosebleeds while on a new medication or associated with other physical symptoms such as easily bruising.
Dr. Mom’s bottom line
^Nosebleeds, while scary to look at, are generally not harmful to your child and can be prevented and easily treated at home. If your child seems to get them frequently (more than once per week) ask about the possible need for ENT evaluation.