Mom and son touching noses and smiling.
25 Feb
bumps and boo boos, germ woes

Nosebleeds in kids: Why they happen and what to do about them

Nosebleeds (epistaxis) in kids can be messy and sometimes downright scary! But have no fear; they are common in childhood and usually nothing to be alarmed about. Armed with some knowledge about why nosebleeds happen and what to do about them, you can feel ready to handle the next gory episode. As with any new symptom, it is best to discuss with your doctor if you have any specific questions or concerns. 

 

Why do Nosebleeds happen?

What are they?

  • Nosebleeds are bleeding from the soft tissues (mucous membranes) inside the nose, usually from a broken blood vessel.
  • Most nosebleeds come from the same area, near the front part of the nose, where there is a collection of tiny blood vessels called the Kiesselbach plexus.

 

What causes them?

Nosebleeds are common in childhood and are more common in dry climates and winter.

  • Dry air causing skin irritation
  • Nose picking
  • Colds and allergies
  • Injury to the nose
  • A foreign body in the nose

 

What do I do if my child gets nosebleeds?

What do while my child has a nosebleed?

  • Stay calm and reassure your child. Avoid commenting on how much blood there is! 
  • Advise your child to breathe slowly through their mouth.
  • Have your child sit and lean forward slightly. They should not lie down or tilt their head back as this can cause them to swallow blood, yuck.
  • Apply firm pressure to the nostrils at the soft area just below the bony bridge of the nose. Hold for at least 5 minutes and resist the urge to peek and see if bleeding has stopped. Set a timer if you need to!
  • You may also choose to apply a cold compress.
  • If bleeding does not stop, repeat the above steps. If bleeding continues, bring your child to a medical provider. In some cases, they may decide to do a procedure called cauterization, where heat is used to help stop the bleeding from a broken blood vessel. 

 

How do I prevent nosebleeds?

  • A humidifier placed in your child’s room can help with dry air.
  • Nasal saline sprays and drops can also help avoid dry skin in the nose moist and protected.
  • If you think your child might have congestion due to allergies – talk with your Pediatrician about possible treatment options.

 

When should I talk to my Pediatrician about nosebleeds?

  • If your child has recurrent nosebleeds.
  • If a nosebleed does not stop or recurrent nosebleeds repeatedly bleed for more than 5 minutes.
  • If your child has other symptoms such as easy bleeding from cuts and scrapes, bleeding from their gums, blood in their stool, or easy bruising.
  • If there is a large amount of blood.
  • If your child feels light-headed, fatigued, or short of breath.
  • If the bleeding results from an injury and your child has continued pain.
  • If you think there may be a foreign body in their nose that you cannot remove.

 

For more information: AAP – nosebleeds

21 Feb
babies, children, germ woes

Fever in Kids

When kids have a fever, it can cause a lot of worry and uncertainty for parents. We get it! This is understandable since fevers can make your child feel awful and in rare cases can be a sign of something serious. When fevers first start it is hard to know whether it is something serious or no big deal! The good news is most fevers are nothing to worry about and armed with a little knowledge and know-how, you and your kiddo will be feeling better in no time!

 

 

What is a fever?

Temperatures fluctuate throughout the day and vary from person to person. If your child feels warm and is flushed, they may have a fever, but this is not an accurate way to assess their temperature as it can be affected by things like their environment, being overdressed, activity level, etc. The most accurate way to assess fever is to use a thermometer.

 

The exact cutoff for what we call a fever in medicine depends on how you measure:
  • measured orally (in the mouth): 100°F (37.8°C)
  • measured rectally (in the bottom): 100.4°F (38°C)
  • measured in an axillary position (under the arm): 99°F (37.2°C)

 

What causes a fever?

For as much worry as they cause, fevers are not a problem in and of themselves and are really just a clue that there is an infection or inflammation going on in the body. Believe it or not, fevers are usually a good thing!
  • Fevers are a normal physiologic response to illness and the body’s way of resetting it’s internal thermostat to try to fight off infection.

 

Will fever harm my child?

  • In the far majority of cases, no.
  • Even high fevers do not usually cause brain damage or other complications.
  • Most of the time we only recommend treating fevers when they make your child feel crummy or to avoid dehydration.

How high is too high of a fever?

Did you know there is not typically a set temperature above which we need to worry?
  • A fever would have to be 108 or higher to cause brain damage. Temperatures this high are very rare and often involve external factors such as a very hot environment.
  • However, sustained fever above 102 can cause dehydration and in some cases a high fever > 104 can be a sign of more serious illness and is a reason to consult a physician.

 

The best way to evaluate how your child is doing is to look at their behavior and appearance. Things to consider:
  • Are they eating and drinking well (emphasis on drinking and hydration, it is ok for appetite to be decreased for a few days.)
  • Do they still have periods during the day when they are playful and happy?
  • Do they look ok when their fever comes down or are they still listless or sleepy?
  • Aside from nap or bedtimes are they relatively alert and interacting with you?

How do I treat a fever?

  • In babies 3-6 months Acetaminophen (Tylenol) is recommended.
  • After 6 months Ibuprofen (Motrin or Advil) can also be used.
  • Do not give your child Aspirin which has been associated with a disorder called Reye syndrome that can occur in the setting of a virus with use of Aspirin.
  • In addition to medications, simple measures such as encouraging hydration, offering cool liquids or popsicles, avoiding overbundeling, keeping the home or bedroom cool, and applying a cool washcloth on the forehead can also help. It is not recommended to put the child in a cold bath as it doesn’t provide any additional benefit and can be very uncomfortable. Shivering can even raise the body temperature. A lukewarm bath can be helpful though.
  • If your child is under 3 months with fever they should be evaluated by a physician.

When should I call my Pediatrician?

Most fevers can be safely treated at home, but as always if you are worried or have questions, give your pediatrician’s office a call! That is what we are here for. Otherwise, below are some signs that it is time to check in with your child’s doc.

 

  • If your child is younger than 3 months and has a temperature of 100.4 or more
  • If your child has an immune system problem or is on medications that weaken their immune system
  • If your child has been in a very hot environment such as a hot car
  • If your child looks very ill, is extremely sleepy or fussy and unconsolable
  • If your child has signs of dehydration; ie. lethargy, sunken eyes, no urine in > 8 hours, not making tears
  • If your child has difficulty breathing that doesn’t improve with clearing nasal congestion
  • If your child has severe pain; head, neck,  throat, ear or abdominal pain
  • If your child has a seizure
  • If your child has had a fever for more than 3 days or persistently higher than 102
  • If your child doesn’t seem to be feeling or looking better when fever comes down
  • If your child has severe vomiting or diarrhea

 

Helpful Resources:

Fever – kidshealth.org

 

Fever without Fear – healthychildren.org