News | Published July 23, 2012

Ask the pediatrician: nose bleeds, varicella vaccine

Hi Dr. Collison,

When a child has a nose bleed is it correct to have the child lean their head back to help stop the bleeding?

It is not a good idea to lean the head backwards to try and help stop the bleeding. When the head is tilted back, more of the blood goes backwards, down the throat and into the stomach. Blood is very irritating to the stomach and can lead to stomach aches and vomiting.

The recommended approach is to stuff the nostrils with gauze and keep the head upright. Once the gauze is packed into each side, then apply direct pressure and squeeze both nostrils together as much as possible. If it continues to ooze more than about 20 minutes, then I suggest taking your child to the emergency department for further assistance.

Dr. Collison,

My son's school is requiring that he receive a second dose of the varicella vaccine, but when I called my family doctor his nurse didn't seem to think that this was necessary. She indicated that it was a new thing being required by schools. Is this true? I don't take medical advice from the state so I am considering skipping this second dose. Am I setting my son up for a nasty case of chicken pox if I avoid the second vaccination?

The state of Pennsylvania has been requiring a second varicella (chicken pox) vaccine for several years now. The reason for the second vaccine is to improve protection and to promote long-term immunity, similar to why we give boosters for tetanus, pertussis, etc. A second vaccine has been shown to improve long-term protection from 80% to about 95%. The biggest concern with varicella is getting the disease as an adult, so I believe that the second dose (booster) is a great idea to help protect your kids for the long term. No vaccine protects 100% but this booster is well worth it to help protect them now and as adults when immunity naturally starts to wane.

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