How to Treat and Prevent Nosebleeds in Children

By Howard J. Bennett, MD

Nosebleeds are common in childhood. They are usually triggered by upper respiratory tract infections, nasal allergies, dry air and nose trauma from falls, picking or blowing your nose too hard. Most people don’t know where the bleeding comes from, which results in a number of ineffective remedies to treat the problem.

Nasal bleeding almost always arises from the front of the nose along the nasal septum, which is the piece of cartilage between the nostrils. More specifically, the bleeding usually comes from a web of small arteries called Kiesselbach’s Plexus. Because the arteries are close to the surface of the nasal septum, they are vulnerable to injury.

The best way to stop a nosebleed is to firmly pinch a child’s nostrils together while he’s sitting down with his head facing forward. Don’t push too hard, however, or he might struggle instead of remaining still. Keep the nostrils closed—without peeking—for 10 minutes. Younger children are more likely to cooperate if you distract them with a video, a treat or other engaging activity. Some children get upset if they have a nosebleed, so it helps if parents remain calm when managing the situation.

Encourage your child not to blow or rub his nose after the nosebleed stops because this could dislodge the clot and restart the bleeding.

Nosebleeds can often be prevented by using a humidifier in your child’s bedroom, especially during the winter. It may also help to apply a thin layer of petroleum jelly or similar product to the nasal septum once or twice a day. This moisturizes the skin that lines the cartilage making it less prone to bleeding. You can apply the goo with a cotton swab or the tip of your index finger, however, be careful not to scratch the child’s nose with your fingernail. Some children may want to apply the ointment themselves.

The following are things not to do when trying to stop a nosebleed:

• Don’t lean the child’s head backwards. This can cause choking or vomiting if blood drips down the back of his throat.
• Don’t put tissues or toilet paper in the child’s nostrils because the bleeding could recur when you remove the tissue.
• Don’t put a cold compress on a child’s forehead or the back of his neck.
• Don’t have the child lean forward and put his head between his knees.

If you think your child has lost a lot of blood or he looks pale, get in touch with your doctor right away because he may need an emergency room visit to stop the bleeding. In my experience, nosebleeds are rarely a serious problem in healthy children.

If your child has frequent nosebleeds, ask your doctor about seeing an ENT specialist for a procedure called nasal cautery. This involves numbing the inside of the nose and using a chemical swab to cauterize the nasal septum. The procedure prevents recurrences about 80% of the time.

In rare cases, nosebleeds may be caused by a clotting disorder called von Willebrand’s Disease. Speak with your doctor if anyone in the family has a history of prolonged or heavy menstrual cycles, unexpected bleeding during surgery or recurrent nosebleeds as this may indicate that someone has the condition.