Parents usually get scared when their kids get a nosebleed.
Fortunately, most nosebleeds aren’t serious. That doesn’t make them less scary when they are happening though, especially when it is your first or it doesn’t stop right away.
There are two things to understand about nosebleeds in kids. They are common and most of the things that you probably know about stopping them aren’t very helpful.
We no longer recommend tilting a child’s head back during a nosebleed, pinching the bridge of their nose, stuffing tissue into their nostrils, or holding a tissue lightly against their nostrils. Although your child’s nose will likely eventually stop bleeding with these methods, it will take a long time and it won’t be from any of those interventions.
When your child has a nosebleed, the best treatment advice is to:
- have your child sit down
- encourage them to lean forward
- pinch the tip of their nostrils firmly for five or ten minutes with their fingers or a tissue if it is available (don’t check every few minutes to see if it has stopped)
- continue to pinch for another ten minutes if it is still bleeding (again, wait and don’t check every few minutes to see if it has stopped)
- for persistent bleeding, some experts recommend blowing out the clot, spraying a nasal decongestant into your child’s nostril, and then applying firm pressure for ten minutes
If blood is still coming out while you are pinching the soft, lower part of your child’s nose, then you likely aren’t pinching firmly enough or may not be pinching in the right spot. Pinching the bony part doesn’t help.
Keep in mind that it takes at least a few days for blood vessels to heal, so your child might easily get another bloody nose in the hours or days after a nosebleed. That’s why some kids might get a nose bleed without really doing anything to provoke it.
After a bloody nose, you might encourage your child to avoid blowing out the clot in their nostrils and leave their nose alone.
Treating Hard to Control Nosebleeds
What about if your child has hard to control nosebleeds?
If the nosebleed is hard to control because it just won’t stop after about 20 minutes, then you likely need to seek quick medical attention.
On the other hand, if you can stop your child’s nosebleeds, but they are hard to control because they keep coming back, then ask yourself these questions and share the answers with your pediatrician:
- Are your child’s nosebleeds seasonal, which could mean that allergies are a trigger?
- Have you been using a nasal steroid to treat your child’s allergies? Nosebleeds can sometimes be a side effect of using a steroid nose spray, especially if you don’t spray towards the outside of the nostril when you use them.
- Does your child frequently pick his nose?
- Have you noticed any other signs of heavy bleeding or easy, large bruising? If not, a bleeding disorder is almost certainly not causing your child’s nose to bleed.
- Do your child’s nosebleeds increase in the winter, when it is dry in the house?
- Does anyone in the house smoke? Second hand smoke is an irritant.
- Has your child been using a nasal decongestant for more than a few days? That can dry out your child’s nasal passages and lead to nose bleeds.
- Could your child’s head or nose have been hit recently?
- Did your child stick anything in his nose?
In addition to treating uncontrolled allergies, things that might help chronic nosebleeds include keeping your child’s nails cut short, encouraging your child to not pick his nose, using nasal gel (or Vaseline) or saline spray to keep your child’s nostrils moist (can discourage picking too), using a cool mist humidifier (this can increase mold and dust mites and make allergies worse though), and avoiding second hand smoke.
A pediatric ENT can help your child with chronic nosebleeds when routine treatments don’t work. Although a little painful, cautery with a silver nitrate stick is an option to seal blood vessels in the nose for some kids who keep getting nosebleeds.
What To Know About Treating Hard to Control Nosebleeds
Don’t panic when your child has a bloody nose. Instead, encourage them to sit, lean, pinch, and wait and learn to prevent chronic nosebleeds.
More Information About Treating Hard to Control Nosebleeds
- Stopping nosebleeds: a pinch will usually do the trick
- AAP – Causes of Nosebleeds
- AAP – Chronic Nosebleeds
- Kids with nosebleeds
- Cochrane – Interventions for recurrent nosebleeds of unknown cause in children
- In Brief: Your Guide to von Willebrand Disease
Last Updated on December 13, 2016 by Vincent Iannelli, MD