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Johns Hopkins All Children's Hospital







Hemophilia: Handling Bleeds

What Is Hemophilia?

Hemophilia is a rare disease that prevents blood from clotting as it should. Kids with hemophilia can bleed easily or longer than normal. So it's important for parents to know how to handle bleeding when it happens.

How Is Bleeding Treated?

Most bleeding from minor injuries can be treated at home. More serious injuries may need treatment in the doctor's office, hemophilia treatment center, or emergency room.

For bruises:

  • Put an ice pack wrapped in a towel on the bruise for about 10 minutes every 2 hours. Do not put the ice directly on the skin.
  • Call your care team if:
    • The area is very painful.
    • The bruise is getting bigger.
    • The bruise makes movement painful.

For mouth bleeds:

  • Apply pressure to the bleeding area.
  • Use an ice pop or piece of ice on the area.
  • When the bleeding stops, help your child avoid hard or hot foods because they can restart the bleeding.
  • If the bleeding does not stop within 20 minutes, call your care team.

For small cuts and scrapes:

  • Rinse the cut or wound with water and apply pressure with sterile gauze, a bandage, or a clean cloth.
  • If the bleeding does not stop after 20 minutes, call your doctor. Follow your doctor's instructions for:
    • giving factor replacement therapy (which gives the body the clotting factor it needs)
    • going to the doctor's office, hemophilia treatment center, or emergency room

For a severe cut that is bleeding a lot:

1. First, control the bleeding:

  • Apply pressure with sterile gauze, a bandage, or a clean cloth.
  • Place another bandage over the first if blood soaks through the bandage, and continue to apply pressure.
  • Raise the injured body part to slow bleeding.

2. Then, call your doctor and follow instructions for:

  • giving factor replacement therapy as soon as possible
  • going to the doctor's office, hemophilia treatment center, or emergency room

For possible bleeding into a joint or muscle, call your doctor right away. Follow the doctor's instructions for:

  • giving factor replacement therapy as soon as possible
  • putting ice on the area
  • giving medicine that is safe for pain, such as acetaminophen (Tylenol or store brand). Don't give aspirin, ibuprofen (Advil, Motrin, or store brand), or naproxen sodium (Aleve or store brand), which can lead to more bleeding.
  • wrapping the joint with an ACE wrap (elastic bandage) for support
  • going to the doctor's office, hemophilia treatment center, or emergency room

If your child has an injury to the head, chest, neck, or belly, call your doctor right away. Follow the doctor's instructions for:

  • giving factor replacement therapy at home right away
  • going to the emergency room or calling an ambulance

When Should I Take My Child to the Emergency Room?

Go to the emergency room if your child:

  • has bleeding that is not stopping even after following your doctor's instructions
  • has severe belly pain
  • has red or tea-colored pee
  • has bloody or black poop
  • has a severe headache, vomiting, dizziness, or is confused
  • has a serious accident such as a fall or a car accident
Medically reviewed by: Cynthia A. Gauger, MD
Date reviewed: February 2020