Nosebleed

What is a nosebleed?

The nasal septum is the wall between the two nostrils and is rich in blood vessels. A nosebleed occurs when the septum is picked or knocked or gets too dry.

Nosebleeds are very common in children. Although the septum bleeds very easily, nosebleeds are usually not serious.

Blood vessels in the nose

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The nasal septum is the wall in the nose that divides the two nostrils. It is rich in blood vessels that can bleed very easily if the septum is picked or knocked or gets too dry.

Causes of nosebleeds

The most common causes of nosebleeds are:

• nose picking, which children often do when the air is dry and mucus inside the nose is dry and crusty
• air dryness, for example in an extremely dry climate or in indoor heat during the winter.

Less common causes of nosebleeds are:

• infections such as rhinosinusitis, which leads to inflammation and more frequent nose blowing
• bleeding or clotting disorders
• injuries to the nose
• foreign objects in the nose (for example small objects that small children can often stick up their nostril)
• drug use (for example anti-coagulants (medicines that prevent blood clotting), nasal sprays and some recreational drugs).

How you can help a child with a nosebleed

Although there may appear to be a lot of blood during a nosebleed, most nosebleeds are not life threatening and can be easily treated at home.

1. Stay calm. If you are calm, your child will calm down. This will make the nosebleed easier to treat.
2. Have your child sit upright in a chair or on your lap. Keeping the head above the heart slows the bleeding.
3. Have your child lean forward. This prevents blood from draining down the throat, which can irritate your child’s stomach or cause gagging or vomiting​. Do not let your child lean back until the bleeding is under control.
4. Using your thumb and index finger, gently squeeze the soft portion of your child’s nose. This is the area located above the nostrils and below the bony ridge that forms the bridge of the nose. Putting pressure on the nasal bones will not stop the nosebleed.
5. Pinch the nose for 10 to 15 minutes (without stopping). If you stop applying pressure too soon, the nose may start bleeding again.
6. Once the bleeding has stopped, have your child play quietly. Urge your child not to blow, pick, rub or sniff their nose for the next few hours.

How a doctor can help your child with a nosebleed

If your child is having repeated nosebleeds, your child’s doctor will examine them to find out where the bleeding is coming from inside the nose.

If the bleeding does not stop, the doctor may treat the bleeding with a medical procedure called nasal cautery. During cautery, the doctor uses a tool to chemically burn the area of the bleeding. This prevents further bleeding episodes.

How to prevent nosebleeds

• Clip your child’s nails short to prevent nose picking.
• If your home is very dry, try keeping a humidifier in your child’s room near the bed.
• Keep your child’s nasal septum moistened with lubricating creams or ointments such as petroleum jelly.
• If your child uses nasal sprays, try to spray them to the outer sides of the nostrils, not onto the septum.

When to see a doctor

See a doctor right away if:

• your child’s bleeding goes on for more than 20 minutes
• the bleeding is caused by a blow to the face, a fall or another type of injury.

Key points

• Nosebleeds occur when the wall between the two nostrils, called the nasal septum, is aggravated.
• Nose picking and air dryness are the most common causes of nosebleeds.
• To treat a nosebleed at home, lean your child’s head forward. Gently squeeze the soft part of your child’s nose for 10 to 15 minutes.
• To help prevent nosebleeds, use a humidifier in your child’s bedroom. Using creams on the nasal septum can also prevent dryness.