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A Blog from Your Kaiser Permanente Pediatricians in Northern California

Nosebleeds? Stop the Flow with These 5 Tips

Nosebleeds? Stop the Flow with These 5 Tips

There are times when doctors and parents don’t seem to understand each other. This often happens when the doctor thinks the child in front of them has what seems to be a minor condition, but to the parent it seems scarier! Once my son had pneumonia. The doctor in me knew he had an easy to treat, run of the mill case. The mom in me? I was worried about him and concerned I’d waited too long to bring him in to his doctor.

That same son also tends to get lots of nosebleeds. As a doctor, I know a nosebleed is usually nothing to worry about. As a mom? It makes me feel a little panicky to see my child bleeding! So when parents come in worried about their child having nosebleeds, I get it and try to slow down and explain why I’m not so worried. Here’s how I often respond to their questions:

  • Why do they start? Inside the nose, the septum between each nostril is lined with a thin layer of “wet skin” called mucosa (or a mucous membrane). Under that thin layer are small blood vessels. If the mucosa dries out, it can crack, scab, or develop a bit of dry mucus. This prompts a kid to blow their nose or to pick at the dry place. When they do, the mucosa can peel away exposing the blood vessels. Do this often enough and the area will bleed easily – simply by blowing, picking, or even just rubbing the nose. A nose can also bleed if it is injured or blown often when a child has a cold or allergies.
  • Why did the nosebleed start when my child is asleep? Yup – that can happen too. An increase in blood pressure from coughing, sneezing, blowing, straining, or just turning over in bed, can cause those fragile blood vessels to bleed.
  • How can I prevent nosebleeds? Put nothing in your nose but your elbow! That’s what I tell the kids. Prevent nosebleeds by not picking or putting wads of tissue in your nose, and by blowing gently! You can get frequent nosebleeds under control by gently rubbing Vaseline over the septum before bed and every morning. A humidifier can be useful in dry climates or when heat or air conditioning dries the air in your home.
  • What if it doesn’t stop bleeding? Here’s how to stop a nosebleed:
    • Have your child sit upright, relax, and breath through their mouth while you pinch firmly with thumb and index finger over the soft part of the nostrils – not higher up where there is firm cartilage.
    • Hold the pressure – without letting go to check – for 5 to 10 minutes. Every time you let go too soon, you can disturb the blood blots that are forming to stop the bleed.

If it’s still bleeding after 10 minutes:

  • Have your child gently blow out the blood clots that should have formed.
  • Hold pressure for another 10 minutes, without checking.

When should I worry? If the bleeding continues for 30 minutes, or if your child is dizzy, faints, vomits, or has blood spurting or gushing from their nose, call your doctor immediately or go to the nearest hospital.

If your child seems ill, has bleeding elsewhere (like their gums) or an unexplained rash, please see your pediatrician. Also, if after a period of having your child rub Vaseline over their septum twice a day and treating their nose more gently (no picking!) and they’re still getting frequent nosebleeds, call or email your doctor. The doctor may examine the nasal septum, ask about any bleeding disorders or problems that run in your family, and consider blood tests.

Hopefully after hearing these 5 tips my patients, their parents, and I are on the same page. Most of the time, while nosebleeds may look scary, you can treat them at home and they aren’t a cause for alarm.

Resources for Parents:

My Doctor Online
Nosebleeds