February 04, 2008,
K.D. asks from Sykesville, MD on September 25, 2007
How to handle frequent nose bleeds in a 4 year old?
My four year old seems to have a lot of unexplained nose bleeds. Today in the tub he stood up and his nose was gushing... blood was everywhere! Last week I discovered bloody sheets and pillowcase. Whenever he gets hit in the nose it usually bleeds. I wasn't concerned until today when his nose started bleeding for no apparent reason. He was crying when it happened (Daddy had just corrected him and he was quite upset), but no physical contact with anything prior to the bleeding. Should I be worried?
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Thanks to everyone who responded! You've all eased my concern! I'll just mention it to our ped and keep an eye on my boy!
J.B. answers from Washington DC on February 04, 2008
My eight year old son has been having nose bleeds for "apparent reason" for a couple years now. My husband said he was like that too, so I havent worried much. I did take him to the doctor once last year because I was worried, so they ran bloodwork, etc., but no conclusions. I think winter and spring have been the "seasons." I would just suggest you start keeping track so you have info to give the doctor if you ever go.
T.C. answers from Washington DC on September 26, 2007
My daughter (now 6) had this problem. Turned out there was a place up inside her nose that had a bunch of blood vessels very close to the surface. She needed ear tubes at the same time, so the surgeon cauterized that spot while she was under anesthesia. Since then, we've only had 1 or 2 nosebleeds. The surgery was about 2 years ago. Get your pediatrician to take a look.
I wouldn't worry about them, unless he's pale and lethargic or has some other troubling symptom. Some kids are just predisposed to nosebleeds.
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C.W. answers from Washington DC on September 26, 2007
I grew up with frequent nosebleeds, from the time I was about 5 until I was about 13 when it finally went away on its own. I had my nose cauterized once, but it didn't help me any. The nosebleeds were more of a pain then anything else, esp in school when I would spontaneously start bleeding for no reason. I'd check in with your ped and have some blood work done to be sure he isn't anemic, but I think it is pretty common with some kids.
D.M. answers from Washington DC on September 27, 2007
Of course you should be concerned. Nosebleeds are not a good thing for a child to have. It could be anything from not so serious to a more serious illness. If there was no contact and his nose bleeds, as you say gushing, that's very serious. You should be seeing or calling a physician to let him know what's going on more so than writing for a response from others. Get your child checked out. I'm sure your doctor can help him.
M.M. answers from Washington DC on September 26, 2007
I also experienced this problem, not with my son, but myself. My episodes happened when I was in middle school, and a couple of times in my late twenties; usually it because I was overheated or something, I would be in the middle of something and sometimes feel the need to blow my nose and all of a sudden it would start. Eventually it stopped happening, but in terms of a kid, I would rather run to the doctor for nothing, then not do anything. Besides, you pay insurance for that reason :) anyway, good luck to you and i hope everything works out.
R.J. answers from Washington DC on January 17, 2008
As a child I would get frequent nosebleeds but as an adult I am fine. I really think he needs medical attention from a ENT doctor. Nosebleeds could be caused from a number of things.
S.H. answers from Washington DC on September 27, 2007
One of my little brothers gets them often. He is 13 now but it started when he was quite young. It could be due to dry air or something like a deviated septum. I would ask his doctor. I know that a humidifier might help to put some moisture back in the air. Especially with fall coming and the humidity level decreasing so significantly. I wouldn't be too worried but would definately keep an eye on it and make the doctor well aware of it and its frequency.
S.L. answers from Washington DC on September 26, 2007
I have two children that get spontaneous nosebleeds. My ped said not to worry unless the bleeding continues for more than 60 minutes. It is true that the loss of blood from a nosebleed is not as concerning as other types of injuries that bleed, but it is a concern and a pain to deal with when you don't know when it will occur or for how long.
The two options are typically live with it or have the vein caurtorized (sp?). The latter is when a doctor burns/sears the vein to keep it from bleeding. I come from a "nosebleeding" family and several of my brothers had to have this procedure done. It is not 100% foolproof, and it is rarely recommended and only for severe and extremely frequent nose bleeding cases.
The typical option ("deal with it") is something that you will have to work out for your situation, and hopefully, these responses will give you some ideas to try.
My children are more susceptible to nosebleeds during allergy season (spring) and the cold, dry winter months. During these months, I use a cotton swab to gently coat the insides of their nostrils with Vaseline in the morning and at night before they go to bed. In the winter months, I run a cold mist vaporize to add humidity to their rooms. They like to bundle under their covers year round, but I have found that if they get themselves too hot, it spawns a nosebleed. I let them fall asleep as they like, then remove some of the coverings later so they won't overheat.
I have also made sure I kept a cloth in a baggie on hand at preschool and in my purse just in case. I found a character cloth that my child picked out that was their special cloth for those "silly nosebleeds" (this also helped to keep them calm about the whole thing). Now they are in elementary school and the school nurse has one as well. Fortunately, between the extra care and them getting older, the nosebleeds have lessened.
Continue to reassure your child. Try to make it seem more like an inconvenience than a concern so he will have that same perspective and not be upset by the nosebleed episodes.
Also, to treat the nosebleeds, make sure he is upright with his head in a normal forward position (do not have him put his head back)- you want the blood to flow in order to clot. Be sure to put pressure (whether with your finger or better yet, with a cold, damp cloth) on the end of the nose cartlidge rather than simply closing the nostril. If you can, get your child to do this, so he feels in control and will learn what to do if a nosebleed happens when you're not around. If the bleeding seems persistent, put something cold (I usually use another damp cloth) on the back of his neck. This helps slow the blood flow which comes from the back of the neck, up and over the top of the head. You may need to rewet the cloth with cold water for prolonged bleeding.
Try to read to him to keep him calm and still for at least 10 minutes while you try to stop the bleeding. If the bleeding does not stop, continue pressure until it does (we've sometimes had to do this for 30 minutes).
After it does stop, be sure your child isn't too rambunctious (engaging in overly active play) right after or the bleeding may start up again. We usually sit and color or do puzzles as a way to give the nose and my kids extra time to recover.
I would bring it up with your ped. They need to have this history, especially if the nosebleeds become a serious matter and require more extensive treatment despite how unlikely that may be. They may also have some other suggestions on what to do to help you handle these epsiodes.
Hope this helps.
J.C. answers from Washington DC on September 26, 2007
Worried isn't a good word. "On top of it "is how I would choose to frame it. Definitely discuss it with the doctor and insist on blood work. The health of our children is not something we should leave to an insecure emotion such as worry. If he has uncontrolled bleeding he should go to the ER, they will insert a plug to stop the bleeding. But the cause still needs to be diagnosed. Hope everything turns out ok.