Dear Doctors: Our 7-year-old daughter has been getting a few nosebleeds each month. It started last fall, and the school nurse thinks it’s from dry air. This has been scary for her. What can be done to make them stop? Is this something to be concerned about?
Dear Reader: Nosebleeds can be alarming for the child having one and the parent helping to deal with it.
They begin suddenly, often without an obvious cause, and involve what seems like a lot of blood.
The medical term for a nosebleed is epistaxis. It occurs when one of the blood vessels that supply oxygen and nutrients to the mucous membranes that line the nose and the nasal cavity becomes damaged and ruptures.
These vessels are close to the surface in young children, which is part of the reason that they have more nosebleeds than adults. Younger kids are also more apt to pick and rub their noses, which can cause blood vessels to break. Blowing your nose too vigorously, a physical blow to the nose or a foreign object in the nose also can result in a nosebleed.
The nurse at your daughter’s school is also correct about the role of dry air. Children who live in an arid climate are at increased risk of developing a nosebleed. Low humidity that comes with the onset of colder winter weather also plays a role. This is due to cold outdoor temperatures and heated air indoors, of which can quickly dry out the delicate membranes within the nose. This can cause them to crack, which can rupture a blood vessel.
To manage a nosebleed, have the child lean slightly forward, just enough so they won’t swallow blood, and breathe through the mouth. Gently pinch the soft part of the nose closed, just above the nostrils, and maintain direct pressure for the 10 minutes or so that it typically takes for bleeding to stop. A cold compress across the bridge of the nose can help.
Help your child understand why she should be gentle with her nose. This includes blowing her nose, which should be done with just the amount of force needed to clear the nasal passages.
A cool-mist humidifier, particularly in her bedroom, will help keep nasal membranes moist. A small dab of a water-based ointment spread inside each nostril can help.
Nosebleeds are common in kids between ages 2 and 10 and rarely dangerous.
If a nosebleed won’t stop, if there’s a lot of blood or an object is lodged in the nose, call your healthcare provider.
Dr. Eve Glazier and Dr. Elizabeth Ko are internists at UCLA Health.
