Holiday shopping, vacation planning, school holiday pageants ... and nosebleeds? Definitely NOT one of my favorite things.
Dr. Nina Shapiro: Unfortunately, the winter months are nosebleed season. Here are some tips on why this happens, and what you can do to prevent and treat nosebleeds for you and your kids:
The inside of the nose is lined with fragile tissue, with many tiny blood vessels right on the surface. The dry air of winter, be it from outdoor climate or indoor heat, dries out the nasal tissue as well, and can lead to cracked areas that bleed. And once they start bleeding, scabs crust over and bleed again.
Seasonal issues aside, one of the most common causes of nosebleeds in kids is nose picking. Sometimes it's a habit, and sometimes kids just scratch at their nose during sleep, from allergies or with a cold.
Because nosebleeds are often caused by dry air (heat) or unconscious picking or scratching, they frequently occur in the middle of the night. Kids will wake up with a face full of blood, stains on the pillow, etc. Because the nose has so many blood vessels, when it bleeds, it bleeds a lot.
There are certainly more rare causes of nosebleeds, such as bleeding/clotting problems, nasal or sinus tumors, or nasal injury. If nosebleeds are not controlled by the techniques below, your doctor needs to take a good look.
What to do?
If you or your child has a tendency to get nosebleeds, prevention is the first step. The first night that your heat goes on, put a little ointment inside the nose at bedtime. Any ointment will work -- vaseline or aquaphor are the easiest. When you do this, aim toward the center part of the nose (the septum), since this is where the nosebleeds originate. Saline (salt water) spray in each nostril before the ointment goes in is the best humidifier. A second choice would be a humidifier in the bedroom. Keep your child's fingernails short. Even if they don't pick their nose, they may inadvertently do so at night.
If your child is having a nosebleed:
Don't panic. Even though it looks like a lot of blood, you can usually get it to stop at home. Your child should sit up straight, not lean forward or have her head back. Just straight. Pinch the front/soft part of the nose. That's probably where it's coming from. If your child is old enough, have him chew on some crushed ice. The blood vessels in the nose come from the roof of the mouth.
If it's a minor nosebleed, you can try some oxymetazoline (afrin) nasal spray (which shrinks blood vessels), but check with your pediatrician before using this.
If your child gets a lot of nosebleeds:
Have your doctor take a look. If the tiny blood vessels become large, your child may need to have nasal cautery, where a small stick containing a chemical called silver nitrate (this used to be used by men to stop little cuts during shaving -- also known as a "styptic") is placed onto those vessels to shrink them away. This can usually be done in the doctor's office. If the cause is still puzzling, the nosebleeds are coming from the back of the nose into the throat; or if they are not well-controlled at home, your child may merit a look with a tiny telescope, to check the nose from front to back. This also may be done in the office, but sometimes a little anesthesia is needed, especially for young kids.
Nosebleeds are incredibly common in kids, but are a definite nuisance. They can often be prevented -- or at least minimized -- with home remedies. Of course the real severe ones may warrant a trip to the doctor's office or emergency room, but thankfully these are few and far between.
|Dr. Nina Shapiro is a graduate of Harvard Medical School, and she completed her residency in ear, nose, and throat surgery at Harvard. She is an Associate Professor and Director of Pediatric Ear, Nose, and Throat at the Mattel Children's Hospital at UCLA. She has treated tens of thousands of children with ear problems, sleep problems, and breathing problems. She lives with her husband and two young children in Los Angeles.|