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HOW  NOSE-BLEEDS  HAPPEN

 

Nose-bleeds are very common in young children, but they are rarely serious. The medical term for a nose-bleed is epistaxis, and the usual cause is damage to the blood vessels inside the nose.

 

• Tiny blood vessels in the nose can swell and burst, or become inflamed and damaged. 
• These blood vessels are concentrated in an area of the nose called Little's area towards the front of the septum (this is the area of gristle in the middle of the nose that separates the nostrils). 
• The blood vessels moisten and warm the air that we breathe before it reaches the lungs, so they are very near the surface of the inner lining of the nose - and this makes them vulnerable to damage. 

A nose-bleed is usually a result of damage to the tiny blood vessels found just inside the nostrils.

 

The causes

 

There are many types of nose-bleed, triggered by a variety of factors.

 

• Most nose-bleeds are caused by the child picking her nose - a common childhood habit.
• A foreign body may be stuck in the nose ­ children may put small items into their nostrils, where they can become stuck, leading to bleeding.
• It's also possible for a nose-bleed to result from your child blowing her nose too hard, or sneezing violently if she has a cold.
• Another type of nose­bleed is one resulting from an allergic reaction, such as hay fever or a reaction to a pet.
• If nose-bleeds occur frequently, this could mean that the lining of your child's nose is particularly fragile or infected.
• Nose-bleeds can indicate a serious health problem, such as a blood-clotting disorder or leukemia, but this is very rare. 

A nose-bleed may be I caused by a physical  injury, or may be due to something as simple as your child blowing her nose too hard.

 

A minor condition

 

Generally nose-bleeds are nothing to worry about - there is often less blood than you think.

• Nose-bleeds are frequent during the winter months, when colds, sinus infections and dry winter air can dry out the lining of the nose and make bleeding more likely. 
• Even if the bleeding makes you anxious, don't panic - it may just be that your child has made it worse by rubbing or picking her nose. 
• If your child suffers from a nose-bleed during the night, you may see dried blood on the pillowcase in the morning. Again, there is no reason to worry. 

When to call the doctor

 

If pinching the nose fails to stop a nose-bleed and it seems particularly severe, or lasts for longer than half an hour, seek medical advice.

 

• You may be advised to take your child to your local accident and emergency department, where a doctor may stop the bleeding by packing your child's nose with gauze (never try to do this yourself). 
• If your child's nose­bleed is due to a foreign object becoming stuck in her nose, don't attempt to remove it yourself, even if you can see it - you could end up pushing it further up her nose. 
• Seek medical advice if your child gets a nose-bleed from a blow to the head or a fall. 

How to treat a mild nose-bleed

 

Don't panic if your child has a nose-bleed - the right treatment should stop it quickly.

 

Try to remain calm, even though your child's nose may appear to be bleeding heavily. If your child gets excited or upset, her agitation is likely to prolong and worsen the nose-bleed. 

Don't tilt your child's head back as this could result in blood flowing down her throat, which may make her sick. Instead, get her to sit tilting her head forward - this will allow the blood to drain from her nose. 

Gently pinch the soft part of your child’s nose between your thumb and index finger 10 minutes if possible, or get her to do it herself. Then gently release. If it is still bleeding, follow the steps for treating a severe nose-bleed. 

Don't allow your child to blow , her nose after you've stopped squeezing it, and don't be tempted to il1sert tissues or cotton wool into her nostril to clean it, as this could disturb any clots that have formed stop the bleeding.

NOTE: your child is likely to have further light nose-bleeds over the following days, until the lining of her nose has fully healed. 

 

How to treat a severe nose-bleed

 

If the treatment for a mild nose-bleed doesn't seem to be working, you will need to try a different approach.

 

• Sit your child up at the table and place a bowl under her face for her to lean over. 
• If she has blood collecting in r mouth, encourage her to spit it out. 
• Pinch her nose very firmly just below the bridge, or get her to do it herself. Apply gentle pressure for 10 minutes. Don't be tempted to release the pressure to see if it has stopped the flow of blood - it is important that it remains constant. 
• Reassure your child and as she leans over the bowl remind her to breathe through her mouth, keeping it open so that any blood can drip into the bowl. If the bleeding persists for more than 30 minutes, seek medical help. 

NOTE: a severe nose-bleed may result in your child vomiting blood that has been swallowed.

 

To treat a serious nose-bleed, your child should be seated with her head forward, while you gently pinch her nose for 10 minutes.

 

Medical treatment

 

If your child has severe nose-bleeds or they recur frequently, she may be referred to an ear, nose and throat specialist for further treatment.

 

Chemical cauterization: this may be recommended, particularly if your child's nose-bleeds seem to be occurring because the lining of her nose is very fragile. This involves using a chemical called silver nitrate, which is applied to the area of to the nose that’s been bleeding, using a cotton bud.

 

Electric cauterization: This is used for more severe cases because the result of the chemical methods are sometimes temporary.  Your child will need to have a general anaesthetic.

 

Preventing nose-bleeds

 

There are several steps you can take to make the occurrence of nose-bleeds less likely.

 

• Dry air can dry out the nasal lining - if the air in your home is dry, or you have the central heating on, use a humidifier in your child's bedroom at night. Alternatively, place a bowl of water in her bedroom. 
• Applying a small amount of petroleum jelly to the inside of your child's nose can relieve any dryness, but ensure that your nails are short. 
• It's extremely difficult to convince a young child that she shouldn't pick her nose, so keep her fingernails trimmed so she's less likely to scratch the lining of her nose. 

For  More  Information:  Please  consult  your  physician  on  your  next  visit.