How to Tell if Your Child's Nose Is Broken

Updated on March 13, 2018
Expert ReviewedHeather Finlay-Morreale, MD, Pediatrician
LauraGSpeaks profile image

Laura's daughter broke her nose playing basketball. The swelling and crookedness took longer than expected to completely go away.

What to Do When Your Child May Have a Broken Nose

It can happen in an instant: Your child is hit in the nose with the football, falls down and lands on their face, or even runs into a doorknob nose-first. When my daughter got smacked in the nose with a basketball thrown at close-range, her nose was gushing blood.

Even though the bones in young childrens' noses are harder to break, there are numerous situations that can happen to kids that leave parents wondering if their child has broken their nose. What to do? Thankfully, kids are resilient and heal rather quickly. Here is what you should do if your child runs into the house screaming in pain with blood gushing from the nose.

How to Stop a Nosebleed in a Child

"I advise bending forward a bit, pinching the nose, and not looking or unpinching for at least 15 minutes," says Dr. Heather Finlay-Morreale, a pediatrician in Sterling, MA.

When a child may have broken their nose, there will usually be some (or a lot of) blood. The first thing to do is get the nosebleed under control.

  • Have your child sit down, lean slightly forward, and hold their head upright. Don't let them lie down, as this will cause blood to run down their throat which can cause nausea and vomiting. Note that blood draining down the throat can cause choking and dark-colored stools or diarrhea the next day, says Jessica DeLuise, a physician's assistant in Philadelphia.
  • Place gauze or tissues on the nose and gently pinch the nostrils closed with minimal pressure. Sometimes children prefer to do this themselves, especially if they are upset and in pain.
  • Hold tissues or gauze in place for 15 minutes without removing.
  • Applying an ice pack to the lower forehead can help.
  • After the nosebleed has stopped, your child should remain seated to prevent the bleeding from starting up again. It's a great time to watch a movie for a while and settle down. Do not clean out the nostrils for several hours as this may dislodge blood clots and cause bleeding to return.

Signs of a Broken Nose in Children and Toddlers

You can't always tell if a nose is broken just by looking at it. Swelling can make it hard to tell if the nose is crooked, but aside from a change in shape here are some of the signs of a broken nose:

  • Tenderness in the facial area surrounding the nose
  • Swelling
  • Bruising under the eyes (black eye)
  • Nosebleed
  • Obviously crooked nose
  • Crunching or creaking noise when touching nose
  • Difficulty breathing through nose

When to Go to the Doctor for a Nose Injury

"Typically broken noses can be set, if needed, 3-5 days after the fracture when the swelling has decreased," says Dr. Finlay-Morreale.

Several things, however, may require immediate attention at a hospital.

  • Major bleeding that can't be stopped. A septal hematoma, if present, needs to be drained to avoid permanent damage
  • Nose is severely deformed or obviously crooked.
  • Breathing is restricted.

Concussion or associated injuries to other bones in the skull require immediate evaluation at a doctor's office or ER. Symptoms of these types of injuries include:

  • Clear fluid leaking from the nose.
  • Jaw misalignment.
  • Inability to move eyes in all directions normally.
  • Vision problems.
  • Speech, gait, or thinking are “off” (indicating concussion)
  • Vomiting.

What Is a Septal Hematoma?

The septum is the firm tissue that separates your nostrils. A septal hematoma is when blood collects in the septum, making it squishy. Symptoms include trouble breathing, congestion, bruising, and a changed shape of the nose.

Septal hematomas can happen when the nose is injured. If you suspect a hematoma, apply ice to the area and take your child to the doctor. The blood may need to be drained from the septum.

"An untreated septal hematoma permanently destroys part of the wall between nasal passages and requires surgical treatment," says Dr. Finlay-Morreale.

Can a Baby Break Their Nose?

Baby bones are more flexible, but if a baby has a bad fall it's possible for the upper bone in the nose to fracture.

Broken noses are complicated for babies because babies can't breathe through their mouths and so will have trouble breathing. Contact your doctor if you think your baby has a broken nose.

Can an X-Ray Diagnose a Broken Nose?

Although X-rays can be performed, the nose is mainly cartilage and injuries to cartilage do not show up on X-rays. X-rays can be useful, however, to determine if the bridge of the nose or portions of the cheekbone are fractured.

No obvious signs of a fracture
No obvious signs of a fracture | Source
Source

How to Treat a Child's Nose Injury at Home

  1. After stopping the nosebleed, apply ice to the nose area. A bag of frozen vegetables wrapped in paper towels works great for this. Ice the nose for at least 15 minutes to reduce swelling. You can continue to apply ice treatments over the next several days.
  2. Over-the-counter pain medication, such as Tylenol, can be given for pain. Remember never to give aspirin to kids under twelve due to the risk of Reyes disease.
  3. Sometimes it is also helpful for the child to sleep propped up with pillows so their head is elevated.
  4. Your child's nose may remain sore and swollen for several days. Keep them from engaging in excessive physical activity, both to avoid another blow to the nose and to help the injury heal.

