Nosebleeds in Children: How to Stop Them and When to Get Help

Why nosebleeds happen

The lining inside the nose is thin and full of tiny blood vessels. Many are close to the surface at the front of the middle wall, called the septum.

Anything that dries, irritates, or injures this area can cause bleeding. Common triggers include:

• Nose picking, rubbing, or forceful blowing
• Dry air from heated indoor spaces, winter weather, or dry climates
• Colds and allergies, which irritate the lining
• Nasal sprays, including allergy steroid sprays, especially when aimed at the center wall
• Minor bumps or injuries
• Objects put into the nose, especially in toddlers

Most childhood nosebleeds come from the front of the nose and are easy to control. Repeated or unusually heavy bleeding can sometimes signal another problem and deserves assessment.

How to stop a nosebleed: step by step

A common mistake is not holding pressure long enough or letting go early to check.

1. Stay calm and reassure your child. Have them breathe through their mouth.
2. Sit upright and lean slightly forward. Keep the head tipped forward so blood can drain out rather than run down the throat.
3. Pinch the soft part of the nose firmly between your thumb and finger, just below the hard, bony bridge. Press both nostrils closed.
4. Hold continuously for a full 10 minutes. Use a clock or timer. Do not release the pressure to peek.
5. Have your child gently spit out blood that collects in the mouth rather than swallowing it.
6. If it is still bleeding after 10 minutes, repeat firm pressure for another 10 minutes and contact your child's clinician for advice. Keep pressure on while arranging help.

If bleeding continues after about 20 minutes of correct pressure, go to the emergency department. Get help sooner for heavy bleeding, weakness, breathing problems, or a child who seems unwell.

What to avoid

• Do not tilt the head back or have your child lie flat.
• Do not pinch only the hard bridge of the nose.
• Do not stuff tissues, cotton, or other material into the nostrils.
• Do not pick out clots or blow the nose to clear them during first aid.

What about a decongestant spray?

A clinician may sometimes recommend a medicated spray such as oxymetazoline to help control bleeding. It is different from plain saline.

Ask your child's clinician before using a medicated decongestant for a nosebleed. Follow a specific plan for the product, age, amount, and duration. Do not let trying a spray delay care for ongoing or heavy bleeding.

After the bleeding stops

A small dark clot or dried blood near the nostril can be part of healing. Leave it alone rather than pulling it out.

For the next 24 hours, try to avoid nose picking, forceful nose blowing, and strenuous exercise. If your child needs to sneeze, encourage an open mouth. After cautery or packing, follow the clinician's instructions about activity and nose care.

Swallowed blood can upset the stomach, but repeated vomiting of blood, choking, or ongoing blood running into the throat needs urgent medical assessment. Do not assume that vomiting blood is harmless simply because there was a nosebleed.

How to prevent nosebleeds

If your child has frequent nosebleeds, focus on reducing dryness and irritation:

• Keep the lining moist. Saline drops, spray, or a saline nasal gel may help. Choose an age-appropriate product and follow its directions.
• If the clinician recommends an ointment, use only the small amount and duration advised at the front of the nostril. Do not put it deep inside. Ask before using petroleum jelly, particularly in a child under 2; do not make deep or prolonged application a routine.
• Use a cool-mist humidifier if the air is dry. Clean it regularly according to the manufacturer's instructions.
• Discourage picking and forceful blowing. Keep fingernails trimmed.
• Keep your child away from tobacco smoke and other irritating fumes.
• Use nasal sprays correctly. Aim away from the center wall toward the outer side of the nostril. Ask the clinician or pharmacist to demonstrate.
• Discuss ongoing allergy symptoms and any medicines that may be contributing to irritation or bleeding.

Our Allergies in Children guide explains common nasal allergy symptoms and treatment options.

When to get help

Call the pediatrician

Arrange medical advice if:

• Nosebleeds are frequent, hard to stop, or interfere with daily life.
• Bleeding repeatedly comes from one side, especially with blockage, pain, or unusual discharge.
• You suspect an object is stuck in the nose. Do not try to remove it by probing inside.
• Your child bruises easily, bleeds from the gums, or has a family history of bleeding problems.
• Your child has a bleeding disorder or takes medicine that affects clotting. Do not stop prescribed medicine on your own.
• Your child is younger than 2 years old and has a nosebleed.

Unexplained new bruises or bleeding from other sites along with a nosebleed deserves prompt advice rather than waiting for a routine visit.

Seek emergency assessment

• Bleeding continues after about 20 minutes of correct pressure.
• Bleeding is heavy or you think your child is losing too much blood. Do not wait to measure an amount.
• Your child is unusually pale, weak, dizzy, or lightheaded.
• Your child repeatedly vomits swallowed blood or blood keeps flowing into the throat.
• The nosebleed follows a significant head or facial injury, particularly with loss of consciousness, repeated vomiting, severe headache, vision changes, or trouble walking.

Keep applying pressure while arranging help if it is safe to do so. Our Head Injuries in Children guide covers related injury warning signs.

What a doctor may do

Most children need only simple first aid. The clinician can examine the nose and review triggers, medicines, other bleeding symptoms, and family history.

If bleeding is difficult to control, a clinician may use a medicated treatment, place a nasal pack, or seal a visible bleeding vessel with cautery. Numbing medicine is often used before cautery.

For frequent or unusual bleeding, the pediatrician may recommend an ear, nose, and throat specialist or blood tests. Not every child with an occasional nosebleed needs testing.

A quick first-aid reminder

• Sit upright and lean forward.
• Pinch the soft part of the nose below the bony bridge.
• Hold for 10 full minutes without checking.
• If bleeding continues, repeat pressure and contact the clinician. Go to the emergency department if it continues after about 20 minutes.
• Get help sooner for heavy bleeding or an unwell child. Call 911 for breathing trouble, collapse, or poor responsiveness.
• Avoid putting things into the nose or disturbing the clot.