Kidsby Molliora
Health

Nosebleeds in children: how do I stop one, and when should we get help?

Short answer

Nosebleeds are common, especially in children, and are not usually a sign of anything serious (NHS). Sit your child up and have them lean slightly forward, then pinch the soft part of the nose with thumb and index finger for ten minutes without letting go (1177, AAP). Do not let them lie down or tilt their head back (AAP). Nose picking, colds and dry air are common triggers, and moistening the nose can help prevent new bleeds (1177, AAP). Contact a health centre if your child has nosebleeds several times the same day or several days in a row. Seek care at once for a heavy nosebleed, or one that has not stopped after 30 minutes (1177).

QuestionWhat appliesSource
Is it dangerous?Usually not. Nosebleeds are common, especially in children, and most can be treated at homeNHS
Why does it happen?Small blood vessels in the nose burst, for example after sneezing, nose picking or when the inside of the nose is dry1177
Head forward or back?Forward. Sit up and lean slightly forward. Lying down or tipping the head back lets blood run down the throat1177, AAP
How long to pinch?Ten minutes on the soft lower part of the nose, without checking1177, AAP
Still bleeding after ten minutes?Pinch for another ten minutes. 1177 says you can also put in a cotton wool plug dipped in cooking oil1177, AAP
After it stops?For 24 hours, try to avoid blowing or picking the nose, hot drinks, hard exercise and lying flatNHS
When to seek care at once?Heavy bleeding, or bleeding that has not stopped after 30 minutes despite the advice1177

Why do children get nosebleeds?

Nosebleeds happen when small blood vessels in the nose burst. They can start when you sneeze, pick your nose or when the inside of the nose is dry (1177). Children are among those most likely to get them (NHS).

  • Picking and blowing: nose picking and blowing the nose too hard are common causes (NHS, AAP).
  • Colds and allergies: a cold or allergy makes the inside of the nose swollen and irritated (AAP).
  • Dry air: children are especially prone to nosebleeds in the winter months, when the lining of the nose becomes dry and crusted (AAP). A very dry home can dry it out too (AAP).
  • Knocks and objects: a blow to the nose can cause a nosebleed, and in children it can also come from something they have pushed up their nose (1177).
  • Some medicines: nasal sprays for allergy can increase the risk, and medicines with acetylsalicylic acid can make bleeding harder to stop (1177). Even ibuprofen can affect blood clotting a little (AAP).
  • Out of the blue: nosebleeds can also come quite unexpectedly, often at night (1177).

How to stop a nosebleed

  1. Stay calm. A nosebleed can look frightening but is rarely serious, and your child will pick up on how you react (AAP). The blood always looks like a lot (AAP).
  2. Sit up and lean slightly forward (1177). Do not let your child lie down or tilt their head back, because blood can then run down the throat and may make them vomit (AAP).
  3. Pinch the soft part of the nose with thumb and index finger for ten minutes. Pinch the lower, soft part, not the hard upper part (1177). Do not let go to check if it has stopped, as that can start the bleeding again (AAP). Older children can do this themselves (AAP).
  4. Breathe through the mouth and spit out any blood that runs down the throat (1177). Swallowing some blood is common and can sometimes make you feel sick and vomit (1177).
  5. Try something cold: sucking an ice cube or putting a cold towel over the nose and forehead can make the blood vessels narrow (1177). The NHS says the evidence that an ice pack works is not very strong.
  6. Still bleeding after ten minutes? Pinch again for another ten minutes (1177, AAP). 1177 says you can put a cotton wool plug in the nose and leave it in for about an hour after the bleeding stops; it is easier to remove if you dip it in cooking oil first. Do not stuff paper tissues into the nose (AAP).

After a nosebleed and how to prevent new ones

The first 24 hours: to lower the chance of another nosebleed, try not to blow or pick the nose, have hot drinks, lift heavy things or do hard exercise, pick at scabs or lie flat (NHS).

  • Wipe instead of blowing: wipe the nose gently instead of blowing it (1177).
  • No picking: remind your child not to pick their nose (1177, AAP). Picking at sores in the nose can spread bacteria and make healing slower (1177).
  • Moisten the nose: saline nose drops or spray can moisten the nose, and an oily nasal spray or nasal ointment from the pharmacy, or a little cooking oil, can soften a dry, sore nose (1177).
  • Humid air in winter: a humidifier can help keep indoor air moist enough when the heating is on (AAP).
  • Avoid smoke: cigarette smoke and other irritating fumes can also cause nosebleeds (AAP).
  • Frequent nosebleeds: if your child gets a lot of nosebleeds, ask a doctor about daily saline drops and a little petroleum jelly in each nostril at night (AAP). A doctor can also seal a bleeding blood vessel with silver nitrate; 1177 says this does not hurt.

Try this week

  1. Practise the steps together when no one is bleeding: sit up, lean forward, pinch the soft part of the nose and count to ten minutes on a clock.
  2. On dry winter days, try saline nose drops or a little oil in the nose for a child who often gets nosebleeds (1177).
  3. Keep a small packet of tissues and a cold pack in an easy place at home, so you are ready.

When to get help

Contact a health centre if your child has nosebleeds several times the same day or several days in a row (1177). The AAP says a doctor may want to check further if your child has more than five nosebleeds a year, the bleeding usually lasts more than ten minutes, or the nosebleeds come with a stuffy nose that never seems to clear. The NHS also advises seeing a doctor for regular nosebleeds, or if your child has a condition that affects blood clotting.

Seek care at once at a health centre or out-of-hours clinic, or at A&E if they are closed, if (1177):

  • the nosebleed is heavy
  • it is a slow nosebleed that has not stopped despite the advice above, 30 minutes after it started

The NHS and the AAP set an earlier limit: the NHS after 10 to 15 minutes of bleeding, and the AAP if the bleeding has not stopped after two rounds of ten minutes of pinching. Also seek emergency care if the nosebleed started after a blow to the head, your child is swallowing so much blood that they vomit, feels weak or dizzy (NHS), is unusually pale or sweaty, or is vomiting blood or brown material that looks like coffee grounds (AAP). If your child hit their head, see our concussion guide.

Call 112 if your child stops responding to you (AAP) or has difficulty breathing (NHS). Call 1177 for medical advice or help finding the right clinic. See also when to seek care for your child.

This guide is general information, not medical advice for your child.

Sources

  1. 1177: Näsblod (Swedish)
  2. NHS: Nosebleed
  3. American Academy of Pediatrics (HealthyChildren.org): Chronic Nosebleeds in Children: What To Do
  4. American Academy of Pediatrics (HealthyChildren.org): How to Stop a Nosebleed