Bleeding symptoms of any kind in your child can be worrying, especially when the cause is not readily apparent. Bleeding can result from minor injuries your child sustains while exploring or playing, such as cuts …

Illustration of nose bleeding
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Bleeding symptoms of any kind in your child can be worrying, especially when the cause is not readily apparent. Bleeding can result from minor injuries your child sustains while exploring or playing, such as cuts and scrapes. It is also commonplace for children to have nosebleeds (epistaxis) and bruises.

Minor instances of bleeding are rarely something to worry about. But if the bleeding is abnormally profuse or does not stop by itself, there could be an underlying problem like a clotting problem or bleeding disorder.

This article will discuss the management of bleeding symptoms in children and the nature of bleeding disorders.

Bleeding symptoms

As mentioned in the overview, bleeding is a common occurrence in healthy children and can be appropriately managed at home. As parents and caretakers will know, cuts and scrapes are often unavoidable when it comes to adventurous toddlers and children. Nosebleeds are also a normal occurrence and can happen as a result of a child having allergies, catching a cold, or because of dry air conditions.

When bleeding is abnormal in duration or severity, there could be an underlying bleeding disorder. If a child bleeds continuously after a routine dental procedure or tends to bruise very easily, it could indicate a clotting problem.

Bleeding disorders

Bleeding disorders prevent the blood from clotting properly, which can result in excessive and profuse bleeding from relatively minor injuries or routine dental procedures.


Hemophilia is an inherited bleeding disease that is characterized by deficient levels of coagulation factors in the blood. This disease is more common in males than females and can cause spontaneous and severe bleeding that is disproportionate to the responsible injury. Serious complications of hemophilia include brain hemorrhaging, hemophilic arthritis (a joint condition caused by repetitive bleeding into joint spaces), and cardiovascular disease. Symptoms of hemophilia include excessive bleeding from minor cuts, easy bruising, and spontaneous nosebleeds with no apparent cause.

Von Willebrand Disease (VWD)

The most common inherited bleeding disorder, VWD is a lifelong condition characterized by clotting issues due to reduced levels of a certain blood protein. This protein, called Von Willebrand Factor (VWF), may be present at abnormally low levels, can be completely absent, or can be dysfunctional. Symptoms are often mild and those with the disease can be unaware that they have it. Symptoms include nosebleeds that last more than 10 minutes, a tendency to bruise easily, and bleeding during or after invasive dental procedures.


A disease characterized by an abnormally low platelet count. Like hemophilia and VWD, thrombocytopenia is indicated by a history of easy bruising and bleeding. This disease can be present in children who are otherwise healthy. Platelets help the blood to coagulate and clot when bleeding occurs, so having a low platelet count can cause prolonged bleeding from minor cuts, internal bleeding, or bleeding from the gums and nose. Thrombocytopenia can be caused by autoimmune disorders, bone marrow suppression, and viruses.

Internal bleeding

Bleeding that happens inside the body is called internal bleeding. Unlike bleeding from cuts and scrapes outside the body, internal bleeding can be dangerous because it is less obvious and can continue without detection. Complications of internal bleeding can range from minor to life-threatening.


  • In Newborns (younger than 1 month), internal bleeding can be caused by swallowed maternal blood, anal fissures, necrotizing enterocolitis (inflammation and death of intestinal tissue, most common in premature babies), and bleeding disorders such as hemophilia and VWD.
  • In infants and toddlers (1 month to 2 years), internal bleeding can be caused by trauma, anal fissures, milk- or soy protein-induced colitis (inflammation of the colon), Infantile and early-onset Inflammatory Bowel Disease (IBS), infectious colitis, and intussusception (the most common cause of intestinal obstruction in infants).


  • Chest/abdominal pain
  • Lightheadedness/fainting
  • Vomiting blood that is dark red or brown, resembling coffee grounds
  • Blood in stool
  • Difficulty breathing
  • Tenderness around the affected area
  • Shoulder pain

When to see a doctor

Do not hesitate to see a doctor if you suspect your child has a bleeding disorder. If they have frequent unexplained nosebleeds, they bleed an abnormal amount from minor cuts, or they bruise easily, you should seek medical advice.

If your child shows signs of internal bleeding, you should seek emergency treatment right away. If left untreated, internal bleeding can cause a child to go into shock. The hypovolemic shock caused by severe blood loss can be life-threatening, and its symptoms include weakness, tiredness, confusion, rapid heartbeat, low blood pressure, sweating, clammy skin, and shallow breathing.

  1. ​​Fox VL. Gastrointestinal bleeding in infancy and childhood. Gastroenterol Clin North Am. 2000 Mar;29(1):37-66, v. doi: 10.1016/s0889-8553(05)70107-2. PMID: 10752017.
  2. Khair K, Liesner R. Bruising and bleeding in infants and children–a practical approach. Br J Haematol. 2006 May;133(3):221-31. doi: 10.1111/j.1365-2141.2006.06016.x. PMID: 16643424.
  3. O’Brien SH, Saini S. von Willebrand Disease in Pediatrics: Evaluation and Management. Hematol Oncol Clin North Am. 2019 Jun;33(3):425-438. doi: 10.1016/j.hoc.2019.01.010. PMID: 31030811.

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