Few things cause a parent to jump out of their chair faster than seeing their child with a face full of blood. It’s graphic. It’s scary. It causes a visceral reaction in both parent and child. The good news is, nosebleeds in kids are common and usually harmless. (The bad news is that shirt may never be the same again.)
Anyone can get a nosebleed, including teenagers and adults—but they tend to be most common in kids ages three to 10, says Baltimore paediatrician Ashanti Woods. Why? Because kids are nose-pickers. That’s right, one of the main causes of nosebleeds is shoving a finger up there. (I can attest to this by the not one, but two times my toddler used a swift finger up my nose as my wake-up call.)
“Most nosebleeds are caused by nasal trauma—picking the nose, frequent blowing of the nose, or a direct injury or blow to the nose such as dodgeball,” says Woods. “The nose is full of very fragile blood vessels so sometimes even rubbing it from outside too vigorously (as in the case of seasonal allergies) can lead to a bloody nose.”
Dry air can also irritate the lining of the nose and cause a nosebleed. Just as your skin is more prone to cracking and bleeding when it is dried out, so is your nose. When the lining is dry, minor rubbing or scratching is enough to start a bleed.
Unfortunately, like vomit and snot, nosebleeds are one of those unpleasant childhood experiences that you’re likely to get the joy of experiencing. So, what should a parent do if their child has one? “Apply pressure [by] to the front—or soft—part of the nose for 10 minutes,” says Woods. Contrary to popular lore, do not lean your kid’s head back. Instead, sit them up and lean their head slightly forward. This prevents too much blood from being swallowed and causing gagging or vomiting. Woods also suggests applying a cool pack to the nose, but only after or while the nose is pinched. This can help lower inflammation and tighten blood vessels.
Reassure your child through this process. Seeing blood can be scary for them and you—and your face may inadvertently reveal your shock or discomfort. Keeping your child calm during a nosebleed will help you to apply constant, uninterrupted pressure for ten minutes. Children should refrain from strenuous activity and from blowing their nose after a nosebleed to avoid re-opening the newly clotted blood vessels.
Nosebleeds are typically more of a nuisance than a medical emergency, and most can be treated at home without the need for a doctor’s visit. But there are some circumstances that do warrant medical attention.
“If a child experiences multiple nosebleeds a week for multiple weeks, then a doctor should be alerted,” says Woods. “Also, if a child has a history of bruising easily, or there is a family history of bleeding disorders, you should see a doctor.”
You should seek immediate medical attention if the nosebleed is from a serious fall or injury, if there is significantly more blood than you would expect, if it doesn’t stop after two attempts of holding the nose closed for 10 minutes, or if your child is feeling dizzy, weak or is having difficulty breathing.
Most of the time, nosebleeds are not indications of anything more than the fragile blood vessels in the nose being injured. “However, if a child’s nosebleed refuses to stop it can be a sign of a bleeding disorder, or infection due to foreign body (such as a bead), or a growth in the back of the nose that needs to be investigated by a specialist,” says Woods.
Thankfully, there are ways to help prevent nosebleeds in the first place. Start by encouraging your kid to keep their fingers out of there, and keep your kid’s nails trimmed to lessen the damage if the finger inevitably goes a-digging.
If you live in a dry environment and you think that’s the source of the nosebleeds, using a cool-mist humidifier in the house can help. Or go straight to the source and use saline nasal drops or spray (but not nasal decongestants) two to three times a day. Applying a bit of petroleum jelly to the inside of your child’s nose using a cotton swab can also help.
Take it easy with the nose-blowing—too rigorous or too frequent blowing can cause nosebleeds, too.
You can also have your child screened for seasonal allergies. “Untreated seasonal allergies lead to frequent nose manipulation (sneezing, rubbing, picking) and can, therefore, lead to nosebleeds,” says Woods. “[Under] parents can consider a trial of seasonal allergy medicines (oral liquids or nasal sprays) to see if a child’s nasal symptoms of stuffy nose and runny nose subside. By doing this, the nose will be touched less and may prevent a nosebleed.” Some allergy medication is approved for children as young as six months, but not all medication is appropriate for every age. Check with your child’s doctor before starting any medication, and check labels carefully.
Woods adds you should make sure saline and allergy medication sprays are administered properly, or else the spray itself can cause a nosebleed. “It should be inserted to the nostril and angled to the ear on the same side as that nostril, and then sprayed.”
No one likes a nosebleed, but if your child wanders into the room looking like they have gone a round with Rocky Balboa—don’t panic. Stay calm, pinch the soft part of the nose for 10 minutes, and then replace that poor shirt.