Recurrent Nosebleeds

How to Stop Recurrent Nosebleeds in Children (Epistaxis)

Most nosebleeds in kids occur for a common reason such as allergies or trauma (hit in the nose or picking the nose). Rarely a child will be born with an abnormal blood vessel or a bleeding disorder. 

To help your child’s nose heal, try the following:

Immediately after their nose starts to bleed:

• It takes 5 minutes for a clot to form, so you must hold pressure for that long by having your child pinch their nostrils together or by packing part of a cotton ball into the bleeding nostril. Please note that you should not have your child hold or tilt their head back when a nosebleed happens. This can be a choking hazard and may cause stomach upset due to blood entering the GI tract.
• If you keep “checking” to see if the bleeding has stopped, the clot will be disrupted, and you will have to start the 5 minutes over again.
• Remove the cotton gently as sometimes a clot will have stuck to the material, and you don’t want the bleeding to restart.
• Encourage your child to avoid picking their nose. That will break the clot/scab and restart the bleeding.

Treatment:

• If mucus is present, gently rinse it out. Consider using saline irrigation by squirt bottle. These kits can be purchased over the counter at any pharmacy.
• Spray 1 pump of over the counter allergy nose spray (such as fluticasone) in each affected nostril to reduce any swelling of the tissue inside the nose.
• Next, apply a thin layer of an over-the-counter water-soluble saline gel (such as Ayr® Gel) to the inside of the nostrils using a cotton swab (Q-tip®). This helps keep the nose moist and protects healing blood vessels.
• Consider running a humidifier in their room at night so their nose stays moist while sleeping.
• Encourage them to drink enough water to stay hydrated.

Repeat the nose spray and gel twice daily (morning and night) for at least a week. Stop when no bleeding has recurred for 7 days. If your child has nosebleeds triggered by allergies, they may need to transition to one squirt daily of allergy nose spray until pollen season ends.