Pediatric Hemostasis and Thrombosis
When dealing with pediatric bleeding disorders, normal cuts, bumps and bruises are anything but normal. These disorders require ongoing medical care, and parents deserve expert care and compassionate support as children grow and follow their treatment plans. At the Hemostasis and Thrombosis Center at Akron Children’s, we diagnose and treat children, teens, and young adults with all types of bleeding or clotting disorders. If your child bleeds more than others, call Akron Children’s to make an in-person appointment or schedule a virtual visit.
Learn more...Questions? 330-543-8580
Facts & Stats
Selected for Our Expertise
One of just 150 federally designated regional comprehensive hemophilia treatment centers in the U.S.
Trusted and Recommended
We treat the largest population of hemophilia B patients in the world
We Include Many Providers
Board-certified pediatric hematologists and social workers, as well as a nurse practitioner, nurse clinician, nurse educator, and physical therapist
From Child to Adult
The move to adult health care doesn’t happen overnight. We help patients and families through it.
Focused Care
We offer a specialty clinic for heavy menstrual bleeding
What Parents Are Saying…
“It’s a balancing act. We’ve had to learn what works for us and works for the kids. Every year they get a little more independent. - Michelle Workinger - mother of Kyle, Joshua, and Alexis Workinger, siblings diagnosed with von Willebrand disease, the most common inherited bleeding disorder”
— Parent of Kyle, Joshua, and Alexis Workinger
Meet Some of Our Specialists:
Jeffrey Hord, MD
An expert in pediatric hemophilia, Dr. Hord has been practicing since 1995 and joined Akron Children’s four years later. He is board-certified in pediatric hematology-oncology and has a special interest in oncology, hematology, oncology supportive care, practice management, and reducing central line-associated blood stream infections. More...
Nicole Kendel, MD
Dr. Kendel joined Akron Children’s as a pediatric hematologist-oncologist in 2022. Extremely knowledgeable in hemostasis disorders, she is a member of the American Society of Pediatric Hematology/Oncology, American Society of Hematology, Children’s Oncology Group, and the Foundation for Women & Girls with Blood Disorders. More...
Stephanie Savelli, MD
Dr. Savelli is director of the Pediatric Hematology-Oncology Fellowship Program and the Survivorship and Late Effects Program. She has a special interest in childhood cancer survivorship and late effects, bleeding disorders in women, and thrombotic disorders, and she is board-certified in pediatric hematology-oncology. More...
Prasad Bodas, MD
A graduate of the Case Western Reserve University School of Medicine, Dr. Bodas directs the Akron Children’s Sickle Cell Program and is a board-certified pediatric hematologist-oncologist. He also focuses on bone marrow transplantation and global health. More...
Debbie Shijo, PT, MPT
Ms. Shijo is a graduate of The University of Toledo and Chatham University and works with patients at the Akron Children’s Hemostasis and Thrombosis Center in Mansfield, Children’s Cancer and Blood Disorders Center in Millersburg, and Osteogenesis Imperfecta Clinic. More...
Amanda Watson, MSN, APRN-CNP
Ms. Watson is a graduate of The University of Akron and is certified in pediatric and oncology nursing. More...Why Choose Akron Children’s for Pediatric Hemostasis and Thrombosis Care?
Through guidelines developed by the National Bleeding Disorders Foundation’s Medical and Scientific Advisory Council, Akron Children’s provides the most up-to-date treatments available for these disorders. Our team includes board-certified pediatric hematologists and social workers, as well as a nurse practitioner, nurse clinician, nurse educator, orthopedist, physical therapist and dietitian. Patients can meet with a hematologist and adolescent medicine doctor to determine the cause and proper treatment for heavy menstrual bleeding.
We also collaborate with the Northern Ohio Hemophilia Foundation to offer educational programs for youth with bleeding disorders. Our outreach nurse coordinator offers training so patients and/or their family members learn how to infuse medication at home. Infusion training may be provided during a home visit or at another location in the community. Additionally, Akron Children’s helps our patients transition from pediatric to adult care.
Hemostasis and Thrombosis Information
Understanding Pediatric Hemostasis and Thrombosis
What is pediatric hemostasis?
Hemostasis is the clotting process by which bleeding stops after a cut or injury. If a child bleeds more easily or longer than normal, they may have a hemostatic disorder.
Common causes of hemostatic disorders in children
Hemophilia and von Willebrand disease – diseases that prevent blood from clotting as it should – happen because a child’s body doesn’t make enough of a certain protein that helps the body form clots and stop bleeding.
What causes thrombosis in children?
Pediatric thrombosis is a condition in which a child’s blood forms a clot where there should not be a clot. It can be caused by a variety of factors, including lifestyle, medications or other medical conditions. Certain genetic conditions can also predispose children to developing clots.
Diagnosing and Treating Pediatric Hemostatic and Thrombotic Disorders
Diagnostic tests and procedures for hemostasis and thrombosis
To diagnose a bleeding disorder hemophilia, doctors order blood tests, including:
- Complete blood count (CBC)
- Prothrombin time (PT)
- Activated partial thromboplastin time (PTT)
- Factor VIII activity test
- Factor IX activity test
- Von Willebrand studies
If hemophilia runs in the family, doctors can do prenatal (before birth) testing with amniocentesis or chorionic villus sampling. More often, when the baby is born, they’ll test a sample of blood from the umbilical cord.
