Babies or small children bumping their heads can give any parent a heart attack. While our first urge as parents is to stop them from crying, we can actually take it instead as an initial indication to how severe the injury is. Cara Barone, M.D., a pediatrician at the Palo Alto Medical Foundation, says, “It’s normal for a child to cry after a head injury – it hurts and they’re scared – but it shouldn’t last longer than 10 minutes. If your child is alert and responds to you, the head injury is likely mild, and a trip to the doctor and tests are not necessary.”
How is it that babies bump their heads so often? Accidental bumps to the head are one of the most common injuries among infants and toddlers. Before putting the blame on yourself for not being a better parent, know that these small accidents are normal and are often largely due to a baby’s physical stature and development, not your parenting.
Babies’ heads are often proportionally larger than their bodies, making it easier for them to lose their balance. Their legs are somewhat shorter in proportion to the rest of their bodies. This makes a child’s centre of gravity closer to the head than an adult’s centre of gravity, making them more likely to have an accident or fall.
As babies’ grow and undergo quick changes, so do their physical strength and abilities. These changes affect their stability and coordination. As they learn new skills such as walking, running and jumping, they become much more prone to accidents such as slipping in the tub, falling backwards, falling off a bed or changing table and tripping over rugs or objects on the floor.
The severity of the head injury depends on the height from which a baby falls, so if your child fell from a higher distance (say, from a crib or countertop) they’re at a greater risk of serious injury.
When to get emergency medical help after your baby bumps their head
In 2015, a study conducted by the National Institutes of Health concluded that fall-related head injuries in young children do not always cause serious harm. According to the study, only about 2 to 3 percent of falls lead to a simple linear skull fracture. Most of these accidents don’t cause neurological problems. Only about 1 percent of skull fractures from fall-related accidents cause moderate to severe brain injury.
It is still important, however, to watch out for any symptoms relating to concussions, which may occur within 24 to 48 hours after the accident. Some of these may indicate much more serious conditions. If your child is experiencing any of the following, consider this as an emergency and bring him or her to the nearest hospital:
- Continuous bleeding from a cut
- A dent or bulging soft spot on the skull
- Excessive bruising and/or swelling
- Vomiting more than once
- Unusual sleepiness and/or difficulty staying alert
- Loss of consciousness or not responding to voice or touch
- Blood or fluid draining from the nose or ears
- A seizure
- A suspected neck or spinal cord injury
- Trouble breathing
When assessing the head injury, the pediatrician or emergency room doctor may ask you details regarding the injury: how it occurred, what your baby was doing before it happened and what symptoms your baby experienced after the injury. They might also do a series of neurological exams to check your baby’s responsiveness to voice and touch. If there’s evidence of a severe brain injury, the doctor may advise for your child to have an imaging test such as a CT scan. If there are no serious findings, they may still ask you to observe your baby for a few hours during a medically supervised “watch and wait” period.
Types and symptoms of fall-related head injuries
The term “head injury” can include an entire range of injuries, from a small forehead lump to more a serious traumatic brain injury. Most short fall-related injuries among babies fall under the “mild” category.
Mild head injuries
Mild head injuries are closed injuries that don’t involve any skull fractures or underlying brain injury. Swelling, bumps or bruises may appear on the skin.
If the fall resulted in a cut or laceration with little to significant bleeding, medical attention is required. The wound needs to be cleaned and sutured even if there’s no brain or skull injury.
In mild head injuries, babies can experience a headache and discomfort. However, at this age, it would be difficult for them to communicate this feeling. It might surface as increased fussiness or difficulty sleeping.
Moderate to severe head injuries
If the accident resulted in more symptoms than simple bumps and cuts, there may be more serious implications. Moderate to severe brain injuries can involve skull fractures, contusions, concussions and bleeding in the brain or around the layers surrounding it.
Concussions affect multiple areas of the brain, and they can cause problems in brain function. Signs of a concussion in children are headaches, loss of consciousness, changes in alertness, nausea and vomiting.
It’s critical that medical treatment is administered as soon as possible to reduce the potential for long-term brain damage and loss of physical and cognitive function.
Treating a baby’s head injury
In most cases, a “watch and wait” period is often recommended for mild head injuries. During this period, you need to observe your baby for any changes in behavior or neurological deficits within 48 hours of the accident.
During the watch and wait period, you may do the following:
- Apply ice only if tolerated by your baby
- Clean and bandage any minor cuts or abrasions to the skin
- Check for changes in the size of your baby’s pupils
- Monitor your baby while they’re sleeping during naps and at night
- Call your baby’s pediatrician for guidance if you’re concerned
For more serious injuries, you will need to strictly follow certain procedures or treatments as prescribed by your child’s doctor. If the child is experiencing severe traumatic head injuries, critical hospital-based intervention (including medical and surgical treatments as well as physical therapy) may be required.
Tips to prevent head bumps and injuries
Expect that, as your baby grows, minor head injuries may happen from time to time. The best way to avoid them is to keep your baby away from further danger. Below are some common tips to prevent these injuries:
- Install and secure baby gates on the top and bottom of stairs
- Watch for wet areas on hard floors (especially around pool and bath surfaces)
- Install non-skid mats in the bathtub and rugs on the bathroom floor
- Firmly secure furniture to walls
- Keep young children away from dangerous things to climb
- Don’t sit or leave your baby up on countertops
- Avoid using infant walkers with wheels
- Remove tripping hazards
- Be cautious at playgrounds that don’t have softer surfaces
Got a question or anything I can help with? My name is Steve Stretton, and I’m the owner and manager at Gelpacks.com. You can drop me a line here. Good luck!