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    Nosebleeds In Children

    Overview
    Causes
    Treatment
    Where To Seek Treatment
    KK Women's and Children's Hospital
    Contributed by the Children's ENT Centre; KK Women's and Children's Hospital

    Overview

    Nosebleeds can be scary, but usually cause no harm to children. Children usually bleed from the superficial and thin blood vessels at the front portion of the nose on the septum, just behind the nostrils. Such nosebleeds usually decrease after puberty as the nose lining thickens from hormonal changes.


    Causes

    The most common causes of nosebleeds are :

    • Nose-picking – this may also increase the frequency of nosebleeds
    • Allergies
    • Colds
    • Injuries

    Air-conditioning has a drying effect on the nasal lining, and increases the risk of nosebleeds. In rare instances, bleeding disorders or tumours may cause nosebleeds.


    Treatment

    nosebleedWhen a child’s nose bleeds, ask him to sit up, lean forward and pinch the lower soft portion of the nostrils together for 5 to 10 minutes, and breathe through the mouth.

    An ice pack can be placed across the nose-bridge and forehead or the cheek to allow for reflex constriction of the tiny blood vessels. The majority of nose bleeding stops during this time. If bleeding starts again, compression can be applied for another 10 minutes.

    Sitting upright keeps the nose higher than the heart, and reduces the flow of blood to the bleeding site.

    If your child’s nose bleeds only once in a few months it is not likely to be of serious concern. However, if it is a regular occurrence i.e. four to five times a month, your child should be reviewed by a specialist to rule out the rare causes – especially so, if your child does not sleep in an air-conditioned environment.

    Other Measures

    A humidifier
    can be used to reduce the drying caused by air-conditioning as it may not be practical to avoid sleeping in an air-conditioned room in Singapore’s warm equatorial climate.

    Advise your child against frequent nose-picking to prevent trauma to the affected area.
     
    If all these measures fail, consult an ENT surgeon who may cauterize (seal off ) the affected area with diathermy (a procedure using an electric current, usually done under general anaesthesia).

    If the child refrains from nose-picking and other predisposing factors are removed, this procedure usually allows for six months to a year of relief from symptoms. The ENT surgeon will also review the child to exclude any serious underlying medical conditions as the cause.

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