Dr Bernadette Carr answers your questions on phobias and nosebleeds

Find out if your child has a phobia or just a simple fear, and if nosebleeds are a common problem for young children.

Q. My five-year-old daughter has developed a needle phobia. She is due to get a booster vaccination soon. How can I make it easier for her?

A. There are very few children who will welcome the idea of vaccination or being injected with a needle. Some children will be more anxious than others and will be prone to worry. 

There is a difference between a phobia and a simple fear. 

A phobia is a significant fear which will cause significant distress to your child. 

Most children will grow out of their fear and there are a number of things you can do to help them with this.

It is a good idea to try to explain to your child exactly what will happen and minimise their distress surrounding this. 

Talking about the doctor’s visit and use of books and reading materials which explain and normalise the visit to the doctor for the injection can all help to reduce anxiety. 

It is important to minimise the issue to your child so they do not magnify it or think about it too long.

Distracting your daughter while she is at the doctor is a good idea and will help to keep her distress at bay. 

The use of rewards or treats like a lollipop or a sticker afterwards can also help to comfort and reassure your child and take their mind off it. 

It is important that you remain calm, firm and reassuring throughout the process so that your child does not pick up on any fears or anxieties you are projecting onto the situation. 

It is also important to normalise the experience as much as possible and that you do not overreact and contribute to the distress. 

Many children overreact and have tantrums after a shot.

Q. My seven-year-old child is having quite a lot of nosebleeds lately and I am worried how best this should be treated. 

Is this a serious problem and do you know what causes them to manifest so frequently?

A. Nosebleeds can be a common problem in young children. 

In most cases this is a harmless issue and is caused by trauma to the nose such as nose picking. 

Sometimes, when a child has a cold or a runny nose this can make the area more sensitive to trauma — frequent rubbing is associated with nosebleeds. 

Cold air can also dry the inner lining of the nose and make it more prone to bleeding.

Sometimes bleeding will occur on the pillow at night. 

If the nosebleeds resolve spontaneously and your child is well with no unusual bruising or bleeding elsewhere, then it is usually a harmless issue which your child will often grow out of. 

If bleeding is severe and does not stop within 20 minutes, you should seek medical help because the nose may need to be packed by a doctor to stop bleeding. 

In some cases nosebleeds occur very frequently and are difficult to stop on their own. 

This can be due to sensitive blood vessels in the front part of the nose being damaged.

In some cases it may be necessary to see your doctor who can apply a cauterising agent to the area to reduce the likelihood of bleeding coming back.

Most nosebleeds can be managed at home and will stop after a few minutes. 

Applying firm pressure to the front of the nose with a tissue while leaning slightly forward should stop the bleeding. 

Use of a cold face cloth to the front of the face can also help to reduce bleeding. 

Encourage your son to keep fingers and other objects out of his nose to prevent bleeding.


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