Common Causes of a Broken Nose

According to the Mayo Clinic, the most common causes of a broken nose in children are:

  • Falls
  • Sports injuries, especially football and hockey
  • Motor vehicle accidents
  • Physical altercations (in older children)

What Your Doctor May Recommend

If the nose still looks crooked after the swelling subsides, an ear nose and throat (ENT) specialist can reset or realign the nose in an office procedure using anesthesia. Typically, if there are no issues with breathing and the sinuses are not affected, this procedure is not done unless it is desired for cosmetic purposes.

This girl broke her nose during an indoor hockey game.
This girl broke her nose during an indoor hockey game. | Source

Medical Treatment for a Broken Nose

If you do take your child in to see the doctor and there is still some bleeding, they may pack the child's nostrils with gauze until the nosebleed stops.

They may straighten a simple fracture and set it using tape.

In some cases, for more complicated breaks, surgery is required to move bone or cartilage back into place.

What Are the Risks of Not Treating a Broken Nose?

Dr. Finlay-Morreale cautions that:

  • If clear fluid is leaking from the nose, this indicates an opening from the nose into the brain. This requires surgery. "Left untreated, this condition can cause life-threatening infections."
  • Untreated concussion symptoms, if a bleed is occurring in the brain, unchecked can lead to death.
  • Associated facial bone fractures can require surgery to repair.

In addition, if there is any pain with eye movement or change in vision, this could indicate eye muscle injury, which can lead to permanent damage if left untreated, says Jessica DeLuise, a physician's assistant in Philadelphia.

What Is a Deviated Septum?

A deviated septum is a potential complication of a nose fracture. It occurs when the tissue that separates the nostrils is displaced or moved, making the breathing passage more narrow.

In the short term, medications like decongestants and antihistamines can help manage a deviated septum, but surgery is required to correct the condition.

My Daughter's Experience

My daughter got smacked in the nose with a basketball thrown at close range. The nosebleed stopped after about 10-15 minutes. I applied ice to the top of her nose as I could see lots of swelling. I gave her Tylenol for the pain and kept her activities limited for the rest of the day. I suspected her nose may be broken due to the amount of pain and swelling she had.

The swelling continued for several days. On day eight, her nose looked slightly crooked to me. On day nine she had two bad nosebleeds, just from running. She encountered no additional bumps to the nose. That was it.....we were off to the doctor. I was convinced her nose was broken. I was upset thinking my daughter had broken her nose and that I had waited so long to take her to the doctor.

Turns out the doctor said he wouldn't have treated her nose any differently had I taken her in earlier. He said many people have fractures to the nose and choose not to treat it. The doctor acknowledged the slight crookedness and noted how tender her nose still was. He also thought she still had a good deal of swelling.

His first question was if she had difficulty breathing out of her nose. Since that answer was no, he said there was no medical reason to have her nose reset. He gave me the option of having an X-ray performed just to rule out any fracture in the bony part of the nose, or a deviated septum. The mom in me chose to have an X-ray done, even though I knew it likely wasn't necessary. As expected, the X-ray was inconclusive. However, It did rule out a fracture in the bony part and the septum of the nose.

The doctor advised me to continue to apply ice every day until the swelling was gone. Once the swelling was completely gone, he said, we could decide if we wanted to go to an ENT to have it evaluated and possibly reset if it was still crooked. Eventually, the swelling went away, but it took much longer than I thought. The crookedness subsided with the swelling.

Expert Review

Heather Finlay-Morreale, MD

Pediatrician
University of Massachusettes Memorial Medical Group
Sterling, Massachusettes
  • The article has been modified since this review was written.

Questions & Answers

    © 2012 LauraGSpeaks

    Comments

      0 of 8192 characters used
      Post Comment

      • profile image

        adeebeh 

        7 months ago

        My daughter hit nose first in gym . still crooked and tender 4 yrs later

      • profile image

        Alyssa 

        8 months ago

        I fell and hit my nose hard and it started bleed after awhile it stop and haven't bled since it's been 3 day since this happened but my nose is still in pain and a little bit swollen I haven't down anything for it I just started putting ice on it today on the 3day I can breathe normal just painful and little swollen. Just wanna know what I should do?

      • profile image

        Pvk 

        2 years ago

        my daughter fall down on a stroller after that her nose bleed and swallow it is ok she is one year old after few minute nose bleeding stop m very worried

      • LauraGSpeaks profile imageAUTHOR

        LauraGSpeaks 

        5 years ago from Raleigh, NC

        Hi Jamie. Apply some ice and monitor your son's nose. I bet he will be fine. Good luck!!

