What causes nosebleeds in kids?

Kids can get nosebleeds if they:

• pick at their noses
• bump their noses or blow their noses too hard
• get foreign objects stuck up their noses
• have allergies
• get infections in their noses, throats or sinuses
• use medicines like nose sprays incorrectly
• strain to do poos when they’re constipated
• have irritated noses because of dry air.

Rare causes of nosebleeds include bleeding disorders and other underlying medical conditions.

The medical term for a bleeding nose is epistaxis.

When should you worry about a nosebleed?

Nosebleeds are very common in kids. Some children get a lot of nosebleeds, and they’re usually nothing to worry about.

With a nosebleed, it helps to remember that although it might look like a lot of blood, usually there isn’t that much.

When should you take your child to the doctor or hospital for a nosebleed?

You should take your child to your GP or local hospital emergency department if they have a nosebleed that hasn’t stopped after 20 minutes, despite firm pressure on the nose.

You should take your child to see your GP if your child:

• has a bleeding nose and is also generally unwell, looks pale or has unexplained bruises on their body
• is younger than 2 years old and has a bleeding nose
• has repeated nosebleeds over several weeks
• has more than 5 nosebleeds a year that require a trip to hospital.

How to stop a nosebleed

The first step to stopping a nosebleed is to stay calm. This will help settle your child if they’re upset by the sight and taste of blood. Crying can make the nosebleed worse.

Then the next step is to apply firm pressure with your finger and thumb on the sides of the nostrils (the soft part of the nose, not the bony part). If the bleeding is coming from only one side of the nose, you can apply firm pressure with 2 fingers along the nostril on that side.

Continue this for 10 minutes with your child sitting up and keeping their head still and slightly tilted forward. Don’t lie your child down or tilt their head back. Wait the full 10 minutes. Don’t keep checking to see whether the bleeding has stopped.

If your child’s nose is still bleeding after 10 minutes of pressure, repeat the process for another 10 minutes.

If the bleeding stops

Discourage your child from blowing or picking their nose for about 24 hours. This will strengthen the blood clot that has stopped the bleeding from the blood vessel in their nose.

Your child might vomit during or after a nosebleed if they’ve swallowed some blood. To prevent this, encourage your child to spit out blood during the nosebleed, rather than swallowing it.

If the bleeding won’t stop

If you can’t stop the bleeding with the treatment steps above, you should take your child to the GP or hospital emergency department.

The doctor might put a spray, cream or ointment up your child’s nose to stop the bleeding.

The doctor might also pack a special cloth dressing into your child’s nose. This can help to stop the bleeding. When the dressing is removed, the doctor might then be able to see where the bleeding is coming from.

Sometimes, doctors use a special chemical to seal off the bleeding and ‘freeze’ the blood vessel. Doctors usually use a local anaesthetic before this procedure. The anaesthetic might be sprayed into your child’s nose or placed using a dressing.

Very rarely, your child might need to see an ear, nose and throat specialist and go into hospital for treatment.

What to do after a nosebleed

After your child has had a nosebleed, discourage your child from picking or blowing their nose.

After a severe nosebleed, ensure your child rests over the next 24 hours. Also keep your child out of hot baths or showers.

Treatments

Sometimes a doctor will recommend that your child uses a saline nasal spray or a lubricating or moisturising ointment to help with dryness. The doctor might also recommend using an antibiotic ointment. To apply these treatments, follow the instructions on the pack, or ask the GP or pharmacist.

How to prevent nosebleeds

If your child’s nose is dry, you can gently rub saline gel on the inside of your child’s nostrils each day for up to a week. You can buy saline gel over the counter at a pharmacy.