Sense of sin may be often great, and more felt than grace; yet not be more than grace. A man feels the ache of his finger more sensibly than the health of his whole body; yet he knows that the ache of a finger is nothing so much as the health of the whole body.
Thomas Adams

Nosebleeds

Nosebleeds

Nosebleeds

Nosebleeds (epistaxis) are very common throughout childhood. They are usually caused by rupture of a small blood vessel on the lining of the lower inside of the nose. This is caused by dryness of the nasal lining plus the normal rubbing and picking that most children do. It often occurs at night, as children sleep on their abdomen and often rub their nose against the pillow. Vigorous nose blowing can also cause bleeding. Nosebleeds are especially common in the Sacramento area because of the dry weather and the large amounts of pollens and resultant nasal allergies.

With the first nosebleed, a blood clot forms on the nasal lining and stops the bleeding. This may feel itchy. Rubbing or picking the nose can dislodge the clot and the nose then bleeds again. This is why a child often has a period of several weeks of recurrent nosebleeds: the nose never fully heals before the clot is knocked off and the bleeding starts all over again.

Treatment: Have the child sit up and lean forward so that he does not have to swallow the blood. Have him blow his nose free of any large clots that might interfere with pressure. Then tightly pinch the soft parts of the lower nose against the center wall for 10 minutes. Don’t release the pressure until the 10 minutes are up; use a watch to time yourself. Older children can be taught to do all of this themselves. During this time, the child should be breathing through his mouth.

If the nosebleed hasn’t stopped, insert a piece of gauze covered with decongestant nosedrops (e.g. Neosynephrine) or petroleum jelly (e.g. Vaseline) into the nostril. Squeeze again for another 10 minutes. Leave the gauze in for another 10 minutes before removing it. If bleeding persists, call the Kaiser advice nurse, but continue to keep the nose pinched closed in the meantime.

A cold washcloth or ice applied to the forehead, back of the neck, or under the upper lip does not help stop nosebleeds and should be avoided.

Prevention: A small amount of petroleum jelly applied two or three times a day to the center wall (septum) inside the nose is often helpful for relieving dryness and irritation. Use a Q-tip coated with the petroleum jelly and insert it only far enough so

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that most of the cotton on the end of the Q-tip is inside the nose.

Increasing the humidity in the room at night by using a humidifier may also be helpful. Get your child into the habit of putting 2 or 3 drops of warm water into his nostril or using a salt water nose spray before blowing a stuffy nose. Remind him not to pick his nose. Aspirin can increase the tendency of the body to bleed and should be temporarily avoided.

Please let us know if :

  • The bleeding has not stopped after two 10 minute applications of direct pressure
  • Nosebleeds occur daily even after petroleum jelly and humidification are tried
  • There are skin bruises not caused by an injury
  • There is blood in the stool or urine or heavier than normal menstrual bleeding
  • The child feels dizzy when he stands up or looks more pale than usual.

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