SYMPTOMS

What is childhood nosebleed?

Nosebleed (epistaxis), commonly known as a bloody nose, is called "nosebleeding" in traditional medicine. It refers to blood flowing forward from the nasal cavity or backward into the mouth. It is one of the common clinical symptoms in otolaryngology and, in some cases, requires emergency treatment.

Nosebleeds are very common in children, and most cases are not serious. A very small number are caused by blood, vascular development, or other abnormal diseases. This type of nosebleed is often difficult to stop.

What are the serious conditions of childhood nosebleed?

Nosebleeds can manifest as recurrent intermittent bleeding or continuous bleeding. The amount of bleeding varies. Mild cases may only show blood in nasal mucus, while severe cases can involve heavy bleeding, leading to excessive blood loss, resulting in low blood pressure, hemorrhagic shock, and even life-threatening conditions. Long-term recurrent nosebleeds can cause anemia.

What causes childhood nosebleed?

Nosebleed is a clinical symptom caused by many factors. The causes can be divided into local and systemic factors. It can be a common symptom of nasal or sinus (small cavities in the surrounding jaw or skull bones) diseases or a local manifestation of certain systemic diseases (such as blood disorders), with the former being more common. Bleeding is mostly unilateral, while bilateral bleeding is relatively rare.

TREATMENT

How to Stop a Baby's Nosebleed?

If your baby has a nosebleed but is generally in good condition, with normal mental reactions and no abnormalities such as nasal foreign objects, severe trauma, pale complexion, or difficulty breathing, you can follow these steps to stop the bleeding:

1. Stay Calm

For older children, offer verbal reassurance, telling them it's okay. For younger babies who don’t understand, remain composed—smiling or acting as if nothing is wrong is better.

• Do not panic excessively, as this may frighten the baby, causing crying, resistance to treatment, or even worsening the bleeding.

2. Lean Slightly Forward

Have the child sit upright and lean slightly forward. For uncooperative babies, parents can hold them while keeping their body slightly tilted forward.

• Do not let the child lie down or tilt their head back, as this may cause blood to flow backward, leading to choking or vomiting from swallowed blood.
• Do not let the child lower their head or lie face down, as this may worsen the bleeding.

3. Pinch to Stop Bleeding

For older children, have them breathe through their mouth while gently pinching the nostrils for at least 5–10 minutes. Most nosebleeds stop within this time, but aim for a full 10 minutes of pressure.

For babies, parents should pinch the nostrils to prevent blood flow, using a pressure similar to blocking their own nose from inhaling. Continuously soothe the baby during this time to reduce crying—distract them with favorite cartoons, verbal comfort, etc.

4. Check if Bleeding Has Stopped

After 10 minutes, release the pressure and check for bleeding. If it persists, repeat the pinching. If bleeding continues after another 10 minutes, seek medical attention immediately.

• Do not press too hard, as this may hurt the baby, causing resistance and hindering the process.
• Do not release the pressure before 10 minutes to check (even if the child resists, maintain pressure for 5–10 minutes). Interrupting may disrupt clotting and prolong bleeding.
• No need to apply ice or cold cloths to the neck, forehead, or nose—this has little effect and may make the baby struggle.
• Do not stuff tissues, gauze, or other objects into the nose. Nasal packing is only for severe bleeding when pressure and medication fail, as it is highly irritating and requires an ENT specialist with local anesthesia. Improper packing may damage nasal membranes and cause more bleeding.

How to Prevent Baby Nosebleeds?

1. After a nosebleed stops, ensure the baby avoids rubbing, picking, or blowing their nose for 2–3 days. Teach them not to pick or blow their nose too hard in general.
2. Maintain indoor humidity at 40%–60%. Use a steam humidifier (mist-free type) or purified water in a mist-type humidifier.
3. Apply petroleum jelly inside the nostrils 2–6 times daily to protect nasal membranes.
4. Clean the nose with saline or seawater nasal drops/sprays 2–6 times daily.
5. Avoid smoking at home or exposing the baby to other irritants like smoke.
6. If the baby has allergic rhinitis, sinusitis, etc., manage and treat these conditions proactively.

DIAGNOSIS

When Should a Baby with Nosebleed Seek Medical Attention?

1. If the baby's nose continues to bleed after two attempts of pinching;
2. In severe cases, if the baby has heavy bleeding, with blood flowing from the mouth, vomiting or coughing up blood, or bleeding from other areas such as the gums;
3. In addition to nosebleeds, the baby shows signs of paleness, weakness, poor mental state or responsiveness, or discomfort from a foreign object in the nose.

POTENTIAL DISEASES

What are the common causes of nosebleeds in babies?

Nosebleeds are very common in children. Although they may look scary, most cases are not serious. Only a very small number are caused by blood, vascular development, or other abnormal diseases, and such nosebleeds are often difficult to stop.

Common causes of nosebleeds in children include dry air (dry cold or dry heat), smoke (secondhand smoke, kitchen fumes, etc.), nose-picking, forceful nose-blowing, nasal trauma, foreign objects in the nose, colds, rhinosinusitis, and nasal allergies, all of which can lead to nosebleeds. Nosebleeds caused by these reasons often disappear during adolescence.

For more causes, you can refer to the "Nosebleed" entry for adults.