About Nosebleeds in Children
Although they can be scary, nosebleeds (also known as Epistaxis) are rarely a cause for alarm. They are common in children ages 3-10 years. Since most nosebleeds in children are caused by nose picking or irritation due to hot dry air, using a few simple tips may help children avoid them in the future.
Caring for Nosebleeds
How to stop the bleeding
- Stay calm and reassure the child.
- With the child upright in a chair or the caregiver’s lap, tilt the child’s head slightly forward. 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, and/or vomiting.
- Gently pinch the soft part of the nose with your thumb and forefinger (just below the bony ridge) with a tissue or clean washcloth.
- Keep pressure on the nose for about 10-15 minutes. If you stop too soon the bleeding may start again. If the bleeding does not stop, make sure you are putting pressure on the right spot.
- If the bleeding does not stop, parents may use Afrin nose spray for children greater than 6 years of age. The Afrin can be used twice a day for no more than 3 days in a row.
- You may use prescription medication such as Amicar or tranexamic acid if it has been prescribed by the hematologist or Hemophilia Treatment Center.
- Have your child relax for a while after the nosebleed. Discourage nose blowing, picking, rubbing, or any rough play.
- If bleeding continues for more than 30 minutes, your child needs to be seen in the Emergency Department for further evaluation.
Preventing Nosebleeds
- Keep the inside of your child’s nose moist with Saline Nasal Gel which can be bought over the counter, e.g. AYR gel or with Vaseline, coconut or olive oil. Dab gently around the base of the opening of the nostrils.
- Encourage fluids so your child can stay well hydrated.
- Humidify bedrooms if the air in the home is dry. This is especially important when the outside air is dry or during winter months when heaters are on. Either warm or cool mist humidifiers are fine.
- Make sure the child wears protective athletic equipment when participating in sports that could cause a nose injury.
- Avoid aspirin, ibuprofen and other NSAIDs as these medicines can make bleeding worse.
- Take precautions such as keeping the nails short and filed.
When To Call Our Office
For children with recurrent nosebleeds despite using moisture preventions, sometimes they may need to see an Ear, Nose and Throat specialist. Sometimes, the child may need a nasal cautery procedure which can be done in the office or the operating room depending on their age. The procedure may help decrease the frequency of nosebleeds, but it is rarely a cure, so it is important to continue doing the things mentioned in the prevention section.
Nasal Cautery – Post Procedure: Sometimes the nose will continue to have some bleeding after the procedure. It should decrease with time. Follow the same precautions as listed above to help the nose stay moist and clot properly if there is a bleed. Follow up with ENT (next available appointment) for recurrent nosebleeds.
Call 858-309-7701 to make an appointment. If your child has a known bleeding disorder, talk to your hematologist/oncologist about how to optimize your blood count or other medications you may need to prevent recurrent bleeding. Please take your child to the Emergency Department if you are unable to stop nosebleeds for more than 30 minutes.
For after-hours emergency or on weekends, call the hospital operator at 858-576-1700 and ask to speak with the hematologist on-call.
For more information about nosebleeds, download the PDF below: