Nosebleeds

Why is my child’s nose bleeding?

Nosebleeds are common in childhood and are not usually a sign of severe illness.

Most nosebleeds happen due to:

• nose picking
• hay fever
• infections such as colds
• sneezing
• blocked or dry nose
• injuries
• high blood pressure
• putting objects into the nose
• changes in weather affecting air humidity or pressure

What is the first aid treatment for nosebleeds?

Simple first aid can usually stop the bleeding. Encourage or help your child to do the following:

1. Sit up and lean forward. Breathe through their mouth.
2. Using your index finger and thumb pinch the soft part of their nose firmly at the tip completely blocking the nostrils for 10 to 20 minutes with the head tilted forward.
3. Encourage your child not to swallow the blood but instead to spit it out as it may cause them to vomit which can cause further nose bleeding.
4. If available, put a cold flannel around the nose and front of face. This will help as it causes the blood vessels to narrow. Alternatively, sucking on some ice will have the same effect.

Following these steps will stop the bleeding in most cases.

The direct pressure of pinching the nose usually helps stop the bleeding and allows clots to form.

If the bleeding has stopped and your child is well, there is no urgent need to see a doctor.

When to see a doctor about nosebleeds

You should see your GP about the nosebleed if:

• There are very regular or frequent nose bleeds which stop with first aid or by themselves
• Your child also has bleeding from other areas, such as from their gums when brushing their teeth
• Your child has also had abnormal bruising or a pinprick rash to the skin

If the bleeding continues despite 20 minutes of first aid, go to your local Emergency Department.

If your child develops difficulty breathing, collapses or loses consciousness, call 999

What other treatments are available for nosebleeds?

If the nosebleed does not stop with first aid, your child might receive:

Cauterisation

If the origin of bleeding is visible, a stick with chemicals at the tip (silver nitrate) can be used to ‘burn’ the bleeding site to stop it. This is quick and simple.

Packing

Sometimes a special sponge or ribbon gauze needs to be put in the nostril to stop the bleeding. This stays in the nostril until your child is seen by the specialist ENT (Ear, Nose, Throat) team.

Other treatments

If the bleeding is very heavy, leading to a drop in blood pressure or major blood loss, this might require intravenous fluids or blood transfusion. This is rare and tends to only happen if your child has a bleeding or clotting disorder or is taking medications that thin the blood or prevent clotting.

Does my child need any medication?

Simple nosebleeds do not usually require any medication.

For nosebleeds that keep happening, an antibiotic ointment might be prescribed to reduce crusting and inflammation in the nose (Naseptin® – chlorhexidine and neomycin, contains peanut oil and soya).

You can put Vaseline (or a similar petroleum jelly) to the inner nostrils, to help moisten the nose in the days to follow.

How can I prevent further nosebleeds?

• encourage your child not to pick or blow their nose after nose bleeds
• avoid hot food, drinks and baths for 24 hours
• avoid strenuous activity

Further information

If you have any further questions or are worried, please contact 111 for advice in the first instance.

There is some more information about nosebleeds  on the NHS.uk website Nosebleed – NHS