The nose has a rich blood supply and nosebleeds (or expistaxis) are very common in children. They are often caused by dryness of the nasal lining, coupled with the normal rubbing and picking that all children do when their noses are blocked or itchy. Vigorous nose blowing or nasal suctioning can also cause bleeding. Children who have nasal allergies are more likely to have nosebleeds because they rub and blow their noses more often. Antihistamines can also dry the nose and result in bleeding. In addition, being hit in the nose or other injuries may cause nosebleeds. Fortunately, you should be able to stop the bleeding if you use the correct technique.
Over 99% of nosebleeds will stop following 10 minutes of direct pressure if you press on the right spot.
- Have your child sit up, lean forward (not backward), and spit out any blood. Swallowed blood is irritating to the stomach. Don't be surprised if your child vomits a small amount of blood or passes a dark stool the following day.
- Gently pinch the soft part of the lower nose between your thumb and forefinger for 10 minutes. If your child is old enough, teach him how and where to hold his own nose. Have your child breathe through his mouth. Don't release the pressure for a full 10 minutes. If the bleeding continues, you may not be pressing on the right spot. Readjust your pressure point and try again.
- If the bleeding persists, insert a gauze covered with petroleum jelly (Vaseline or Aquaphor) or water-based jelly (K-Y) into the nostril. Squeeze again for 10 minutes. Leave the gauze in for another 10 minutes before you remove it. If bleeding still continues, call your child's healthcare provider while continuing to hold pressure in the meantime.
- A cold washcloth applied to the face will not help stop nosebleeds.
- Pressing on the bony part (bridge) of the nose will not be effective in controlling the bleeding.
- Help the area heal by applying a small amount of petroleum jelly twice a day to the center wall inside the nose (the septum) with a cotton swab.
- Use a humidifier to reduce the dryness of the air in your home.
- Loosen up dried mucus. Get your child into the habit of putting 2 or 3 drops of warm water or nasal saline drops in each nostril prior to blowing a stuffy nose.
- Avoid certain medications. Aspirin can increase the tendency of the body to bleed easily for up to a week and can make nosebleeds last much longer.
- Treat your child’s nasal allergies. Talk to your doctor about optimizing treatment for allergic symptoms to break the itching-bleeding cycle and to minimize trauma to the nasal lining.
- Avoid exposure to nasal irritants, especially cigarette smoke.
Seeking Medical Care
- Call immediately if the bleeding does not stop after 30 minutes of direct pressure.
- Call during office hours if nosebleeds are a frequent problem or if you have additional concerns or questions.