What to Do About Nosebleeds

Nosebleeds are very common throughout childhood. They often begin unexpectedly, even during sleep. They are usually caused by dryness of the nasal lining plus the normal rubbing and picking that all children do when the nose becomes blocked. Vigorous nose blowing can also cause bleeding. All of these behaviors are increased in children with nasal allergies.

Home Care

Have your child spit out any blood that drains into his throat. Tell him to sit up and lean forward so he does not have to swallow the blood. Have a basin available. Have him blow his nose to get rid of any large clots that might interfere with applying pressure to the nose to stop the bleeding. Swallowed blood is irritating to the stomach. Don’t be surprised if your child vomits it up.
Apply pressure to the soft part of the child’s nose. Tell your child to breathe through her mouth and squeeze the soft parts of the nose against the center wall for 10 minutes. Don’t release the pressure until 10 minutes are up. If the bleeding continues, you may not be pressing on the right spot.

If the nosebleed doesn’t stop, use nose drops and squeeze again. Insert a piece of gauze covered with vasoconstrictor (decongestant) nose drops, such as Neo-Synephrine, into the nostril. If you don’t have nose drops, coat the gauze with petroleum jelly. Squeeze the soft part of the nose again for 10 minutes. Leave the gauze in for another 10 minutes before removing it. If bleeding persists, call our office but continue the pressure in the meantime.

Take steps to prevent future nosebleeds

The following steps can help avoid nosebleeds:

• Apply a small amount of petroleum jelly to the center wall (septum) inside the nose twice a day to help relieve dryness and irritation.
• Increase the humidity in your child’s bedroom at night by using a humidifier.
• If your child picks his nose a lot, help him give up this habit or at least make him more aware of it. With his permission, have him put an adhesive bandage on his index finger each morning as a reminder. Also, cut his fingernails weekly.
• Get your child into the habit of putting two or three drops of warm water in each nostril before blowing a stuffy nose.
• Don’t give your child aspirin. One aspirin can increase the tendency of the body to bleed easily for up to a week and can make nosebleeds last much longer than they would otherwise.
• If your child has nasal allergies, treating them with nonprescription antihistamines helps break the itching-bleeding cycle.

Avoid these common mistakes. Applying a cold washcloth to the forehead, back of the neck, or underneath the upper lip does not help stop a nosebleed. Nor does pressing on the bony part of the nose. Do not pack the nose with materials such as gauze or cotton, because bleeding usually recurs when they are removed.

Call Our Office Immediately If:

• The bleeding does not stop after 20 minutes of direct pressure.
• Your child faints or complains that she feels dizzy when she stands up.
• Your child acts or looks very sick.
• Your child has any skin bruises or mouth bleeding not caused by an injury.

Call During Regular Hours If:

• Your child is under 1 year of age.
• Nosebleeds occur daily even after you use petroleum jelly and humidification.
• Your family has a history of easy bleeding.
• You have other concerns or questions.