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Nose bleeds

Nose bleeds are a common childhood problem. Children usually grow out of nose bleeds by age 11.

Normally they don't last long and can be managed at home. 

Causes of nose bleeds include:

  • a minor injury for example a bump to the nose
  • nose picking
  • coughs and colds
  • allergic rhinitis (hayfever)
  • foreign body (something stuck up the nose)
  • a bleeding disorder (very rare)

The bleeding is usually from the front part of the nose. The amount of blood may seem like a lot but it is rare for children to lose so much blood that it causes any problems (such as anaemia). This only happens with frequent, heavy nose bleeds over several weeks or months.

If your child's nose bleed was caused by a head injury, visit our head injury page for more advice.

The advice below should help you decide if your child’s nose bleed needs further help or if it can be managed at home.

If your child has any of the following:

  • Takes medication to stop blood clotting for example warfarin, heparin or aspirin
  • Under 2 years old
  • Bleeding lasts more than 30 minutes despite first aid treatment, see below
  • Bleeding from both nostrils (suggests a nose bleed from the back of the nasal passage)
  • If despite sitting your child upright and getting them to lean forward, they are choking on the blood (this suggests a nose bleed from the back of the nasal passageway)
  • Their nose looks out of shape after an injury 

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

(first aid for a nose bleed should be started at the same time – see below)

If your child has any of the following:

  • Discharge from the nose as well bleeding as may be due to something stuck up their nose
  • Frequent small nose bleeds that respond to first aid
  • If your child has nose bleeds and bruises on their body
  • A family history of a bleeding disorder

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

(first aid for a nose bleed should be started at the same time – see below)

If none of the above red or amber features are present:

  • Use the advice below to care for your child at home
  • If your child continues to get frequent nose bleeds, please arrange to speak to a health professional

Self care

Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local community pharmacist, or call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across West Yorkshire with consent from the Hampshire development groups.

First aid for nose bleeds:

  • Keep your child calm by giving lots of reassurance
  • Sit your child up and lean them slightly forward (see diagram below)
  • Encourage them to breathe through their mouth 
  • Apply constant pressure for 20 minutes to the soft front part of the nose by pinching it between index finger and thumb
  • Encourage them to spit out the blood. Swallowing blood can make children sick which may restart the nose bleed
  • It is tempting to release the pressure from the nose to check if the bleeding has stopped. Do not do so until the 20 minutes has finished
  • Keep the area cool to help stop the bleeding. You can offer your child a cold drink or an ice lolly to suck. An ice pack can be wrapped in a tea towel and placed on their forehead or the top of their nose

If the bleeding doesn't stop, recheck that you are squeezing the soft front part of the nose and apply pressure for a further 10 minutes.

If at this point, there is ongoing bleeding then call an ambulance via 999. Calmly continue applying first aid measures until they arrive.

FireShot Capture 346 - First aid - Nose bleeds - www.ehsdb.com.jpg

After the nose bleed:

If the bleeding has stopped then for the next 24 hours your child should:

  • Not pick or blow their nose
  • Avoid vigorous exercise and sport 
  • Avoid straining and heavy lifting
  • Avoid hot baths, showers and warm drinks 

How to prevent future nose bleeds:

If your child's nose is dry and cracked, apply a petroleum-based jelly (for example Vaseline) to the nostrils twice each day for a week. This can be done by using your little  finger and gently rubbing it on the inside of the nose. Do not use this method in children under 4 years of age as they are unlikely to sit still and their nose may be injured.

If your child is suffering from constipation, increase their fluid intake and the amount of fibre in their diet. Ask your doctor or local community pharmacist for a stool softener to prevent them from straining.

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice on a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents, carers and young people more information about other organisations that might also be able to help.

Pharmacists are experts in many aspects of healthcare, and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment, and many have private consultation areas. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand. Watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns, or to the Community Paediatricians, or the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 0300 373 0944

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

For more information about what Health Visitors do: What does a health visitor do?

School nurses care for children and young people, aged 5 to19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and, or emotional health needs.

 

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse. Phone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Contact your local school nursing team:

Bradford School Nurses 01274 221203

Wakefield School Nurses (0 to 19 service) 0300 373 0944 (local rate number)

Leeds School Nurses 0113 843 5683

Calderdale School Nurses 030 3330 9974 (local rate number)

Kirklees School Nurses 0300 304 5555 (local rate number)

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand. Watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Please note, the online version of NHS 111 is only recommended for children over the age of 5. If your child is under 5 years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as:

  • loss of consciousness
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand. Watch this video with them about going to A&E or riding in an ambulance