Nosebleeds in Toddlers

Nosebleeds are very common in toddlers. While they can be downright messy at times, most nosebleeds are not a cause for concern.

The nose has lots of vessels that provide a rich blood supply. When the lining of the nasal passage breaks down and erodes, the vessels become exposed and can bleed. Most nosebleeds come from the anterior (front) part of the nose. These types of nosebleeds ooze more slowly but constantly. A posterior nosebleed, originating from the back of the nose, is often an arterial bleed, so the blood flows more forcefully.

By far the most common cause of nosebleeds in toddlers is due to trauma. Little kids love to put their fingers or other objects up their noses, which often causes trauma to the small vessels in the mucosal lining. Other common causes include breathing in dry air, upper respiratory and sinus infections, allergies, facial trauma, and nasal foreign bodies. Many times, children will have nosebleeds and the reason is not clear.

Less common causes of nosebleeds include blood disorders, such as Von Willebrand disease, hemophilia, or low platelets from an underlying cause. These disorders may also be associated with easy bruising, prolonged bleeding from minor cuts, and a family history of a bleeding disorder. Anatomical defects in the nose such as vascular abnormalities or a nasal mass can also uncommonly cause bleeding.

For most children, nosebleeds are a hassle but are rarely a cause for true concern. Most nosebleeds occur from one nostril and stop on their own after a few minutes. If your child has a nosebleed, first and foremost don’t panic. Apply gentle but firm pressure to the lower half of the nose for a full 10 minutes, being careful to tell your child to tilt the head forward slightly so as not to swallow blood. Be sure to keep firm pressure the entire time, as removing the pressure could cause the nose to start bleeding all over again.

If the nosebleed does not stop after 20 minutes of constant pressure, a trip to the pediatrician or ER may be in order. Never stuff tissues or anything else up a child’s nose to get it to stop bleeding.

For severe recurrent nosebleeds, a child may need an evaluation by a pediatric ear nose and throat physician for further evaluation and possible cauterization of the bleeding vessels.

To prevent nosebleeds, it is important to teach children from an early age not to put anything in their noses, including fingers or toys. Toddlers who suffer from an upper respiratory infection or those who live in a dry climate may benefit from nasal saline drops or spray to moisten the mucosal lining.

Sources:

• American Academy of Pediatrics
• How to Stop a Nosebleed.
  American Academy of Pediatrics
• What to do About Chronic Nosebleeds.
  Pediatrics
• Epistaxis.

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