[sak9645]

Nosebleeds are very common in young children who have small noses and short nasal passages. There isn't enough room for cold air to get warmed by body heat and moistened by body fluids, and the cold, dry air quickly causes drying of the delicate tissues of the nose. Blood vessels crack and leak.

Nosebleeds scare people, but the amount of blood lost is surprisingly small. They are not much different from menstrual periods in that respect. When a woman has her period, it looks as if she is losing a lot of blood, yet she isn't. The only women who really lose a lot of blood when menstruating are those with conditions, such as fibroids, that cause hemorrhaging. Most kids' nosebleeds do NOT involve hemorrhaging and will not harm their health at all.

If your child is subject to nosebleeds, it's easy to panic, especially when one occurs at 3 a.m., you're exhausted, and your child is terrified. But don't. Just keep three things at hand: 1) A nasal aspirator if your child is too young to blow his/her nose; 2) A spray bottle of saline solution; and 3) A spray bottle of Afrin nasal spray. Do NOT let other people in the home use either of the spray bottles, and don't use them again on your child after using them when he/she has a nosebleed at the time he has a cold or other respiratory illness, to avoid spreading germs.

The baby books always tell you to sit your child up, with head upright or slightly tilted forward, and to pinch the nostrils for up to ten minutes, having the child breathe through his mouth, to allow the blood to clot.

Well, I have to tell you that very few babies and young children will sit still, letting you hold their noses, for ten minutes. The idea of sitting up with head upright or forward is fine, since you don't want a child to have blood going down his/her throat and upsetting his/her stomach. Kids can vomit and feel terrible when they swallow a lot of blood. But forget this ten minutes of pinching the nose, unless your child is unusually mellow. For one thing, ten minutes may not be enough to stop the blood flow, especially if your child is upset and crying.

Here's what worked for us and for many kids I know. First, use the nasal aspirator, or have your child blow his/her nose, to clean some of the blood and mucus out. Spray in some saline solution and suction or have your child blow his/her nose again.

Then, immediately, squirt some Afrin nasal spray (or one of its generic equivalents) into each nostril. Afrin contains a substance that constricts blood vessels; that's what makes it work as a decongestant. The blood flow should start to decrease, as the blood vessels start to constrict. If it's still pretty heavy, give one more squirt to each nostril. Your child may yell, because Afrin tastes bad if any goes down into his/her throat, or because it stings a wee bit, but it really isn't a painful experience.

In most cases, the bleeding will slow and come to a stop very quickly -- within a minute or two. Do NOT blow the nose again. Just clean the child up and let him/her go back to bed or whatever.

IF the child's nosebleed does not stop, even after using Afrin, then call your doctor or go to the emergency room. Your child may need to have a blood vessel cauterized, and your doctor may want to take some tests to rule out clotting problems. Or if the nosebleed was due to a fall on the face, there may have been an injury that is causing bleeding.

To prevent future nosebleeds, especially in the winter, do the following. Buy some Bacitracin ointment, and put a dab on a Q-tip into each nostril when the child gets up, and again at bedtime. If you can't find Bacitracin (which I recommend because it has mild antibacterial properties), you can get away with using Vaseline. Do not put enough to make it hard for your child to breathe; use only a small amount.

Some people like to use a squirt of saline beforehand, and that is fine. Saline does not contain medicine, and is harmless; it's just salt water, often buffered with something like baking soda to make it sting less. It is a good nasal moisturizer. Do NOT use Afrin, however, as a substitute for saline, when trying to PREVENT nosebleeds.

Do not use Afrin when your child has a cold, either. Afrin and other products like it can cause "rebound" congestion if used too frequently for colds and nasal allergies. Some people actually wind up needing to take steroids to open up their nasal passages, because they have overused the product and they can't breathe through their noses at all.

Use the Afrin ONLY when your child has a nosebleed that doesn't stop quickly on its own, and only use a squirt or two per nostril.

Some people find that using a room humidifier or vaporizer in winter moisturizes indoor air enough to reduce nasal drying and the incidence of nosebleeds. But do be careful if you use them. The steam type can cause serious scalding, so do not place them where a child can get at them or yank them off a table by pulling on the electrical cord. The "cool mist" type usually need very careful and frequent cleaning to avoid buildup of molds and bacteria.

And, of course, humidifiers don't help if a child goes outdoors in winter. That's why I would recommend the Bacitracin or Vaseline. It's a cheap and effective way to keep the nasal membranes from drying and cracking. You can even use an extra dab before your child goes to play in the snow.

Sharon



Sharon