What causes nosebleeds?

The skin inside your child’s nose is very delicate. It's filled with many tiny blood vessels. That’s why even a small injury can bleed a lot. The most common causes of nosebleeds in children include:

• Nose picking or frequent rubbing of the nose.

• Putting a foreign object in the nose.

• Dryness inside the nose.

• Allergies, colds, or other upper respiratory infections.

• Certain medicines.

• Injury to the nose.

• Abnormal tissue growths, such as polyps.

How are nosebleeds treated?

Most nosebleeds are easy to treat at home with pressure. They usually stop in less than 5 to 10 minutes. If home treatment doesn't work, or if your child gets a lot of nosebleeds, they may need medical treatment from a doctor.

Keep the following list of do's and don’ts in mind.

DO

Leaning back is the wrong way to stop a nosebleed. Instead, have your child lean forward and apply pressure to the nostrils.

• Keep your child calm, and comfort them. Make sure they are breathing through their mouth normally.

• Have your child sit or stand and lean their head forward (NOT backward). This keeps blood from pooling at the back of the throat, where it may be swallowed. If your child appears to be swallowing blood or has a lot of blood in the mouth, have them spit the blood out. If swallowed, it can lead to vomiting.

• Ask older children to gently blow their nose. Then squeeze the lower third (soft part) of the nose with your thumb and forefinger. Younger children may not understand how to blow gently.

• Keep squeezing the nose for 15 minutes without looking to see if bleeding has stopped.

• If bleeding continues, repeat the step above by squeezing the nose for 10 to 15 minutes on the lower third of the nose without looking to see if bleeding has stopped.

• You can also put a cold compress or ice pack on the "bony" bridge of the nose.

• If the bleeding doesn't stop, contact your child's doctor right away or go to the emergency room or urgent care clinic.

• When the bleeding stops and a clot forms, discourage rubbing or blowing the nose for several days. This will allow the blood vessels to heal.

• Wash your hands carefully with soap and clean, running water after taking care of your child’s nosebleed.

• Let your child sit down if they want, but don’t let them lie down during a nosebleed.

• Your child may wish to take it easy for the rest of the day after a nosebleed.

• Contact your child's doctor before giving your child any over-the-counter medicine, especially for the first time.

DON’T

• Don’t have your child lie down, tilt their head back, or place their head between their knees during the nosebleed. This is not needed, and it may even make the nosebleed worse.

• Don't put gauze or tissues in your child's nose to stop the bleeding.

• Don’t give your child aspirin or ibuprofen.

• Don't give your child a pain reliever. If your child needs one, call your doctor.

• Don't smoke or allow others to smoke in the home or around your child.

If nosebleeds happen often

If your child is having nosebleeds often, take them to see their doctor or another provider who specializes in treating ears, noses, and throats (ENT). Your child may need a saline (special saltwater) nasal spray, nasal gel, or nasal ointment to moisten the inside of the nose, especially in the winter. Follow all instructions when using these on your child. In some cases, the doctor may need to do a quick procedure to keep the vessels from bleeding. 

How are nosebleeds prevented?

To help prevent nosebleeds in your child:

• Use a nasal saline gel or nasal ointment to moisten the inside of the nose, especially in the winter. Use these products on the inside of your child’s nose before bedtime.

• Try to keep your child from frequently rubbing their nose. 

• Try to keep your child from picking their nose. Nose picking is a common cause of nosebleeds. Keep their fingernails trimmed to reduce nose injury.

• Treat nasal allergies. This may help stop cycles of itching, picking or scratching, and bleeding. Contact your child's doctor before giving them any over-the-counter medicine, especially for the first time.

• Use a cool-mist humidifier to add humidity to the air, if the doctor advises it. Clean and dry the humidifier daily to prevent bacteria and mold growth. Don't use a hot water vaporizer. It can cause burns.

• Stay away from smoking and exposure to secondhand smoke.

When to call your child's health care provider

Contact your child’s doctor right away if your child's nose is still bleeding after the treatment listed above.

Call 911

Call 911 or get emergency care right away if your child:

• Has trouble breathing or has chest pain.

• Is not acting normally.

• Is crying or fussing and can't be soothed.

• Has bruising on the abdomen, backs of the thighs, or buttocks. (These are fleshy places that don’t normally bruise.)

• Has small, flat, purple spots (petechiae) anywhere on their body.

• Has pale skin or weakness anywhere in the body.

• Has a nosebleed after a head injury.

• Bleeds from a second area, such as the gums.

• Has blood in their stool.

• Has very heavy bleeding, with large clots visible.