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: Nosebleeds Are Common In Children
DEAR DR. PAUL: My 6 year old son keeps getting nose
bleeds especially during the winter. They are easy to sop, but
I am concerned. He is well otherwise. Could there be a problem?
PEDIATRICIAN DR. PAUL Answers: Thanks for your question,
as this is a concern of many parents. Nosebleeds, medically know
as "Epistaxis" are common in children and fortunately not usually
associated with any serious underlying problem. Most of the time
nosebleeds stop on their own without any specific treatment. With
age the tendency for nosebleeds decreases.
What causes nosebleeds? An obvious cause is nasal trauma or injury,
including picking the nose. We also know, like with your son,
that the tendency to have nosebleeds increases during the winter
months when the dry air irritates the inside lining of the nose
resulting in bleeding. Interestingly, there seems to be a family
tendency. In other words children with recurring nosebleeds often
have relatives who have had the same. We also know that children
with large adenoids, nasal allergies and chronic sinusitis tend
to have more nosebleeds. High blood pressure (rare in children
) is also associated with a nosebleeds. In very rare circumstances,
frequent or excessive nosebleeds may reflect a bleeding problem
such as low platelet counts or lack of certain blood clotting
factors (i.e. Hemophilia). In these cases there is a generalized
bleeding tendency (cuts tend to bleed more than normal etc) making
it relatively easy to distinguish a normal child form one who
has a blood clotting problem. Again, let me reiterate, most children
with Epistaxis are otherwise normal.
There are two aspects to treatment: Trying to stop a nosebleed
and trying to prevent it. While most nosebleeds stop on their
own within a few minutes, compressing or clamping the nose between
the thumb and index finger will help. Contrary to what most people
do, the head should be tilted forwards and not backwards. Tilting
the head backwards will cause the blood trickle down the child's
throat possibly resulting in coughing, choking or swallowing of
the blood. In most children gentle nose compression or pressure
will stop the bleeding easily. If the bleeding persists, medical
attention should be sought as application of certain medications
and/or inserting of nasal packing (cotton) gauzes will likely
be needed. Certain children with recurrent nosebleeds may need
an evaluation by an ENT doctor who will look for any bleeding
site (a weekend blood vessel) and burn or cauterize it with silver
nitrate application.
Prevention of nosebleeds is the other aspect of treatment. Obviously
avoidance of trauma and wearing appropriate face protection during
sports is important. Also, you should try to teach your kids not
to pick their nose. During the winter months, make sure that the
humidity in the house is adequate (about 40%). A humidifier can
be used to bring the humidity up to this normal level. Another
approach is to apply petroleum gel (Vaseline) or nasal saline
lubricating gel into the nostrils at night. By keeping the inside
lining of the nose moist, this treatment can also help prevent
nosebleeds.
For more information on humidifiers go to:
DR.PAUL'S COLUMN ON HUMIDIFIERS |
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designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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