Nosebleeds are common in children and most often are not serious. You can respond to nosebleeds in a way that helps keep your child from getting scared, teaches them how to manage them, and informs them how to prevent future nosebleeds.

• If your child has a nosebleed the first thing is to remain calm.  You can explain to your child that there are small blood vessels in the nose and one must have broken.  Reassure your child that this is common and that they can help make it better.
• Have your child sit up (not lie down). Explain that applying pressure—”pinching the nose” below the bony nasal bridge—can help stop the bleeding. Try to have your child squeeze their nose with your help. Typically a nosebleed should stop bleeding within a couple of minutes.
• Nosebleeds typically occur because of mild trauma to the blood vessels inside the nose (especially the nasal septum).  Picking the nose and rubbing the nose increases the likelihood of nosebleeds especially when the air is very dry or if a child has a cold or allergies.
• Avoid scolding your child for nose picking. Instead remind them to be gentle to the nose because of the fragile blood vessels and to try to not put fingers (especially fingers with sharp nails) in the nose. Make sure your child is not putting objects op the nose—like beads or Legos—this too can cause nosebleeds.
• Keeping the inside of the nose moist is key to prevent future nosebleeds! Nasal saline spray can help prevent dryness. A humidifier can also help add moisture to the air and decrease the likelihood of nosebleeds, just make sure to clean the humidifier frequently.
• New studies have shown that children with the bacteria Staphylococcus aureus in the nose are more likely to have nosebleeds. You or your child can apply an antibiotic ointment (such as Mupirocin) to the inside of the nostril with a q-tip. You can explain that putting the ointment on makes the blood vessels less likely to break. Ask your child to remind you to apply the ointment everyday for up to a week to prevent future nosebleeds.

‍When to go see the doctor about a nosebleed:

• If a nosebleed will not stop bleeding after 5-10 minutes despite applying pressure to the nose appropriately, go to the doctor/ER immediately
• If you see a growth or foreign body in the nose
• If your child is under the age of 2
• If your child is passing large clots of blood
• If your child is easily bruising or bleeding elsewhere

Remember, how you respond to medical issues can help your children stay calm, help them understand their bodies and how to care for themselves!

This week’s tip was created with expert advice from Dr. Michael Rothschild, Pediatric ENT.

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