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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.


How Do I Stop A Nosebleed?

Have your child sit up and lean forward so as not to swallow the blood. Have a basin available. Have your child spit out any blood that drains into the throat. Use salt water nose drops (Ocean, Ayr) to loosen large clots that might interfere with applying pressure to the nose to stop the bleeding. Swallowed blood is irritating to the stomach and may cause your child to vomit.

Apply pressure to the soft part of your child's nose. Tell your child to breathe through the mouth and pinch the soft parts of the nose (just above the openings of the nose) against the center wall for 10 minutes. Do not release the pressure until 10 minutes are up. If the bleeding continues, you may not be pressing on the right spot.

If the nosebleed does not stop, use salt water nose drops and squeeze again. Use a Q-tip and coat the cotton tip with Vaseline. Insert the Q-tip into the nose only as far as the cotton tip and coat the inside lining of the nose. Squeeze the soft part of the nose again for 10 minutes. If bleeding persists, continue the pressure and call our office.


How Do I Prevent Further Nosebleeds?

The following steps can help lessen nosebleeds:
  • Apply a small amount of vaseline to the center wall (septum) inside the nose 2-4 times a day to help relieve dryness and irritation.
  • Increase the humidity in your child's bedroom at night by using a humidifier.
  • Children will commonly scratch at their nose, especially when they have a runny nose. Apply a topical antibiotic cream (polysporin) at the entrance of the nasal openings. This will lessen the itching and scratching.
  • Get your child into the habit of putting two or three drops of salt water nose drops in each nostril before blowing a stuffy nose.
  • If your child has nasal allergies, treating them with nonprescription antihistamines helps break the itching-bleeding cycle.
  • Do not give your child aspirin. One aspirin can increase bleeding for up to a week and can make nosebleeds last much longer than they would otherwise.

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.
  • Pressing on the bony part of the nose will not stop a nosebleed.
  • Do not pack the nose with gauze or cotton, because bleeding usually recurs when the gauze is removed.

Call our office immediately if:
  • The bleeding does not stop after 20 minutes of direct pressure.
  • Your child faints or complains of feeling dizzy when standing 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 vaseline and humidification.
  • Your family has a history of easy bleeding.
  • You have other concerns or questions.

Adapted from Barton D. Schmitt, MD


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