HEALTHNET

Is it common for children to have frequent nosebleed?

Nosebleeds are very common in children. The nose would bleed when one of the small veins in its lining bursts.

(Posted on 1 November 2007)

Q1. My son has frequent nosebleed. Is it common among children?

A1. Nosebleeds are very common in children. Children often have veins that are very close to the skin, especially the veins on the mucous membrane. The nose would bleed when one of the small veins in its lining bursts.

Nosebleeds may be provoked by:

Minor trauma

Some children like picking their nose or blowing it too hard. Children who play rough games and have their nose knocked may experience nosebleeds.

Infections

"Rhinitis" is an inflammation of the mucous membrane lining the inner wall of the nose. It is a common cause for cough and colds in children. Inflammation of the nose brings about the growth of new blood vessels in the anterior part of the nose. These new blood vessels are usually prominent and can bleed easily.

Allergy

Children with allergic rhinitis would have experienced intense itchiness in their nose, and tend to rub and pick their nose so frequently that results in nosebleeds.

Dryness

Many doctors think that nasal drying is a common cause for nosebleeds. Nasal drying is common in cold dry winter as well as in air-conditioned rooms in summer. A dry climate with indoor heating would result in hot dry air that irritates and dries out nasal membranes. The itchy crusts would then be picked and subsequent bleeding.

Q2. Does frequent nosebleed signify that there is potential nasal problem?

A2. Nosebleeds are more often a nuisance than something really serious. If the child gets frequent nosebleeds, it may be a good idea to consult a doctor to exclude the possibility of underlying causes, such as:

Serious infections

Frequent nosebleeds can be caused by infections in the upper respiratory tract, such as sinusitis and infected adenoids.

Foreign body in the nose

Sometimes small kids would play around, pushing small objects up into their own nasal cavities, thus damaging the delicate blood vessels and result in frequent nosebleeds.

Clotting problems

Children with bleeding disorders, such as decreased blood platelets or deficient blood clotting factors can have serious nosebleeds that are difficult to stop.

Bring your child to see a doctor if:

The child frequently gets nosebleeds that take more than 15 minutes to stop.
The child has trouble in breathing.
The child is bleeding elsewhere, for example from their gums or under the skin.
The child appears not to be healthy in between nosebleeds.
The blood is not fresh, or if the child have purulent or foul smelling nasal discharge.

Q3. What is the appropriate way to stop a nosebleed?

A3. Most nosebleeds look much worse than they really are. Almost all nosebleeds can be treated at home.

1. Stay calm

A nosebleed can be a very traumatic event for the child. The frightened behavior of parents would only aggravate the situation, and makes the bleeding harder to control.

2. Sit upright

Bleeding will stop faster if the child is sitting upright instead of lying down. By remaining upright, blood pressure in the veins of the nose is lowered. This discourages further bleeding. Also when lying back, blood would run down the throat, and the child may vomit after swallowing a lot of blood.

3. Pinch the nose

When the child sits down, hold their nostrils with your fingers, a handkerchief or a facecloth.
Pinch the lower, soft part of the nose between the thumb and forefinger.
The grip should be firm and steady.
Hold the child's nose continuously for 10 minutes. Look at the watch to ensure 10 minutes have passed before letting go.
If the child is old enough, teach them how and where to hold their own nose.

4. Seek medical care immediately if

The bleeding lasts for more than 20 minutes
The nosebleed caused by an accident

5. After the nosebleed has stopped

The child should not play any rough games for the next day or so.
Tell the child not to pick, rub or blow their nose for a couple of days.

Source: Quality HealthCare