Definition

• Bleeding from 1 or both nostrils
• Not caused by an injury

Health Information

Causes

• Nosebleeds are common because of the rich blood supply of the nose. Common causes include:
• Dryness of the nasal lining. In the winter, forced air heating often can dry out the nose.
• Allergy medicines (Reason: Dry out the nose)
• Vigorous nose blowing
• Ibuprofen and aspirin (Reason: Increases bleeding tendency)
• Suctioning the nose can sometimes cause bleeding
• Picking or rubbing the nose
• Factors that make the nasal lining more fragile. Examples are nasal allergies, colds and sinus infections.

Care Advice

1. Overview:
   • Nosebleeds are common.
   • You should be able to stop the bleeding if you use the correct technique.
   • Here is some care advice that should help.
2. Squeeze the Lower Nose:
   • Gently squeeze the soft parts of the lower nose together. Gently press them against the center wall for 10 minutes. This puts constant pressure on the bleeding point.
   • Use the thumb and index finger in a pinching manner.
   • If the bleeding continues, move your point of pressure.
   • Have your child sit up and breathe through the mouth during this procedure.
   • If rebleeds, use the same technique again.
3. Put Gauze Into the Nose:
   • If pressure alone fails, use a piece of gauze. Wet it with a few drops of water. Another option is to put a little petroleum jelly (such as Vaseline) on it.
   • Insert the wet gauze into the side that is bleeding. Press again for 10 minutes. Reason it works: The gauze puts more pressure on the bleeding spot.
   • Special nose drops: If your child has lots of nosebleeds, buy some decongestant nose drops. An example is Afrin. No prescription is needed. Put 3 drops on the gauze, insert and press. These nose drops also shrink the blood vessels in the nose.
   • Caution: don’t use decongestant nose drops if your child is younger than 1 year.
   • If you don’t have gauze, use a piece of paper towel.
   • Repeat the process of gently squeezing the lower soft parts of the nose. Do this for 10 minutes.
4. Prevention of Recurrent Nosebleeds:
   • If the air in your home is dry, use a humidifier. This will keep the nose from drying out.
   • For nose blowing, blow gently.
   • For nose suctioning, don’t put the suction tip very far inside. Also, move it gently.
   • Do not use aspirin and ibuprofen. Reason: Increases bleeding tendency.
   • Bleeding areas in the front of the nose sometimes develop a scab. The scab may heal slowly and re-bleed. If that happens to your child, try this: Apply a small amount of petroleum jelly (Vaseline) to the spot. Repeat twice daily for a few days.
5. What to Expect:
   • Over 99% of nosebleeds will stop if you press on the right spot.
   • It may take 10 minutes of direct pressure.
   • After swallowing blood from a nosebleed, your child may vomit a little blood.
   • Your child may also pass a dark stool tomorrow from swallowed blood.

Call Your Doctor If

• Can’t stop bleeding with 10 minutes of direct pressure done correctly
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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