Nosebleeds in Children

Nosebleeds are a condition commonly seen in children. Most cases resolve spontaneously and represent nothing more than a nuisance to the parent and child. Occasionally nosebleeds become persistent and may require specific treatment. In rare instances, a nosebleed may be the presenting symptom of a serious local or generalized disease.

Nosebleeds are often the result of extremely dry nasal linings, which lose the protective layer of mucus. This leads to the tissue becoming fragile which then has a tendency to bleed following the slightest trauma. Nosebleeds are most common during the winter because of the increased incidence of colds leading to swollen nasal tissues with enlarged blood vessels. In addition, central heating during the winter tends to dry the nasal linings.

When a nosebleed occurs, it is important to help the child to remain calm. Then:

  1. Pinch all the soft parts of the nose together between your thumb and the side of your index finger or soak a cotton ball with Afrin, Neo-Synephrine, or Dura-Vent spray and place this into the nostril
  2. Press firmly but gently with your thumb and the side of your index finger toward the face, compressing the pinched parts of the nose against the bones of the face
  3. Hold that position for a full five minutes by the clock
  4. Keep the head higher than the level of the heart. Sit up or lie back a little with the head elevated
  5. Apply ice – crushed in a plastic bag or washcloth – to the nose and cheeks

More severe cases with frequent bleeding and significant blood loss may require more aggressive treatment. A chemical cauterization (burning) of the enlarged blood vessels using a silver nitrate stick can be performed in the doctor’s office. If bleeding recurs after an attempt at local cautery, more aggressive measures may be required including electrical cautery or surgery to tie off the bleeding blood vessel is possible. Surgical intervention is extremely rare in children.