Clinical Reference Systems: Pediatric Advisor 10.0
Nosebleeds (epistaxis) are very common throughout childhood.
They are usually caused by dryness of the nasal lining plus
the normal rubbing and picking that all children do when the
nose is blocked or itchy. Vigorous nose blowing can also
cause bleeding. Children who have nasal allergies are more
likely to have nosebleeds because they rub and blow their
- Stopping the bleeding
- Lean forward and spit out any blood. Have your child
sit up and lean forward so he does not have to
swallow the blood. Have a basin available so he can
spit out any blood that drains into his throat.
Swallowed blood is irritating to the stomach. Don't
be surprised if it is vomited up.
- Apply pressure by squeezing the soft part of the nose.
- First your child should blow his nose to free any
large clots that might interfere with applying
pressure. Then tightly pinch the soft parts of the
nose against the center wall for 10 minutes. Don't
release the pressure until 10 minutes are up. If the
bleeding continues, you may not be pressing on the
right spot. During this time, your child will have
to breathe through his mouth.
- If bleeding continues, use vasoconstrictor nosedrops
and squeeze again. Insert a gauze covered with
vasoconstrictor nosedrops (for example, Neo-
Synephrine) or petroleum jelly into the nostril.
Squeeze again for 10 minutes. Leave the gauze in for
another 10 minutes before you remove it. If bleeding
persists, call your child's physician but continue
the pressure in the meantime.
- A small amount of petroleum jelly applied twice a day
to the center wall inside the nose (the septum) often
helps relieve dryness and irritation.
- Increasing the humidity in the room at night by using
a humidifier may also be helpful.
- Get your child into the habit of putting two or three
drops of warm water in each nostril before blowing a
- Avoid aspirin. One aspirin can increase the tendency
of the body to bleed easily for up to a week and can
make nosebleeds last much longer.
- If your child has nasal allergies, treating allergic
symptoms with antihistamines will help break the
- Common mistakes in treating nosebleed
- A cold washcloth applied to the forehead, bridge of
the nose, back of the neck, or under the upper lip
does not help stop nosebleeds.
- Pressing on the bony part of the nose does not help
- Try to avoid packing the nose with anything because
when it is removed, the nose usually starts bleeding
CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:
- The bleeding does not stop after 20 minutes of direct
pressure on the nose.
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- Nosebleeds are a frequent problem even after petroleum
jelly and humidification are used.
- You have other concerns or questions.
Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems