Weiss Pediatric Care

Nosebleed

Definition

  • Bleeding from 1 or both nostrils
  • Not caused by an injury

Call or Return If

  • Can't stop bleeding with 10 minutes of direct pressure done correctly
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Causes

  • Nosebleeds are common because of the rich blood supply of the nose. Common causes include:
  • Dryness of the nasal lining. In the winter, forced air heating often can dry out the nose.
  • Allergy medicines (Reason: Dry out the nose)
  • Vigorous nose blowing
  • Ibuprofen and aspirin (Reason: Increases bleeding tendency)
  • Suctioning the nose can sometimes cause bleeding
  • Picking or rubbing the nose
  • Factors that make the nasal lining more fragile. Examples are nasal allergies, colds and sinus infections.

After Care Advice

Overview:
  • Nosebleeds are common.
  • You should be able to stop the bleeding if you use the correct technique.
  • Here is some care advice that should help.
Squeeze the Lower Nose:
  • Gently squeeze the soft parts of the lower nose together. Gently press them against the center wall for 10 minutes. This puts constant pressure on the bleeding point.
  • Use the thumb and index finger in a pinching manner.
  • If the bleeding continues, move your point of pressure.
  • Have your child sit up and breathe through the mouth during this procedure.
  • If rebleeds, use the same technique again.
Put Gauze Into the Nose:
  • If pressure alone fails, use a piece of gauze. Wet it with a few drops of water. Another option is to put a little petroleum jelly (such as Vaseline) on it.
  • Insert the wet gauze into the side that is bleeding. Press again for 10 minutes. Reason it works: The gauze puts more pressure on the bleeding spot.
  • Special nose drops: If your child has lots of nosebleeds, buy some decongestant nose drops. An example is Afrin. No prescription is needed. Put 3 drops on the gauze, insert and press. These nose drops also shrink the blood vessels in the nose.
  • Caution: don't use decongestant nose drops if your child is younger than 1 year.
  • If you don't have gauze, use a piece of paper towel.
  • Repeat the process of gently squeezing the lower soft parts of the nose. Do this for 10 minutes.
Prevention of Recurrent Nosebleeds:
  • If the air in your home is dry, use a humidifier. This will keep the nose from drying out.
  • For nose blowing, blow gently.
  • For nose suctioning, don't put the suction tip very far inside. Also, move it gently.
  • Do not use aspirin and ibuprofen. Reason: Increases bleeding tendency.
  • Bleeding areas in the front of the nose sometimes develop a scab. The scab may heal slowly and re-bleed. If that happens to your child, try this: Apply a small amount of petroleum jelly (Vaseline) to the spot. Repeat twice daily for a few days.
What to Expect:
  • Over 99% of nosebleeds will stop if you press on the right spot.
  • It may take 10 minutes of direct pressure.
  • After swallowing blood from a nosebleed, your child may vomit a little blood.
  • Your child may also pass a dark stool tomorrow from swallowed blood.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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