When to worry about a child’s nose bleed

How do you know when to worry about a child’s nose bleed? In this post, I’ll give some insight into nosebleeds in children.  Little kids’ noses can bleed a lot, and it can be scary for both the parent and the child. I see people come into the E.R. for nosebleeds all the time, but that’s not always necessary.  Most nosebleeds can be taken care of at home.

What can Dr. Mom do?

If your child is having a nosebleed:

• The first thing to do is stay calm. The kid is probably already scared from seeing blood coming out of their nose, so it’s best if they don’t also see mom or dad panicking.
• Put pressure on it. Like any cut or wound that you get anywhere else on the body, you want to put pressure on it to stop bleeding. Pinch the nose shut while you apply pressure for several minutes (not just 10 seconds).
• Have the child lean forward, not look upwards: When you’re pinching the child’s nose you don’t want the child looking up at the sky. You want them to lean forward like they’re blowing out birthday candles. By looking up, the blood can go down to the back of the throat and make the child gag or throw up the blood. That same blood that’s coming from the nose is going to come out in the vomit which scares people even more. They think that they’re throwing up blood from their stomach which is not true.
• Give it time: Like any other scrape on the body, nosebleeds need time to heal. The area has already been injured, so you should expect another nosebleed later that same day or the next.  Parents sometimes worry that their child is having multiple nosebleeds, but it usually is the same wound that just hasn’t fully healed and bled again.

To Prevent Nose Bleeds

There are some things you can do as a parent to prevent some nosebleeds.

• First make sure your kid is not a nose picker. That’s usually the number one culprit.
• Prevent your kids nose from getting too dry. Nose dryness will increase the likelihood of a nose bleed.  I recommend using nasal saline.  I have used this with my own family, and the number of nosebleeds has decreased.   You can get nasal saline over the counter.  I have found that nasal saline gel works better than the drops for nosebleeds because it’s a little bit thicker.
• A cool mist humidifier in the child’s bedroom is the second thing that I recommend.  Little kids will commonly get the nosebleeds in the middle of the night or during the morning dawn hours because they’ve been in their bedroom asleep under the vents of a blasting air conditioning or heater.  The dry environment from our HVAC commonly contributes to nose dryness and thus nosebleeds.

When should you go to the ER for Nosebleeds

Again, how do you know when to worry about a child’s nose bleed? You can go to the ER if the nosebleed doesn’t stop, meaning if you applied pressure for 10-15 minutes and blood is still gushing out.  Bleeding that stopped but then you have a big sneeze and a clot comes out? No ER necessary.  Under the weather with a cold and now having a little blood on your tissues with all the coughing and sneezing?  Go to your primary care doctor.  An adult on blood thinners and uncontrolled high blood pressure and a nosebleed that won’t stop?  Yes, please come to the ER (but please also take your blood pressure medication if you haven’t already done so).

If your child is having frequent nosebleeds that don’t seem to get better with simple measures of reducing nose-picking and providing a humid bedroom environment, then it’s time for a chat with their primary care doctor.  If a person is having frequent nosebleeds and gum bleeding and a lot of easy bruising on the skin, then it’s time for a chat with their primary care doctor.  And like always, if you have ANY concerns or further questions regarding the matter, it’s time for a chat with your primary care doctor!!