Even slight damage to the delicate mucous membrane lining of the nose can rupture tiny blood vessels and cause
bleeding. Babies rarely have nosebleeds, but toddlers and school-aged children often do. Fortunately, most children outgrow this common but rarely serious event by the time they are teens. A tendency for nosebleeds often
runs in the family. Many children have nosebleeds for no apparent reason.
A nosebleed usually comes on suddenly, with blood flowing freely from one nostril. A child who has nosebleeds at night may swallow the blood in his sleep. He will vomit it up or pass it in his stools later. Most nosebleeds stop by themselves within a few minutes. For persistent (won't go away) bleeding, see
Chronic Nosebleeds: What to Do.
Nosebleeds are unlikely to signal serious illness, although bleeding can result from injury. Children may cause bleeding by
picking their noses; toddlers often injure the nasal membranes by forcing objects into their nostrils. Children are especially prone to nosebleeds during colds and in the winter months when the mucous membranes become dry, cracked, and crusted or when a chronic condition such as
allergic rhinitis (hay fever) damages the membrane.
A child with a chronic illness that causes forceful coughing, such as
cystic fibrosis, may have frequent nosebleeds. And parents of children with clotting disorders such as hemophilia or von Willebrand disease, should be vigilant about harmful habits such as nose-picking. If your child's nosebleeds last for longer than 8 to 10 minutes routinely, your pediatrician may wish to test for a blood clotting disorder.
Call Your Pediatrician Right Away If:
- Your child is pale, sweaty, or not responding to you.
- You believe your child has lost a lot of blood.
- Your child is bleeding from the mouth or vomiting blood or brown material that looks like coffee grounds.
- Your child's nose is bleeding after a blow or injury to any part of the head.
Consult your pediatrician before giving your child medicated nose drops or nasal sprays to treat problems that affect the nose and respiratory passages. Although sold over-the-counter for the relief of congestion, some medications may actually increase congestion after a few days' use. This increased congestion is known as the rebound effect, and can be even more uncomfortable and difficult to treat than the original problem. For a natural nose spray, try using a saline, salt water spray.
Stopping a Nosebleed
Stay calm; the nosebleed is probably not serious, and you should try not to upset your child. Your child will pick up on your emotional cues.
Keep your child sitting or standing and leaning slightly forward. Don't let him lie down or lean back because this will allow blood to flow down his throat and might make him vomit.
Don't stuff tissues or another material into the nose to stop the bleeding.
Firmly pinch the soft part of your child's nose—using a cold compress if you have one, otherwise your fingers—and keep the pressure on for a full 10 minutes. Don't look to see if your child's nose is bleeding during this time; you may start the flow again.
If bleeding hasn't stopped after 10 minutes, repeat the pressure. If bleeding persists after your second try, call your pediatrician or take your child to the nearest emergency department.
While most nosebleeds are benign and self-limited, a child with severe or recurrent bleeding or bleeding from both nostrils should be evaluated by a pediatrician. If necessary, your child will be referred to a
pediatric otolaryngologist (ENT) specialist.