Treatment options for pediatric hemostatic disorders
The medical care team for kids with bleeding disorders usually includes:
- A hematologist (a doctor who treats blood conditions)
- A nurse who specializes in conditions related to bleeding
- Orthopedists (doctors who care for bones, joints, and muscles)
- Physical therapists to help with strengthening and stretching and joint health
- Social workers and/or psychologists to help kids and parents cope with hemophilia
The main treatment for hemophilia is factor replacement therapy. This therapy gives the body the clotting factor it needs. It is given intravenously (IV, into a vein). A person may get factor replacement on a regular schedule (known as prophylaxis) or as a treatment for bleeding. Several products are now available. Talk about treatment options with our hemophilia care team.
Factor replacement can be done:
- At a hospital or hemophilia treatment center
- At home by a nurse
- At home by the person with hemophilia or someone else, after being trained
Doctors also can give medicines to help control bleeding during procedures (such as dental cleanings) and surgeries.
What are signs of a bleeding disorder?
- Nosebleeds that occur frequently or last longer than 15 minutes
- Heavy menstrual bleeding that lasts more than 7 days or requires your child to change product more than once every 2 hours
- Prolonged bleeding with minor cuts and scrapes
- Bleeding with surgery or dental procedures
Managing thrombosis in children
Children who develop blood clots are treated with blood thinners like Lovenox, which are administered by subcutaneous injection. Akron Children’s teaches families to give these injections at home rather than spending additional time in the hospital.
Preventing Hemostatic and Thrombotic Disorders in Children
Lifestyle factors that contribute to pediatric hemostasis
Many lifestyle factors can contribute to a person’s risk for developing a blood clot. Minimizing these risks means:
- Remaining physically active and maintaining a healthy body mass index
- Avoiding cigarette smoking, which significantly increases the risk of developing blood clots
- Moving and stretching whenever possible during long airplane flights and car trips, since extended immobility during travel can also raise the chances of developing blood clots
Certain medications can also lead to an increased risk of blood clots. Patients who have previously had a blood clot or with an immediate family member who has had a blood clot should note this when discussing new medications with their doctor.
Frequently Asked Questions About This Condition/Specialty
- Bleeding lasting longer than seven days
- Soaking through a pad or tampon in less than two hours
- Passing blood clumps bigger than a quarter
- Bleeding that stops you from going to school or participating in other activities
Hemophilia is a rare disease that prevents blood from clotting as it should. It happens because the body doesn’t make enough of a protein called a clotting factor. Clotting helps stop bleeding after a cut or injury. If clotting doesn’t happen, someone can bleed easily or longer than normal.
von Willebrand disease, or VWD, is a genetic bleeding disorder that prevents blood from clotting properly. Bleeding disorders are rare, but von Willebrand disease is the most common bleeding disorder. This disorder affects males and females equally.
Most bleeding disorders are inherited and often affect multiple family members. We recommend discussing siblings with your hematologist to decide if testing is necessary.
What do I do if my child has a nosebleed?
- Gently blow out the mucus and unstable clot through the nose.
- Pinch the soft part of the nose below the bony part with your thumb and finger or nose clips and hold for 10 minutes.
- Set a timer and don’t check until the timer is finished.
- Consider applying an ice pack to the bridge of the nose while continuing to pinch the nose.
How can I prevent a nosebleed?
- Place a humidifier in the child’s bedroom.â¯
- Spray nasal saline into each nostril twice a day.
- Place petroleum jelly/Vaseline/Saline Gel into both nostrils, making sure to cover the nasal septa.
- Avoid nose picking.
- Keep fingernails short to avoid accidentally scratching the inside of the nose.
Akron Children’s Resources for Parents
Our KidsHealth pages are an excellent resource to learn about pediatric hemostatic disorders, how we treat them, and what the road ahead may look like as your child grows.
- Hemophilia: How do you recognize it, and how can you help your child’s treatment?
- A guide to handling bleeds when your child has hemophilia
- What is von Willebrand disease?
- Talking to your child about periods – because they need reliable information
Other Resources
There are a wealth of organizations, foundations, and groups locally, nationally, and worldwide supporting children and adults with hemostatic disorders and their families through information sharing and research:
Factor deficiencies can be treated with infusions of the necessary Factor proteins: Akron Children’s provides the following detailed information cards for patients to carry in the event that they require medical attention for a bleed.
- DDAVP 2 Deficiency Card 6033
- DDAVP Deficiency Card 6033
- Emergency Card - Factor 8 Deficiency Card 6033
- Emergency Card - Platelet Function Defect
- Emergency Card - Factor 8 Deficiency Card 6033 B
- Emergency Card - Anticoagulation Card
- Emergency Card Factor 7 Deficiency Card 6033
- Bleed Pocket Information Card - 3638 HTC
- Emergency Card - Factor 9 Deficiency Cards 6033
Akron Children‘s Anywhere Mobile App
Managing your child‘s health, made easier
Akron Children‘s Anywhere Mobile App
Managing your child‘s health, made easier
Akron Children‘s Anywhere is designed to be your “go-to app” for managing your child‘s health. It provides tools for finding a primary care doctor or specialist, finding locations and directions, and making everyday health decisions as well as giving you quick, secure access to MyChart and other tools. And when your child needs care, the renowned experts at Akron Children‘s are just one tap away.
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