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Ask Dr. Sears: Frequent Nose Bleeds

Q.  I have a two and a half year old toddler boy named Jacob. He is very active and healthy, though he is very small for his age. Jacob frequently gets nosebleeds, sometimes three times a day. His doctor did a total blood count and, except for his low nutrophil count, everything is okay. What can I do to help him from getting nosebleeds and make it easier for him when he gets them

A. This is particularly common during the late-fall and winter months. Central heating lowers the humidity in the room air, and this dries out the lining of the nose, leaving kids more susceptible to nosebleeds. In addition to what you're already doing, try these nose-comforting remedies:

Allergy-proof your child's bedroom.

Nasal allergies are one of the most common causes of nosebleeds in children. Remove all dust-collectors and stuffed or pet animals from your child's sleeping environment. Install a HEPA air filter in your child's bedroom. Use hypoallergenic bedding and either turn off the central heating in your child's bedroom (more on this, below) or put a filter on the heating vent. Above all, don't allow smokers near your child, as smoke is a huge nasal irritant.

Use a warm-mist vaporizer in your child's bedroom.

I suggest you switch to a warm-mist vaporizer instead of a cool-mist one. The hot steam will usually provide enough heat for an average-sized child's bedroom, letting you turn off the central heating at night. The increased humidity in the bedroom air will moisten his nasal passages. Be sure to put the vaporizer out of Jacob's reach, since it can pose a burn hazard.

Hose the nose.

Another remedy for nasal congestion and nosebleeds, especially during the winter months, is what I call a "nose hose." Spritz some saltwater nose drops or saline nasal spray into each nostril. Do this several times a day, especially before bedtime and upon awakening in the morning. If you sit him on your lap so he is upright it won't bother him as much as if you try to do this when he's lying down. Saline nasal spray is available without prescription at your pharmacy, or you can make your own saltwater nose drops with a quarter teaspoon of salt to eight ounces of water.

Discourage nose picking.

This is another common cause of nosebleeds, especially among older children. In fact, instead of asking children if they pick their noses, I ask them "Which finger do you use to pick your nose?" Children tend to pick their noses just because they itch. Hopefully some of the allergy-proofing techniques will reduce the irritants in the air and reduce nasal irritation. But if he still picks his nose, another simple trick to discourage nose picking is to keep his fingernails trimmed short.

Improve your child's nutrition.

You mentioned Jacob's nutrophil (white blood cell) count was low. I recommend you cut artificially sweetened foods and beverages out of his diet. These foods can suppress the body's immune system. I also recommend adding foods with omega 3 fats to his diet. Not only will these boost your child's immune system, but they can also improve the integrity of blood vessels. The best source is coldwater fish, such as wild salmon, but you can get omega 3's from plant sources such as flax oil, as well.

Consult an ENT specialist.

Usually nosebleeds in toddlers are easy to control with the above measures. But occasionally the structure of a child's nose can make him predisposed to nosebleeds. What happens is the blood vessels lining the nasal septum —the bone dividing the two nostrils—are so prominent and easily irritated that they bleed easily. When this is the case, a pediatric ENT specialist can coagulate these vessels to keep them from bleeding.

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