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When Your Child Has Nosebleeds

Side view of child leaning head back and pinching bridge of nose. Red X indicates not to do this. Side view of child leaning head forward and pinching bridge of nose.
Leaning back is the wrong way to stop a nosebleed. Instead, have your child lean forward and apply pressure to the nostrils.

Nosebleeds (epistaxis) are common in children. They rarely mean a serious problem. Nosebleeds in the front part of the nose are the more common in young children and usually easy to stop. Bleeding usually occurs in a single nostril only. A newborn baby with nosebleeds may need to see an ear, nose, and throat (ENT) doctor. 

Nosebleeds in the back part of the nose, near the throat, are less common in children than nosebleeds in the front. A nosebleed that occurs deeper in the nose often comes out of both nostrils. It's harder to stop. These can be more serious and cause a lot of blood loss.

Children can sometimes have nosebleeds in their sleep. You can treat most nosebleeds at home. And you can take steps to help your child prevent them.

What causes nosebleeds?

The skin inside your child’s nose is very delicate. It's filled with many tiny blood vessels. That’s why even a small injury can bleed a lot. The most common causes of nosebleeds in children include::

  • Nose picking or frequent rubbing of the nose

  • Putting a foreign object in the nose

  • Dryness inside the nose

  • Allergies, colds, or other upper respiratory infections

  • Certain medicines

  • Injury to the nose

  • Abnormal tissue growths such as polyps

How are nosebleeds treated?

Nosebleeds are easy to treat at home. With correct treatment, most nosebleeds will stop in less than 5 to 10 minutes.

Keep the following list of do’s and don’ts in mind.

Based on the age of your child, the cause of their nose bleed, or both, the healthcare provider will tell you how to care for your child's nosebleed. Always call the provider to discuss your child's nosebleeds.

DO

  • Keep your child calm and comfort them. Make sure they are breathing through their mouth normally.

  • Have your child sit or stand and lean their head forward (NOT backward). This keeps blood from pooling at the back of the throat, where it may be swallowed. If your child appears to be swallowing blood or has a lot of blood in the mouth, have them spit the blood out. If swallowed, it can lead to vomiting.

  • Ask older children to gently blow their nose. Then squeeze the lower third (soft part) of the nose with your thumb and forefinger. Younger children may not understand how to blow gently.

  • Continue squeezing the nose for 5 to 10 minutes without looking to see if bleeding has stopped.

  • If bleeding continues, repeat the step above by squeezing the nose for 5 to 10 minutes on the lower third of the nose without looking to see if bleeding has stopped.

  • You can also put a cold compress or ice pack to the "bony" bridge of the nose.

  • If the bleeding doesn't stop, contact your child's healthcare provider right away or go to the emergency room or urgent care clinic.

  • Once the bleeding stops and a clot forms, discourage rubbing or blowing the nose for several days. This will allow the blood vessels to heal.

  • Wash your hands carefully with soap and clean, running water after taking care of your child’s nosebleed.

  • Let your child sit down if they want, but don’t let them lie down during a nosebleed.

  • Your child may wish to take it easy for the rest of the day after a nosebleed.

  • Contact your child's healthcare provider before giving your child any over-the-counter medicine, especially for the first time.

DON’T

  • Don’t have your child to lie down, tilt their head back or place their head between the knees during the nosebleed. This is not needed, and may even make the nosebleed worse.

  • Don’t give your child aspirin.

  • Don't give your child a pain reliever. If your child needs one, call your healthcare provider.

  • Don't smoke or allow others to smoke in the home or around your child.

If nosebleeds happen often

If your child is having nosebleeds often, take them to see their healthcare provider or a doctor who specializes in treating ears, noses, and throats (ENT). Your child may need a saline (special saltwater) nasal spray, nasal gel, or nasal ointment to moisten the inside of the nose, especially in the winter. Follow all instructions when using these on your child. In some cases, the healthcare provider may need to do a quick procedure to keep the vessels from bleeding. 

How are nosebleeds prevented?

To help prevent nosebleeds in your child:

  • Use a nasal gel or nasal ointment to moisten the inside of the nose, especially in the winter. Use these products on the inside of your child’s nose before bedtime.

  • Try to keep your child from frequently rubbing their nose. 

  • Try to keep your child from picking their nose. Nose picking is a common cause of nosebleeds.

  • Treat nasal allergies. This may help stop cycles of itching, picking or scratching, and bleeding. Contact your child's healthcare provider before giving them any over-the-counter medicine, especially for the first time.

  • Use a vaporizer to add humidity to the air, if the provider advises it. Clean and dry the humidifier daily to prevent bacteria and mold growth. Don't use a hot water vaporizer. It can cause burns.

  • Avoid smoking and exposure to secondhand smoke

When to call your child's healthcare provider

Call your child’s healthcare provider right away if your child has any of the following:

  • Nose that is still bleeding after 10 to 15 minutes of treatment listed above

  • Daily nosebleeds

  • New symptoms

  • Fever (see Fever and children, below)

Call 911

Call 911 or seek emergency care right away for any of the following:

  • Trouble breathing or chest pain

  • Not acting normally

  • Crying or fussing that can't be soothed

  • Bruising on the abdomen, backs of thighs, or buttocks. These are fleshy places that don’t normally bruise.

  • Small, flat purple spots (petechiae) anywhere on your child’s body

  • Pale skin or weakness anywhere in the body

  • Bleeding from a second area, such as the gums

  • Blood in the stool

  • Very heavy bleeding, with large clots visible

  • Bleeding that doesn't stop after 30 minutes of direct pressure or you can’t stop the bleeding

  • Multiple nosebleeds

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

© 2000-2020 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.