Why does my child keep having nosebleeds?

What you need to know about this alarming, though usually harmless, childhood problem.

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Nosebleeds have been a part of 5-year-old Hansel’s life for as long as he can remember. The first time he bled, he was just under a year old.

Recalls his mum Marissa Lee, “I noticed some streaks of blood on his pillow and pyjamas in the morning, then realised it came from his nose.”

She adds that the nosebleeds would occur around two to three times a month on average. Some days, the bleeding would be severe, other days, it would be light. Whenever Lee brought Hansel to the paediatrician, she would be told that his blood vessels were thin at his young age, so any irritation or dryness would trigger the bleeding.

“It has happened a few times at his childcare centre, so they know what to expect and how to handle it. I was told it’s quite common and as long as it is not a sign of something more severe, we are okay in managing it,” she notes.

“There was just so much bloody tissue paper all around us.”

The only challenge, Lee says, was managing it when they were in public. Once, about two years ago, Hansel had a severe nosebleed at an indoor playground, which frightened other parents and children.

“He was busy playing, so didn’t notice, and the blood basically flowed very quickly before anyone had time to react and his T-shirt was soaked,” she recalls. She pinched the top of her son’s nose and placed an ice pack on it, but the blood continued to flow.

“Usually the bleeding stops in 5 to 10 minutes, but this time it didn’t ― there was just so much bloody tissue paper all around us. In the end, one of the staff produced a disposable cup and we let the blood flow into that,” she says. Hansel had to sit at the side with a cup under his nose for almost half an hour before the bleeding subsided.

Thankfully, Hansel rarely has severe nosebleeds these days, and Lee has her fingers crossed that he is outgrowing the condition. “He does still get it once in a while, but it’s usually quite light, and happens when he is sniffly or has a cold.”

Nosebleeds are common, but usually nothing to worry about. Find out what causes them… next!

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What causes nosebleeds?

Dryness and irritation are the most common causes of nosebleeds, particularly in children who have very tiny blood vessels that are easily damaged and bleed.

“It is often due to minor trauma, for example, in nose picking, when the child has a flu or cold, allergic rhinitis, or when the air is dry ― like in air-conditioned rooms or in temperate countries in winter,” says Dr YT Pang, a senior ENT and allergy consultant at the Centre for Ear Nose Throat Allergy & Snoring.

He adds that up to 50 per cent of children will experience at least one nosebleed episode. Most of them are not serious, though, even though the amount of blood lost may seem like a lot.

What should parents do?
Even though you might feel panicky, stay calm and reassure your child that everything is going to be fine.

Seat your child on your lap and lean him forward slightly, so that the blood does not flow down the throat. Gently pinch the soft part of his nose (around both nostrils) shut for around 10 minutes, and try not to peek to check if the bleeding has stopped.

“While pinching his nose, ask your child to breathe through his mouth. Calm him down and ask him to focus on his breathing.”

“The nosebleed will stop with pressure,” says Dr Pang. “While pinching his nose, ask your child to breathe through his mouth. Calm him down and ask him to focus on his breathing.”

He adds that if the nosebleeds are recurrent, or if the bleeding does not stop within 30 minutes, a specialist should take a look at him.

How to prevent future nosebleeds
One way to stop nosebleeds is to cauterise the prominent blood vessels inside the nose, Dr Pang explains. The doctor either puts silver nitrate on the spot that’s bleeding, or uses electrocautery (a small probe with a mild electric current running through it) to seal or destroy the tissue under local anaesthesia or when he’s sedated.

More importantly, the underlying cause should be dealt with. This can include placing a humidifier in your child’s bedroom at night (especially if the air-conditioning is turned on), trimming his finger nails and treating his allergies if he has any.

For more advice on how to eliminate the causes of your child’s nosebleeds, talk to your doctor.

Photos: iStock

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