Synonym
EpistaxisNosebleeds (epistaxis) usually look worse in babies and toddlers than they actually are. Nosebleeds are relatively common in babies and toddlers, but in most cases they are not dangerous. The nasal mucosa contains many small blood vessels that form a vascular network very superficially in the front part of the nasal septum.
For various reasons such as nasal drilling or snorting too violently, these veins can be injured and burst. In most cases the nosebleed stops by itself and the blood loss is often minimal. Parents should be careful, however, because in rare cases a medical emergency due to high blood loss can occur if the bleeding is not stopped.
Causes
Nosebleeds in babies can have many causes. There are many small veins in the nasal mucosa, which are very sensitive to injury and can be damaged by minor irritation. If, for example, the nasal mucous membranes are dried out by dry air or the nasal mucous membrane is irritated by a cold, nosebleeds can quickly develop.
Of course, frequent blowing is also a mechanical irritation that can injure veins. In dry air, the nasal mucosa is less elastic and tears more quickly. Nosebleeds can also be caused by “picking your nose“, especially if your fingernails are too long or not round enough.
This leads to scratching of the mucous membrane and the veins. Inserting a foreign object (e.g. a toy) or falling on the nose can also cause nosebleeds in babies. Prolonged crying can also be the cause of nosebleeds. In rare cases, severe and prolonged nosebleeds are caused by a coagulation disorder.
Therapy
To stop nosebleeds in the baby, some simple measures can be followed. The first is to gently squeeze the baby’s nostrils. This puts pressure on the veins in the nose and stops the bleeding.
This should be done for a few minutes, as releasing too early can cause the nosebleed to start bleeding again. Also, if possible, the baby’s head should be held upright and not tilted backwards. This prevents the baby from swallowing blood.
Swallowing blood may cause nausea and vomiting, but choking will increase the pressure in the head and stimulate bleeding. Another measure is to place a cold cloth in the neck. This causes the blood vessels in the nose to constrict as well, which means that less blood can flow out of the vessels and the bleeding is stopped more quickly.
Parents should also try to calm the baby. Too much crying and excitement will cause the blood pressure to rise and thus also the bleeding. If the bleeding cannot be stopped after 15 minutes despite pressure on the nostrils, or if the bleeding is very heavy, an emergency doctor must be called or driven to the doctor, as a life-threatening condition can develop due to the high blood loss.
The nose should continue to be closed until the doctor arrives. No tissues or tamponades should be placed in the nose, as removing them can cause the closed wounds to reopen and the bleeding to start again. If the nosebleed is caused by a foreign body, a doctor should always remove the foreign body.
This should never be removed by the patient himself. In the event of a fall or blow to the nose, which is followed by a nosebleed, care should be taken to check whether the nose is broken or there are signs of a concussion. In these cases a doctor must be consulted in any case. (see: Nosebone fracture symptoms) In the case of recurrent nosebleeds and also bleeding that is severe and prolonged, a pediatrician should look at the baby, examine the nose and do a blood test to rule out a possible rare congenital coagulation disorder.
