Ask an ENT: Nosebleeds in Kids

What causes frequent nosebleeds in children?

So many things can contribute to a bloody nose—which happens when tissues inside the nose bleed because of a broken blood vessel. Some causes of bloody nose are behavioral and some are environmental and seasonal. Let’s look at the basics:

• Weather and temperature: Oh, the Northeast and its erratic weather patterns. Chilly winters are a huge culprit, especially when the air is dry, freezing and “biting.” Nosebleeds during winter are very, very common in both kids and adults. If you live in a dry or high-altitude climate (like Colorado), they can happen at any time of year.
• Indoor air quality: Dry heat is a major ingredient in recipes for nosebleeds. Dry heat can cause drying, crusting and cracking inside the nose. More on what to do about this later.
• Nose picking: Gross, but true: frequent nose picking can lead to frequent nosebleeds. Teach your child to not pick their nose and reinforce that doing so can cause sickness because fingers are full of germs and nasal passages are sponges that soak them up. #themoreyouknow.
• Blowing nose too hard: Forceful nose-blowing can rupture those nasal membranes and cause bleeding. Key word here? Gentle.
• Seasonal allergies: Seasonal allergies can cause dryness, irritation, and increased nose blowing, all of which can contribute to nosebleeds.

Are my child’s nosebleeds a symptom of something more serious?

Most likely not, but keep an eye on your child’s nosebleeds to rule out anything serious. Call your doctor if you:

• Cannot stop your child’s nosebleed within 20 minutes or if it keeps happening over and over again.
• Notice facial or head injuries in addition to your child’s nosebleed.
• Think the amount of blood is very significant.
• Observe that your child feels faint or has trouble breathing.
• See that your child is bleeding elsewhere like in the stool or urine.
• Feel that your child bruises easily (Don’t Google.)
• See that the nosebleeds always come from one side.

What is the best way to stop my child’s nosebleed? 

First, be calm for both of your sakes. Then:

• Have your child sit up straight and lean forward slightly. Don’t have them lie down or put their head between their knees as this can make symptoms worse;
• Try pinching the nostrils closed for five minutes (do not pinch the bridge or “bony part”). Do it gently—and avoid stopping and checking because that will only prolong the nosebleed;
• Hold a cold compress to the bridge of their nose, and;
• Finally, resist the temptation to stuff the nose with tissues or gauze. This will cause further irritation (and more nosebleeds).

What can I do to prevent or improve my child’s nosebleeds?

Here are some at-home remedies for nosebleeds you can try:

• Saline drops or gel: Using saline just a couple times a day can help keep the nasal passage moisturized—nosebleeds don’t like moisture! Saline gel may be easier for smaller children to tolerate. 
• Run a cool-mist humidifier at their bedside: If the air inside is dry, this can be a life saver. Remember to follow the instructions for cleaning exactly to avoid germ and mold buildup.
• Apply petroleum jelly inside the nostril: Use the pad of your finger to push the ointment towards the septum (the cartilage that divides the nose into two sides), or if your child is able, encourage them to apply it themselves. Don’t go too far up.
• Stay hydrated—always. Encourage your kids to listen to their body when they feel thirsty and drink plenty of water. It can only help.

A nosebleed can look a bit scary, but again, it’s usually it’s not a sign of anything serious. Of course, follow your parental instinct and always call your child’s pediatrician or ENT if you’re at all concerned. As always, please dial 911 in a true emergency.