What Are Some Special Topics for Young Children with Hemophilia?

Mouth Bleeding

Causes of mouth bleeds:

• Small cuts in the gums or tongue
• A tear in the skin that attaches the upper lip to the gums, which is called the frenulum
• Babies teething on hard or sharp objects

Signs of a mouth bleed:

• Red drool and or stains from red drool

What to do about mouth bleeding:

• Contact the Hemophilia Treatment Center at 513-517-2234
• Your child may need factor to stop bleeding, which is given in the vein
• Your child may need another medication called anti-fibrinolytic, which is given by mouth and slows down the breakdown of blood clots

Vaccinations

Treatment for vaccines can vary. Check with your child’s hematologist before they get vaccines or shots.

Where to go to get my child vaccinated:

You can choose to get your child’s shot done at the hematology clinic or their primary care doctor. Our team can give your child’s primary care doctor instructions on safely giving shots.

Treating with factor before vaccines:

• Discuss the plan with our team before the shot
• Your child’s factor levels will be normal if they are given factor before the vaccine and they can have the shot in the muscle (this is called intramuscular)
• Apply pressure to the site for five minutes after the shot is given

Vaccines without a dose of factor before:

• Apply ice to the area five minutes before the shot is given
• The shot should be given under the skin, in the fatty tissue (this is called subcutaneous)
• Apply ice and pressure to the area five minutes after the shot is given

Safety and Injury Prevention

Babies and toddlers learn from exploring. This is very important to their growth. As they learn to crawl, stand and walk, they are going to fall down. Some falls can cause bruising or muscle bleeding. You can take a few steps to stop serious injuries from happening while allowing your child to play and explore.

Tips for childproofing:

• Padding can be taped or glued to sharp table or corner edges
• Baby gates can be used around the stairs to prevent falls
• Crib rail covers, made of rubber or fabric that ties-on, can provide a cushion to possibly stop a head injury from happening and reduce injury from teething
• Crib bumpers, even made out of mesh, should not be used
• Several childproofing items are sold at a discounted price at Cincinnati Children’s Hospital’s Family Resource Center

Medical alert system:

A medical alert bracelet has:

• Information about your child’s medical condition
• A 24-hour number that an emergency medical professional can contact for more information

Please contact your child’s nurse care manager if you are interested in getting a medical alert bracelet for your child.

Emergency Card:

• Contains important information about your child’s bleeding disorder
• You can show the card to medical staff in the emergency department
• Your child’s nurse care manager will provide you with an updated card each time you come into hemophilia comprehensive clinic
• Keep this card in your wallet or purse, or take a picture of it on your smart phone

Childcare

It is important to teach the people that will be caring for your child with hemophilia. Babysitters, family members, childcare center, and teachers should all have basic information to keep your child safe while they are in their care.

Suggestions on educating your child’s caregivers or teachers about hemophilia:

Emergency plans:

• Make a plan for emergencies and share this with your child’s caregiver.
• An emergency plan can be written or typed and include information about your child’s bleeding disorder and when and how they should contact you.
• Serious head injuries are considered an emergency and 911 must be called when a head injury happens.

Planning for minor injuries:

• Make a plan with your child’s caregiver or teacher for injuries that are not an emergency.
• Let them know that they should always tell you about any falls, bumps or injuries.

Healing after injuries:

• Healing after some injuries may require your child to have limited activities.
• Always talk to your child’s caregiver or teacher so that they can play safe activities while your child is healing.

Education to childcare providers and schools:

• We can help you teach your child’s babysitter, childcare center or school about their bleeding disorder.
• Please contact your child’s nurse care manager for more information about this service.