Nose Bleeding in Children

Nose Bleeding in Children

Nosebleeds are common in kids between 2 to 10 years old, and most are caused by nose-picking or dry air. They can be scary, but are rarely cause for alarm. Most will stop on their own and can be easily managed at home. Persistent, recurring, or very heavy bleeding may require medical attention. Doctors refer to nosebleeds as epistaxis. Around 60 percent of people will experience a nosebleed at some point during their life. However, nosebleeds occur most commonly in children aged between 2 and 10 years.

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. 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.

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 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 nose bleeding in children last for longer than 8 to 10 minutes routinely, your pediatrician may wish to test for a blood clotting disorder.

What is Nose Bleeding in Children?

A nose bleeding is bleeding from tissues inside the nose i.e. nasal mucus membranes caused by a broken blood vessel. The medical word for nosebleed is epistaxis. Most nosebleeds in children occur in the front part of the nose close to the nostrils. This part of the nose has many tiny blood vessels. These can be damaged easily.

Nosebleeds can look scary, but is usually not a serious problem. Nose bleeding in children are common. They happen more often in dry climates. They also happen more during the winter. That’s when dry heat in homes and buildings can cause drying, cracking, and crusting inside the nose. Many children outgrow nosebleeds during their teen years.

Nosebleeds can be anterior or posterior. An anterior nosebleed is the most common, with blood coming from the front of the nose. It is caused by the rupturing of tiny blood vessels inside the nose, known as capillaries. A posterior nosebleed comes from deeper inside the nose. This kind of nosebleed is unusual in children, unless it’s related to a face or nose injury.

Causes of Nose Bleeding in Children

Nosebleeds often caused by harmless activities such as your child picking their nose, blowing it too hard or too often, or from getting knocked on the nose during play. Other causes of a nosebleeds may include:

  • overly sensitive blood vessels that burst and bleed in warm, dry weather
  • infections in the nose, throat and sinuses i.e. common cold
  • allergies i.e. dust mite allergy or hay fever
  • a foreign body in the nose i.e. when a child has pushed something up their nose
  • constipation i.e. excessive straining when going to the toilet
  • certain medications i.e. anti-inflammatory medicines or nose sprays
  • an underlying medical problem, but this is very uncommon.
  • Bacterial infection - Bacterial infections can cause sore, red, and crusted areas on the skin just inside the nose and in the front of the nostrils. These infections can lead to bleeding.
  • Trauma - When a child gets an injury to the nose, it can start a nosebleed. Most are not a problem, but you should seek medical care if you are unable to stop the bleeding after 10 minutes or you are worried about the injury as a whole.
  • Dry air - Whether it’s heated indoor air or a dry climate, the most common cause of nosebleeds in children is dry air that both irritates and dehydrates nasal membranes.

Less common causes include:

  • conditions that affect bleeding or blood clotting, such as hemophilia
  • certain medications, including blood thinners
  • heart disease
  • high blood pressure
  • cancer

Sometimes, children can have multiple nosebleeds over a several weeks. Frequent nosebleeds are caused by problems relating to blood clotting or abnormal blood vessels. If a child is experiencing nosebleeds that are not related to the causes listed above, consult your doctor.

Who are at risk of Nose bleeding?

A child may be more at risk for nosebleed if he or she:

  • Lives in a dry climate
  • Picks his or her nose
  • Has allergies
  • Has a cold

Symptoms of Nose bleeding

The main symptom of a nosebleeds is blood dripping or running blood from the nose. Bleeding from the mucus membranes in the front of the nose comes from only one nostril. Bleeding higher up in the nasal cavity may come from both nostrils. It may be painless. Or your child may have pain caused by an injury or an area of sore tissue inside the nose. The symptoms of a nosebleed can be like other health conditions.

What to do when you see nose bleeding in children?

A person can usually treat a child's nosebleed at home. It is important to stay calm because most nosebleeds are short-lived and do not indicate a serious problem. To treat a child with a nosebleeds:

  • Start by sitting the child down and reassuring them. Have them sit upright and leaning slightly forward.
  • Do not lean the child back or lie them down because this can cause them to swallow the blood and may lead to coughing or vomiting.
  • Gently pinch the tip of the child's nose between two fingers using a tissue or clean towel and have them breathe through their mouth.
  • Do not keep removing your fingers to check if the bleeding has stopped. The blood needs to clot and this takes time. Reading a book can be a good distraction for your child. Have a clock handy so you can be sure 10 minutes has gone by.
  • Continue to apply pressure for around 10 minutes, even if the bleeding stops.
  • If your child can tolerate it, place a cool towel or covered icepack on the back of their neck while they sit on your lap.
  • Offer your child an icy pole or cold drink to cool them down and get rid of the taste of blood.
  • Encourage your child to spit out any blood that has dripped from their nose into their mouth. Swallowing blood may make your child vomit, which can cause the nosebleed to continue or worsen.

Note: Do not fill the child's nose with gauze or tissue and avoid spraying anything into the nose.

When to consult a doctor?

Children with nosebleeds do not typically require medical attention. Most nosebleeds are short-lived, and it is usually possible to treat the child at home. However, talk to a doctor if:

  • bleeding occur frequently
  • it change from a familiar pattern to a new one
  • occur alongside chronic congestion or other signs of easy bleeding or bruising
  • begin after the child starts taking a new medication
  • regularly require a trip to the emergency room
  • it occurs following a head injury, fall, or blow to the face
  • the child also has an intense headache, a fever, or other concerning symptoms
  • the child's nose appears misshapen or broken
  • the child shows signs of having lost too much blood, such as looking pale, having little energy, feeling dizzy, or passing out
  • the child begins coughing up or vomiting blood
  • the child has a bleeding disorder or is taking blood thinners

Medical Treatment for Nose bleeding in children

Children with severe nosebleeds should see a healthcare professional. Treatment options for nosebleeds include:

  • applying silver nitrate to blood vessels to seal them
  • cauterizing, or burning, the blood vessels to seal them
  • packing the nose with medicated gauze to constrict the blood vessels

After stopping the bleeding, a doctor will examine the child to determine the cause. In some cases, the child may require surgery to fix a problem with the blood vessels in the nose.

Tips for Preventing Nosebleeds

Since most nosebleeds in children are caused by nose-picking or irritation from hot dry air, using a few simple tips may help your kids avoid them:

  • Keep your child's nails short to prevent injuries from nose-picking.
  • Keep the inside of your child's nose moist with saline nasal spray or gel, or dab antibiotic ointment gently around the opening of the nostrils.
  • Run a cool-mist humidifier in bedrooms if the air in your home is dry. Keep the machine clean to prevent mildew buildup.
  • Make sure your kids wear protective athletic equipment during sports or other activities that could cause a nose injury.
  • Teach your child not to pick his or her nose or blow it too hard.
  • Talk with your child's healthcare provider if your child has allergies that may lead to nosebleeds.
  • Don not smoke in the home or around your child.

Even with proper precautions, kids can still get a bloody nose occasionally. So if your child gets a nosebleed, try not to panic. They are usually harmless and are almost always easy to stop.

Allie Leon, Chief Fun Officer

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