      • Jamie Brock profile image

        Jamie Brock 

        5 years ago from Texas

        Thank you for this info.. a little while ago my 4 year old son just smacked his nose right to the floor and the blood was pouring out. It scared me because he hit it so hard that it seems its likely he could have broken it. I was trying to find something about it online and ran into your hub. I feel a little better now. It's not bleeding anymore and doesn't seem to be too swollen, at least not yet. Again, thank you :)

      • LauraGSpeaks profile imageAUTHOR

        LauraGSpeaks 

        6 years ago from Raleigh, NC

        Ragged, that is useful info regarding using vitamin C for nosebleeds. I hav not heard of that. thank you for sharing..

      • theraggededge profile image

        Bev G 

        6 years ago from Wales, UK

        Useful info. Thanks. No busted noses but all three of my kids have had many nosebleeds. We have learned how to deal with them and they seem to lessen as they get older. The best way to stop them, we discovered, is a couple of Vitamin C tablets and sips of cold water. However, if we give Vit C daily to prevent them, A. it doesn't and B. it's then ineffective when they do get a nb.

      • chrissieklinger profile image

        chrissieklinger 

        6 years ago from Pennsylvania

        Great hub, many times with things like this you debate going to the doctor. My daughter has thought she has broken all kinds of bones in her body but we always wait a day and watch for swelling and bruising.

      • angela_michelle profile image

        Angela Michelle Schultz 

        6 years ago from United States

        This is such an important topic, and I'm glad you shared it!

      • LauraGSpeaks profile imageAUTHOR

        LauraGSpeaks 

        6 years ago from Raleigh, NC

        Hi TahoeDoc. Thank you for sharing your experience and your valuable information regarding a septal hematoma. I appreciate your comments.

      • TahoeDoc profile image

        TahoeDoc 

        6 years ago from Lake Tahoe, California

        Good timing on this hub. I was on call just last night when I got a call to come in to the hospital. A child got hit in the nose with a hard object. He had only a trickle of blood from the nose, but it was swollen and he thought it was harder to breathe through it.

        In his case, the diagnosis was a septal hematoma. This can become a surgical emergency or at least needs to be drained in the operating room (usually) urgently. In this condition, it may not seem like the injury is that bad because the blood collects in the septum- the cartilage that runs down the middle of the nose. After the blood collects there, it can cut off circulation to the septum causing death of the cartilage tissue. It can also predispose to infections there.

        Nose injuries with swelling inside (obvious or expected) the nose, usually detected as obstructed breathing as you listed above, should be evaluated immediately by a doctor rather than be treated at home, to rule out this emergency. This septal hematoma is more of an emergency than a broken nose, usually. Just wanted to reiterate that since I saw it in the last day. :) Good job! Voted up and thanks for publishing useful and reliable medical information.

      • MikeNV profile image

        MikeNV 

        6 years ago from Henderson, NV

        Good information and personal experience. Like to see this type of hub. Voting up.

      • LauraGSpeaks profile imageAUTHOR

        LauraGSpeaks 

        6 years ago from Raleigh, NC

        Judi Bee, I do fine with bloody noses, but any more than that, I need help too! Janis, you are right, deviated septums can cause all kinds of sinus related issues. I am glad you got an accurate diagnosis for your daughter.

      • Janis Goad profile image

        Janis Goad 

        6 years ago

        Great hub. The title is a real gripper, and caught my attention immediately.

        My daughter had a deviated septum from birth, which we did not diagnose until her late teens when we finally got a referral to an ENT specialist about her constant ear and sinus infections.

        If the nose is broken and heals crooked, it can contribute to recurring sinus infections, so it is worth getting X-rays and finding out.

      • Judi Bee profile image

        Judith Hancock 

        6 years ago from UK

        Really useful advice, but in my case there is only one response to any injury involving blood - call a responsible adult. I tend to cope for about two minutes before having to lie down myself, I really am no good with gore. Actually, just reading this has made me feel woozy. Voted up though!

      working

      This website uses cookies

      As a user in the EEA, your approval is needed on a few things. To provide a better website experience, wehavekids.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

      For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://wehavekids.com/privacy-policy#gdpr

      Show Details
      Necessary
      HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
      LoginThis is necessary to sign in to the HubPages Service.
      Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
      AkismetThis is used to detect comment spam. (Privacy Policy)
      HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
      HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
      Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
      CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
      Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
      Features
      Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
      Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
      Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
      Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
      Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
      VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
      PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
      Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
      MavenThis supports the Maven widget and search functionality. (Privacy Policy)
      Marketing
      Google AdSenseThis is an ad network. (Privacy Policy)
      Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
      Index ExchangeThis is an ad network. (Privacy Policy)
      SovrnThis is an ad network. (Privacy Policy)
      Facebook AdsThis is an ad network. (Privacy Policy)
      Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
      AppNexusThis is an ad network. (Privacy Policy)
      OpenxThis is an ad network. (Privacy Policy)
      Rubicon ProjectThis is an ad network. (Privacy Policy)
      TripleLiftThis is an ad network. (Privacy Policy)
      Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
      Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
      Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
      Statistics
      Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
      ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
      Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)