Nosebleeds

What are nosebleeds?

Nosebleeds are a common occurrence in childhood. They may occur from trauma to the nose, dry nasal passages on non-humid days, inflammation due to allergies, and, of course, nose picking. They may also occur for no particular reason that can be identified. These episodes of nosebleeding can be quite distressing for parents because just a few drops of blood can appear to be a deceptively large amount, so a nosebleed that lasts for five minutes may appear like the child is haemorrhaging.

What are the symptoms?

Bright red blood coming from the nose

What can/should be done at home

The most common reason for failing to stop a nosebleed is simply improper technique. When a nosebleed occurs:

  • Tilt the head slightly back and preferably keep the child upright, either standing or in a chair. Keeping the head higher than the heart will decrease the amount of blood pooling that can occur in tissues that have a lot of blood vessels, such as the nose. You want to stop the bleeding by applying pressure to the site of bleeding. Pinch about halfway up the nose, where the bone and cartilage meet. If pressure is applied only at the opening of the nose, you catch a lot of blood, but do not apply pressure in the correct spot. Keep pressure on the nose for at least ten minutes, and no peeking. This is where most adults fail because ten minutes can be a long time to hold pressure to the nose. It is difficult to resist the urge to ‘peek’ just to see if the bleeding has stopped. Each time this ‘peeking’ is done, the clot that was forming inside the nose gets ripped away, and bleeding may start again, giving the appearance of abnormal bleeding.

When to get immediate attention

Rarely, a child who has an underlying bleeding disorder may have frequent and severe nosebleeds without any other symptoms. There are clues that may support the idea of a problem causing these nosebleeds. If the answer to any of these questions is ‘yes’, tell your doctor:

  • Is the child taking any medication? Aspirin and aspirin-containing products can cause bleeding problems, as can other over-the-counter medications.
  • Have there been any other excessive bleeding episodes in the past? Bleeding problems from where the umbilical cord fell off, after having dental work or a tonsillectomy, or from otherwise minor cuts may be a clue to a bleeding problem. Children with bleeding disorders may also bruise rather easily or extensively.
  • Is there anyone in the family that has a bleeding disorder?
  • Is the nosebleeding always from both nostrils? In children with no bleeding tendency or family history of bleeding tendency, nosebleeds that usually occur on just one side are unlikely to be caused by a bleeding disorder. This absolutely does not mean that a nosebleed that occurs on both sides of the nose means there is a bleeding disorder. It just means that if it usually occurs on only one side, the likelihood of the nosebleed being from a bleeding disorder is rather remote.