What causes them?
Many nosebleeds are idiopathic - that is there is no obvious cause, or the cause is unknown. But in children frequent colds and the drying effect of central heating can cause irritation of the delicate mucus membrane that lines the nose. This becomes inflamed, crusted or cracked, and is much more likely to bleed.

Bumps to the nose, especially once it's inflamed, and vigorous nose blowing can trigger a bleed. Rare causes include tumours and thrombocytopenia, a shortage of platelets - the tiny cells in the blood that plug damaged blood vessels. This causes problems with the blood's clotting mechanism, especially in children.

Nosebleeds are described as either anterior or posterior depending on which part of the nose the bleeding comes from. Children almost always have anterior nosebleeds, from a vein (unlike older adults where it's more likely to be posterior and come from an artery).

Small children who suffer frequent respiratory infections are at increased risk. Some children just have a tendency to nosebleeds, for no obvious reason.

What are the symptoms?
Fairly obviously, loss of blood from the nose is the major symptom. Some children can sense a bleed starting before it's obvious. The child may also be aware of blood entering the throat from the back of the nose especially if they hold their head back or lie down (this can cause a bad taste).

What's the treatment?

Most nosebleeds in children can be easily treated. Keep the child as calm as possible. Tell them to tip their head forward and breathe through their mouth while you pinch the soft parts of the nose together between your thumb and index finger, just below the bony part of the nose.

Then press the pinched nose firmly towards the face. Keep this position for five full minutes (ideally ten) making sure the child's head is held up well above the level of the heart.

If bleeding persists, apply a cold pack against the face and get medical advice. If nosebleeds are frequent, surgical treatment (such as cautery to seal the blood vessels) may be needed.

How do you prevent them?
Keep the child's nasal mucosa as moist as possible, especially if they have a cold. Use a humidifier in their room, a saline nasal spray, or apply a dab of petroleum jelly just inside the nostril (older children only).

Teach them not to pick their nose, especially when they get a cold.

This article was last medically reviewed by Dr Rob Hicks in July 2006.