Nose Bleeding in Children

Children between the ages of three to ten are prone to nosebleeds. While it can look serious, in most cases it isn’t. It is important to know what to do when your child has a nosebleed, to help alleviate any symptoms. However, if your child has recurrent nosebleeds or if the bleeding doesn’t subside, you will need to consult a doctor immediately. Here is what you should know about nosebleeds in children.

Types of Nosebleeds

Nosebleeds, also known as epistaxis, are of two types:

1. Posterior Nosebleeds

Posterior nosebleeds are rare in children and tend to occur in adults with high blood pressure. Children may have this type of nosebleed only in the event of serious injury to the nose or face. Here the bleeding happens from deep inside the nose and the blood tends to flow down the throat even when the person is upright.

2. Anterior Nosebleeds

Anterior nosebleeds are where blood comes out of the thin, superficial blood vessels or capillaries that are in the front part of the nose. These are common in children and are harmless.

How to Stop Nose-Bleeding in a Child

If your child has nosebleeds, follow these steps.

• Make your child sit in an upright posture. He may lean forward but not backward, as it can cause the blood to flow into the throat.
• Apply ice to the outer walls of the nose and neck.
• Ask your child to spit out any blood that accidentally trickles towards the throat.
• If your child is old enough, ask him to gently press the soft bridge in the centre of the nose for 20-30 minutes with a tissue. If your child is too young, you will have to do this for him.
• In case the bleeding continues even after 30 minutes, seek medical assistance.

Causes of Epistaxis in Children

Nosebleeds can be caused due to many reasons. Some of them are:

• Allergies and cold may cause irritation and make the inside of the nose swell, rupturing the capillaries.
• Trauma caused due to acts like picking the nose, blowing the nose too hard or inserting some sharp into the nose can also result in nosebleeds. It can also occur if your child has injured his nose by falling or fractured the nasal bone.
• Bacterial infection can make the skin inside the nose red and sore, leading to bleeding.
• Dry air or low humidity is also a common cause of nosebleeds, as it irritates the membranes on the nose and causes dehydration.
• Anatomical problems can cause nosebleeds due to abnormal structures and growths inside the nose that cause crusting.
• Problems with blood clotting caused due to certain medications like aspirin or diseases like haemophilia can cause nosebleeds. However, this is very rare.
• Children with chronic illness and those who require additional oxygen or medications may have nosebleeds, as the lining of the nose is adversely affected in such cases.

Recurrent Nosebleeds in Kids

There is no fixed number of nose bleed events to be labelled as recurrent epistaxis. However, if your child has nosebleeds frequently, you will need to consult a doctor.

Recurrent nosebleeds may also happen if your child has a nose-picking problem. Frequent nose picking can make the lining of the nose irritated and expose the blood vessels, which then tend to rupture very easily.

How is the Diagnosis Done?

Diagnosis of nosebleeds includes a thorough physical examination to determine the underlying cause. A specially lighted scope will be used to check the insides of the nose, and a complete medical history should be provided to the doctor. Based on the physical examination, the doctor will determine the seriousness of the condition and the need for imaging like Xrays or CT scan or lab tests like blood tests and allergy tests.

Treating Child Nose Bleeding

Common nosebleeds can be stopped by applying direct pressure to the nose or to the bridge of the nose. In case of bleeds that don’t stop soon, you can apply ice to the bridge of the nose to decrease blood flow or use nasal sprays that shrink the blood vessels for a while.

How to Treat Recurrent Nosebleeds in Children

Here are some of the best ways to treat recurrent nosebleeds in children.

• Using humidifiers or vaporisers in the bedroom of your child can add moisture to the air and prevent drying of the nasal mucosa.
• Use of petroleum jelly or lanolin (wool wax) has not proven to be effective to prevent recurrent bleeds against no petroleum jelly use.
• Antibiotic ointments can be used if there is a sore or exposed blood vessel on the nasal septum.
• In case of more stubborn bleeds, an ENT may suggest cauterisation, where the skin around the bleed is burnt to prevent infection.

How to Prevent Nose Bleeding in Kids

To prevent bleeding from the nose in a child, ask your child to stop picking his nose and make sure you clip his nails to prevent injury to the nasal lining. You can also keep humidifiers in your child’s room to lower the chances of dry air. If your child gets frequent nosebleeds, you can also check with your doctor about using saline nose drops to maintain moisture in the nose.

When to Consult a Doctor

You will need to call the doctor if:

• The nosebleed occurred as a result of the insertion of a sharp object in the nose.
• You think that your child has lost a lot of blood.
• You notice bleeding on your child’s gums or other areas.
• Your child has started a new medicine.
• The child is pale and isn’t responding.
• The child has regular nosebleeds.

If you encounter nosebleeds in your child, don’t panic as most nosebleeds are virtually harmless. Follow the required steps to stop the bleeding. If it continues even after 20 minutes, you will need to take him to a doctor for further diagnosis. However, make sure not to panic, as that will only make your child worry.

Also Read: How to Clean Your Baby’s Nose