Everything You Need to Know About Nosebleeds in Children
Nose bleeds are very common in young children. Kidspot’s resident GP Dr Sam Hay explains what causes the outburst of blood from the nose and worrying signs parents need to look out for.
Most people hate the sight of blood. And when it’s splattered across your child’s face, dripping copiously onto their pristine Sunday-best jumper, parents panic. Nosebleeds in children are quite common, which means parents need to be prepared.
Most nosebleeds in children are short-lived and the bleeding minor, with everything settling down within minutes. Whilst it looks like an unbelievable amount of blood – soaking tissues and covering clothes – it’s incredibly rare to lose a dangerous amount of blood. In fact, it’s usually only a few dessert spoons full, and when you consider your kids have a few litres of blood flowing round their system, the amount they lose is inconsequential.
Even if your kids have a few bleeds over a few days or weeks, the chances of them losing a dangerous amount of blood, leading to issues such as anaemia or iron deficiency, is extremely low. In fact, it would only be possible if they are getting frequent nosebleeds over months.
What causes nosebleeds in children?
I don’t care what anyone says – all kids (and dads) are nose pickers! And if they pick their nose, they’re sure to get a nose bleed from time to time. But there’s more to it than simply sticking fingers up noses.
Most nosebleeds are related to insignificant activities – a knock in the playground, nose picking, or even using tissues too vigorously or often. The nosebleed, known in the medical word as epistaxis, occurs when the fragile small blood vessels inside the nose burst. Just inside the nose, lining the central septum, are a bunch of small fragile blood vessels that sit really close to the surface – we call this Little’s Area. They are super delicate, which means even the smallest amount of trauma can cause them to rip, tear and bleed.
Decent knocks and bumps are obvious, but what are the other factors that contribute to nosebleeds in children?
Colds and infections
Any nasal or sinus infection will cause Little’s Area to inflame and become sensitive, hence prone to more bleeds. But it’s the excess snot that causes the biggest problem. Wandering fingers or vigorous tissue use causes the dry snot to rip apart the underlying blood vessels.
Change in weather
Hot dry conditions tend to dry the lining of the nose out, which causes Little’s Area to become more delicate and fragile, allowing it to crack and bleed more easily. The same goes for air conditioning.
Constipation or coughing
Over straining will increase pressure inside the tiny blood vessels, increasing the chances they will pop.
Chronic allergic rhinitis leads to chronic inflammation and snot issues inside the nose.
Things that shouldn’t be up there
Kids love to poke stuff up their nose! I’ll never forget extracting a fluffy craft ball from my little one’s nose in the middle of the night.
Other medical issues
These are uncommon, so please don’t panic mums and dads! But if your kids are also struggling with multiple bruises, especially with the simplest knocks and bumps, then your doctor may need to consider other problems, including blood clotting disorders.
How to perform first aid on a nosebleed in children
Nosebleeds cause distress for all, especially kids when they see and taste all the blood. But nosebleeds in children aren’t painful.
Try your best to settle your child (and dad) down, because kicking and screaming will only make bleeding worse.
Get them to sit down, leaning forward, so any bleeding simply drips down onto the ground. This also stops them from swallowing too much blood.
Squeeze the soft front part of the nose firmly together, holding just in front of the boney bridge. Kids can do it once old enough, but they must be squeezing firmly enough.
Don’t let go! You need to keep squeezing for ten minutes. This ensures the bleeding stops properly the first time, as it takes many minutes for the blood to clot and block the blood vessels.
After 10 minutes gently have a squiz. If there’s still bleeding – don’t panic. Start another 10 minutes of squeezing.
Ask your kids to spit out any blood that ends up in the mouth. Swallowed blood can lead to vomiting which will only make the blood nose worse.
An ice pack or cold towel across their neck can help to make them feel more comfortable and may also speed things up.
Give them a cold drink or icy pole to suck on. By clearing the taste of blood you’ll help with their distress.
After the bleed settles, keep kids quiet for a day or so, avoiding unnecessary knocks and bumps. Avoid hot foods, drinks, showers, and baths, as they may promote any clotting to break off. And definitely stop them from picking or blowing their nose for a few days.
When you need a trip to the doctor
If after 30-40 minutes of squeezing the bleeding won’t stop, you’ll need to get them checked out.
Your GP or hospital doctor can examine the nose and identify culprit broken blood vessels. Once identified they can consider some further treatments, such as specialist ointments or cauterisation, a process where the vessel is gently frozen or burnt to stop it from bleeding.
Sometimes the nose needs to be packed with gauze to keep the blood vessels closed, or antibiotics prescribed to treat any infection.
What if your child keeps getting nosebleeds?
Some kids are prone to regular nosebleeds, and the great news is there’s usually no reason for panic. Probably the most important strategy, after stopping kids (and dad) from picking their nose, is to keep the inside of the nose well moisturised. Applying petroleum or paw-paw based ointments into the nose to keep Little’s Area moist and protected, stopping it from drying and cracking. This can be done with a cotton tip or the end of your pinky finger, gently wiping the ointment over the middle part of each nostril. After applying, gently squeeze and massage the nose, allowing the ointment to spread and cover the fragile blood vessels.
If that still doesn’t work, then take your kids to the GP for a check-up. Consider earlier review if they also suffer other bleeding or bruising issues, or if you can’t conquer any constipation.
There’s no doubt nosebleeds are a rite of passage for kids, they’re all going to get them. The greatest majority will settle with super basic strategies, and if you look after that nose, you’ll easily stop them flaring up all the time. Good luck mums and dads.
If you’re concerned about your child’s health, please speak to your local health practitioner for advice.
This article was first published in KidSpot and republished on theAsianparent with permission.