“My kid is waking up with blood all over the pillow from the nose, is he/she ok”?? Oh nose bleeds this time of the year. For one thing- any time our kids bleed from any orifice it can be scary. It can also be embarrassing for our children if one occurs during school or with friends.
Most of the time children have what is called “benign” nose bleeds. This means that it occurs for a reason that is “not bad”. Causes can be from picking noses, blunt trauma (even just rubbing the nose from itching), or a foreign body (did they stick something up there?).
Other causes of nose bleeds can most likely be from dry air, cigarette smoke, inhaled corticosteroids (like flonase), a sinus infection, sinus congestion, or a strong cough. Yes, even a cough can cause a nose bleed– it increases the pressure in the sinus cavity and can cause little breaks in the skin inside the nose.
Well, my doctor told me to use flonase for my allergies, what should I do? Steroids can cause breakdown and fragility in the skin inside the nose– therefore causing increased bleeding. Talk to your doctor about by mouth allergy medications and/or an allergy nasal spray such as azelastine which does not have steroids to help.
Here are some tips to help decrease those pesky nose bleeds– first things first— HUMIDIFY! Get a humidifier and put it in your child’s bedroom at night so his/her little nose doesn’t dry out and crack open. Another thing you can do is put a little bit of vaseline right on the inner part of the nose to help hold in moisture as he/she sleeps.
If you see any raw/open areas around/in the nose you can ask your provider for mupirocin to use instead of vaseline. Mupirocin will decrease the incidence of a stubborn little bacteria (staph aureus) which can be a cause of bleeding from the nose.
What do I do if my child’s nose is actively bleeding? First apply pressure to the bridge of nose by pinching it, and have child slightly tip head forward. DO NOT have child tilt head back. This can cause the blood to go down the throat and even in to the lungs (let’s not open up that can of worms).
If that doesn’t seem to work, get some ice and apply to bridge of nose while continuing to hold pressure. And if the nose continues to bleed, another at home measure is to give 1-2 sprays of Afrin nose spray to the affected side. Afrin is a decongestant and constricts the blood vessels of the nose which helps form a clot.
If a nose bleed persists for longer than 30 minutes or if the child is having multiple nose bleeds per week, please consult with your provider. Sometimes labs need to be drawn to rule out other causes of nose bleeds, or maybe a referral to ENT (ear nose throat) for cautery.