Is this your child's symptom?
- Bleeding from 1 or both nostrils
- Not caused by an injury
If NOT, try one of these:
What to Do
Select the First Symptom that Applies
Call 911 Now
- Passed out (fainted) or too weak to stand
- You think your child has a life-threatening emergency
Go to ER Now
- Bleeding a lot after 20 minutes of squeezing the nose correctly
Call Doctor or Seek Care Now
- Nosebleed that won't stop after 10 minutes of squeezing the nose correctly
- Large amount of blood has been lost
- New skin bruises or bleeding gums not caused by an injury also present
- High-risk child (such as with low platelets or other bleeding disorder)
- You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
- You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
- Age under 1 year old
- New onset nosebleeds happen 3 or more times in a week
- Hard-to-stop nosebleeds are a frequent problem
- Easy bleeding is present in other family members
- You have other questions or concerns
Self Care at Home
- Mild nosebleed
Care Advice for Nosebleed
- What You Should Know About Nosebleeds:
- 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 nose bleeds, buy some decongestant nose drops. An example is Afrin. No prescription is needed. Put 3 drops on the gauze and press. The nose drops also shrink the blood vessels in the nose.
- Caution: don't use decongestant nose drops if your child is under 1 year of age.
- 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.
- Prevent Recurrent Nosebleeds:
- If the air in your home is dry, use a humidifier to 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. It may heal slowly and re-bleed. If that happens to your child, try this tip. Apply a small amount of petroleum jelly (Vaseline) to the spot. Repeat twice a day. Do not use for more than 2 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.
- Call Your Doctor 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
Causes and Background Information
Causes of Nosebleeds
Nosebleeds are common because of the rich blood supply of the nose. Common causes include:
- Spontaneous Nosebleed. Most nosebleeds start up without a known cause.
- Rubbing. Rubbing or picking the nose is the most common known cause. It's hard to not touch or rub the nose.
- Blowing. Blowing the nose too hard can cause a nose bleed.
- Suctioning. Suctioning the nose can sometimes cause bleeding. This can happen if the suction tip is put in too far.
- Sinus Infections. The main symptoms are lots of dry snot and a blocked nose. This leads to extra nose blowing and picking. The sinus infection is more often viral than bacterial.
- Nose Allergies. The main symptom is a very itchy nose. This leads to extra rubbing and blowing.
- Dry Air. Dryness of the nasal lining makes it more likely to bleed. In the winter, forced air heating often can dry out the nose.
- Allergy Medicines. These help the nasal symptoms, but also dry out the nose.
- Ibuprofen and Aspirin. These medicines increase the bleeding tendency. Aspirin is not used in children.
- Bleeding Disorder (Serious). This means the blood platelets or clotting factors are missing or not working right. A bleeding disorder should be suspected if the nosebleed can't be stopped. Excessive bleeding from the gums or with minor cuts is also a clue. Bleeding disorders are a rare cause of frequent nosebleeds.
Copyright 2000-2018. 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.