Tag: seasonal allergies

Treating Hard to Control Nosebleeds

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.

Nosebleeds

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.

Treating Nosebleeds

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.

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Treating Hard To Control Allergies

Allergies (hay fever or allergic rhinits) are common in kids.

That makes it a good idea to learn how to control your child’s allergies.

What Triggers Your Child’s Allergy Symptoms?

There are several good reasons to try and figure out what your child’s allergy triggers are, including that it can help you:

  1. avoid the trigger – stay away from cats if your child is allergic to cats
  2. minimize the trigger – control dust mites in your home if that is a trigger
  3. know to give your child her allergy medicine before she will be exposed – start medicines before fall allergy season if she is allergic to ragweed

That doesn’t mean your child needs an allergy test though. You can often figure out what triggers your child’s allergies if you are mindful of the pattern of her symptoms (year round vs seasonal), what she is doing or exposed to when they worsen, and by checking pollen counts on both good and bad allergy days.

Allergy Medicines for Kids

Unfortunately, simply trying to avoid allergy triggers isn’t usually enough.

Most kids with allergies also take one or more of these medicines, many of which are now available over-the-counter, without a prescription:

  • short acting antihistamines – Benadryl (can be sedating)
  • long acting antihistamines – Allegra, Claritin, Zyrtec
  • non-antihistamines – Singulair
  • steroid nasal sprays – Flonase, Nasacort, Nasonex, Omnaris, Rhinocort
  • antihistamine nasal sprays – Astelin, Astepro, Patanase
  • allergy eye drops – Pataday, Zaditor

And to work best, your child should likely start his allergy medicines before his allergy season and take them every day.

Treating Hard To Control Allergies

So what do you do when these allergy medicines don’t control your child’s allergies?

The first thing you likely want to do, and something many people overlook, is to make sure that your child’s symptoms are really caused by allergies. Remember, just because your child has a runny nose, it doesn’t mean that he has allergies. Or even if he often has allergies, it doesn’t mean that allergies are causing every runny nose. If your child has a runny nose and congestion and allergy medicines aren’t working, then he may just have a cold.

If your child does have allergies and they are just hard to control, then you might want to:

  • review your allergy trigger control methods (allergy proof dust covers on mattresses, no mold in house, keep windows closed in the car, etc.)
  • consider if you are triggering your child’s allergies even more, for example, dust mites and mold like humidity, so a humidifier in your child’s room would not be a good idea if your child is allergic to dust mites or mold
  • make sure your child is taking the correct dose of his allergy medicine
  • make sure your child is taking the correct medication for his allergy symptoms, keeping in mind that antihistamines don’t treat congestion, but Singulair (montelukast) and steroid nasal sprays do
  • try a different allergy medicine, although tachyphlaxis reportedly doesn’t occur with antihistamines – they shouldn’t become less effective over time
  • try a combination of medicines, for example, a long acting antihistamine plus a steroid nasal spray
  • try a different combination of medicines, for example, Singular plus an antihistamine nasal spray
  • make sure your child is able to avoid second hand smoke
  • consider that your child could have vasomotor rhinitis or nonallergic rhinitis
  • ask about allergy testing, which can be done by your pediatrician (blood tests at almost any age) and/or a pediatric allergy specialist (blood or skin tests)

A pediatric allergist can also be helpful in diagnosing and managing your child’s allergies, especially if you think your child needs to start oral (sublingual immunotherapy) or shot (subcutaneous immunotherapy) allergy preventative treatments.

What To Know About Treating Hard To Control Allergies

Allergies can be hard to treat and control in kids, but they can often be managed if you understand how to avoid common allergy triggers and use allergy medicines properly.

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