Nosebleeds

What to Do:

• Stay calm and reassure your child.
• With your child upright in a chair or in your lap, tilt his or her head slightly forward.
• Gently pinch the soft part of the nose (just below the bony ridge) with a tissue or clean washcloth.
• Keep pressure on the nose for about 10 minutes; if you stop too soon, bleeding may start again.
• Do not have your child lean back. This may cause blood to flow down the back of the throat, which tastes bad and may cause gagging, coughing, or vomiting.
• Have your child relax a while after a nosebleed. Discourage nose-blowing, picking, or rubbing, and any rough play.

Call the Doctor if Your Child:

• has frequent nosebleeds
• may have put something in his or her nose
• tends to bruise easily
• has heavy bleeding from minor wounds or bleeding from another place, such as the gums
• recently started taking new medicine

Seek Emergency Care or Call the Doctor if Bleeding:

• is heavy, or is accompanied by dizziness or weakness
• is the result of a fall or blow to the head
• continues after two attempts of applying pressure for 10 minutes each

Different Kinds of Nosebleeds

The most common kind of nosebleed is an anterior nosebleed, which comes from the front of the nose. Capillaries, or very small blood vessels, inside the nose may break and bleed, causing this type of nosebleed.

A posterior nosebleed comes from the deepest part of the nose. Blood flows down the back of the throat even if the person is sitting or standing. Kids rarely have posterior nosebleeds, which occur more often in older adults, those with high blood pressure, and people who have had nose or face injuries.

Causes and Remedies

The most common cause of anterior nosebleeds is dry air. A dry climate or heated indoor air irritates and dries out nasal membranes, causing crusts that may itch and then bleed when scratched or picked. Colds also may irritate the lining of the nose, and bleeding can occur after repeated nose-blowing. When you combine a cold with dry winter air, you have the perfect formula for nosebleeds.

Allergies also can cause problems, and a doctor may prescribe medications such as antihistamines or decongestants to control an itchy, runny, or stuffy nose. This can also dry out the nasal membranes and contribute to nosebleeds.

An injury or blow to the nose can cause bleeding and usually is not a serious problem. If your child ever has a facial injury, use the tips outlined to stop a nosebleed. If you can't stop the bleeding after 10 minutes or you are concerned about other facial injuries, take your child to see a medical professional right away.

Nosebleeds are rarely cause for alarm, but frequent nosebleeds might indicate a more serious problem. If your child gets nosebleeds more than once a week, you should contact your doctor. Most cases of frequent nosebleeds are easily treated. Sometimes tiny blood vessels inside the nose become irritated and don't heal. This happens more frequently in kids who have ongoing allergies or frequent colds. A doctor may have a solution if your child has this problem.

If bleeding is not due to a sinus infection, allergies, or irritated blood vessels, the doctor may order other tests to see why your child is getting frequent nosebleeds. Rarely, a bleeding disorder or abnormally formed blood vessels could be a possibility.

Preventing Future Nosebleeds

Since most nosebleeds in kids are caused by nose picking, or irritation due to hot dry air, using a few simple tips may help your kids avoid them in the future.

To help prevent nosebleeds:

• Keep your child's nails short to prevent injuries from nose-picking.
• Keep the inside of your child's nose moist with saline nasal spray or dab antibiotic ointment gently around the opening of the nostrils.
• Humidify bedrooms with a vaporizer (or humidifier) if the air in your home is dry. Look for a cool mist model, as a hot steam humidifier could scald a child. Keep the machine clean to prevent mildew build-up.
• Make sure your kids wear protective athletic equipment when participating in sports that could cause a nose injury.

Even when taking proper precautions, kids can still get a bloody nose occasionally. So the next time your child gets a nosebleed, try not to panic. They're usually harmless and are almost always easy to stop.

Reviewed by: Kate M. Cronan, MD
Date reviewed: January 2011