July 15, 2024


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Pediatric Nasal Bleeding: Causes, Dos and Don’ts – Expert Insights

Bengaluru, Jan 27: Nasal bleeding in children can be a cause of concern for parents, prompting anxiety and distress. Dr. Sunitha Madhavan, Senior Consultant ENT Specialist at Kinder Hospital, Whitefield, Bengaluru, sheds light on the common causes and offers practical advice for parents.

Dr. Sunitha Madhavan explains, “As an ENT consultant, I frequently come across children experiencing nasal bleeding. The nose is a highly vascular structure with a rich blood supply, making it susceptible to bleeding at any time.”
She highlights the causes of nasal bleeding in children, emphasizing the potential impact on daily activities. “Nasal bleeding commonly occurs in childhood, typically between the ages of 3 to 8 years. It can originate from the front or back of the nose, sometimes trickling into the throat. The causes range from minor to, in rare cases, life-threatening.”

The majority of cases, approximately 70 to 80%, are spontaneous and without a specific cause, known as primary epistaxis. Dr. Sunitha Madhavan identifies factors such as cold dry air in winter leading to dryness, crusting, and bleeding. Viral infections tend to spread more during the winter season.

Local causes, including digital trauma or nose picking, rubbing of the nose due to allergies, and blunt trauma, can contribute to recurrent bleeding. Dr. Sunitha Madhavan mentions, “Upper respiratory infections, sinusitis, vasculitis, structural abnormalities like deviation of the nasal septum, infected polyps, angiomas, and angiofibroma are potential causes of nasal bleeding.”

Nasal bleeding can be attributed to various factors, as outlined by Dr. Sunitha Madhavan. She notes, “The presence of a foreign body is a frequent cause of nosebleeds. Children, often unknowingly, may insert objects into their noses, and they might not disclose this activity. Consequently, there could be yellow discharge or bleeding from the nose. In some instances, children have been found to insert potentially harmful items like batteries into their nasal passages.”
Furthermore, Dr. Madhavan points out that benign lesions such as angioma and angiofibroma, while uncommon, can also contribute to nosebleeds.

Besides, Long-term intranasal use of steroids or faulty administration can also lead to bleeding. Secondary causes involve underlying health conditions such as anemia, bleeding disorders, platelet disorders, leukemia, vascular abnormalities, liver disease, and hemorrhagic infections like dengue. Dr. Sunitha Madhavan urges parents to stay informed about these dos and don’ts, emphasizing the importance of seeking medical evaluation for recurrent episodes of nasal bleeding.

Dos and Don’ts in Nasal Bleeding:

Relax and avoid stress during minor bleeding.
Sit with the head slightly tilted forward, pinch the nose, and breathe through the mouth to prevent airway obstruction.
Use decongestant nasal drops and topical antiseptic cream for crusting.

In severe bleeding, seek immediate medical attention, applying pressure on the nose and breathing through the mouth.

Correct anemia through iron-rich foods or supplements.


Avoid nose picking; trim fingernails.

Refrain from forceful blowing of the nose.

Don’t panic; stay calm.
Avoid lying down immediately to prevent aspiration or swallowing of blood.

Do not swallow the blood; seek medical attention, especially in cases of severe bleeding.

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