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Bleeding

 

Bleeding From the Navel

Many times in newborns, a small amount of blood is noted on the navel after the cord falls off. As long as the bleeding does not make a spot on clothing larger than a quarter, it is of no significance. The navel should be kept clean with alcohol and the bleeding will usually stop on its own. If after two or three days the bleeding continues to be a problem, contact your physician. Significant bleeding from the navel of an infant is extremely rare. If your child loses enough blood to soak a cloth diaper the size of a quarter, there is redness of the skin surrounding the navel or pus draining from the navel, contact your physician.

Bleeding From a Superficial Wound

Bleeding from an accidental cut or scrape can usually be managed by holding steady pressure over the site with a clean dry cloth. In the case of a deeper cut, the wound should receive immediate medical attention and pressure should be held on the area during transport.

Vaginal Bleeding in the Newborn

Occasionally, because of the effect of the mother’s hormones, infant girls will have a small amount of vaginal bleeding the first few days of life. This will stop spontaneously and requires no treatment.

Nose Bleeds

Nose bleeds can be caused by dryness of the lining of the nose or by picking or rubbing the nose too vigorously. Allergies or upper respiratory infections may aggravate the problem.

Moisturization of the nasal passages with saline (salt-water) nasal spray on a regular basis can help. Additionally, a child with recurrent nose bleeds can benefit from antibiotic ointment (Polysporin or Vasolene) applied to the inside of the nose with a Q-tip daily for several days.

To stop active nose bleeds, have the child sit up, and pinch the nose together or use an ice pack. After the bleeding stops, do not remove the clot from the nostril, as this may cause the bleeding to start up again. If the bleeding continues for more than ten minutes despite the above measures or if your child suffers chronic nose bleeds, contact your physician.

Rectal Bleeding

Rectal bleeding can be a more serious type of bleeding. Although it can be due to something as simple as a small tear around the rectum, children with any type of rectal bleeding should be checked by your doctor.

Other types of bleeding such as blood in the urine, coughing up blood, wounds that fail to stop bleeding, etc., of course are potentially serious and your doctor should be notified.

Bites

Dogs or Other Domestic Animal Bites

Any animal bite that breaks the skin requires two types of management. The first is local wound care. If the wound is minor, it should be thoroughly cleansed with soap and water, and then Neosporin ointment applied. The wound should be carefully watched for signs of secondary infection (pain, swelling, redness, red streaks, fever, discharge). If these symptoms should occur or if the wound is more extensive, then contact your physician.

The second part of management of animal bites involves the prevention of rabies from the bite exposure. If the animal is well known and has been vaccinated against rabies, there is little chance that your child will catch this disease. The offending animal should be kept confined ten days and observed. If the animal is healthy at the end of ten days, the child has no need for rabies prevention. If, however, your child is bitten by a stray or wild animal, an animal which cannot be found or an animal that subsequently dies, it is very important to bring this to your physician’s attention immediately. As with any other wound, it is important that the child be up-to-date with their immunization to tetanus. After an animal bite or other dirty wound, a tetanus immunization is required if the child has not had one in the past five years. If your child is not up-to-date and they suffer a wound, you should contact your physician during regular office hours.

Human Bites

Human bites should be treated like domestic animal bites.

Insect Bites and Stings

Most insect bites and stings are not dangerous unless the child is severely allergic to a particular bite or sting.

Treatment

  • If the stinger is present, remove it with a horizontal scraping motion.
  • Place a cold compress on the bite for several minutes to reduce swelling and redness of the bite or sting. Some redness and swelling are to be expected. You should contact your doctor if this becomes severe.
  • Treat with Benadryl elixir (per package instructions; for dosing for children less than 6 years of age please contact physician for dosing instructions.) and/or a paste of baking soda and water to relieve the symptoms.
  • Apply 0.5% Hydrocortisone ointment or cream to the area to help with further itching. This is available without prescription.
  • Call your physician for any difficulty in breathing.
  • Use Acetaminophen (Tempra, Tylenol) for pain. (see Dosing Guide).

Snake Bites

Non-poisonous snake bites are the same as bites from a dog or other domestic animal. Reptile bites do not cause rabies. If a child has been bitten by a poisonous snake, they should be taken immediately to the nearest hospital. You should make no effort to treat this yourself. Cutting the wound, oral suction, suction from snake bite kits, compresses, tourniquets, etc., are no longer recommended for poisonous snake bites.

Tick Bites

Most tick bites are harmless, but ticks are potential carriers for three serious diseases: Rocky Mountain Spotted Fever, Ehrlichia, Tularemia, and Lyme Disease. All three infections involve a 5 to 10 day incubation period followed by fever, muscle aches and headache. Tularemia (rabbit fever) causes swollen tender lymph nodes in areas near the tick bite. Rocky Mountain Spotted Fever and Lyme Disease can involve characteristic rashes over the entire body, but these vary greatly. If your child has a history of tick bites with any of these symptoms, it is important that they be seen by their physician. If a tick is found, it can be removed with tweezers, grasping the tick nearest the mouth and pulling it straight out with steady pressure, followed by a soap and water scrub. It is common for a small crusty sore to remain at the site for several days. This is not an indicator of severe disease. The tick-borne diseases are much less likely to occur if a tick is removed within 24 hours of imbedding.