My Baby Hit Their Head! Should I Worry?

Health Line

3 days ago

While most minor head bumps aren't a cause for concern, some injuries can be quite serious. It's important to know the signs that you need to call your pediatrician or seek emergency care.
You see baby teeter, then totter, and then — in a 'Matrix'-like moment that somehow occurs both in slow motion and in the blink of an eye — they tumble. Oh, the screams. The tears. And a big goose egg – bulge – that's growing by the second.
We know how scary it can be when your precious baby bumps their head. And if you're living this right now — icing your little one's knot while searching for what to do next — you're in the right place.
First, take a deep breath and try to remain calm. Most of the time, fall-related bumps to the head are minor and don't require medical attention.
In fact, an older 2015 study concluded that fall-related head injuries in young children don't usually cause serious harm. A more recent 2023 study of falls from cribs found that while falls that cause head injuries can result in serious head injuries, these falls most often lead to minor injuries.
When your little one hits their head, it can be hard to know if you need to head to the ER, see your pediatrician, or watch and wait. Read on for more information about head injuries in babies and ways to tell if your baby needs immediate medical care.
When to get emergency medical help after your baby bumps their head
If your baby is showing any of these symptoms after experiencing an injury to their head, call 911 or take them to the nearest emergency room immediately:
loss of consciousness or not responding to voice/touch
difficulty waking your baby
uncontrolled bleeding from a cut
trouble breathing
a dent or bulging soft spot on the skull
a suspected neck/spinal cord injury
baby's pupils don't match – are different sizes
a seizure or unusual jerky movements
seems confused or doesn't recognize familiar people
excessive bruising and/or swelling
vomiting more than once (especially if the vomiting is delayed for hours after head injury)
unusual sleepiness and/or difficulty staying alert
blood or fluid draining from the nose or ears
difficulty standing or walking (if baby is walking or pulling up)
weak arms or legs
Why do babies bump their heads?
Accidental bumps to the head are one of the most common injuries among infants and toddlers. But this fact alone might not stop you from continuously replaying the scene in your head while thinking about how you would rewrite the ending.
But a fall-related knock to the noggin is 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.
In addition, babies' physical strength and abilities are constantly changing, which affects their stability and coordination. The same adorable wobbly walk could put them in harm's way when encountering a new, uneven surface or a fun object to move toward.
This, coupled with a baby's and young child's tendency to engage in more daredevil acts that have them climbing, jumping, or trying to fly just for the thrill, can be the perfect equation for a nasty plunge. In fact, babies are notorious for these common head injury culprits:
slipping in the tub
falling backwards
falling off a bed or changing table
falling after climbing on furniture or up on countertops
falling in or out of the crib
tripping over rugs or objects on the floor
falling down steps or stairs
falling while using an infant walker (one of the reasons why such walkers are considered unsafe)
The height from which a baby falls is correlated to the severity of injury, so if your baby fell from a higher distance (such as from a crib or countertop), they're at a greater risk of serious injury, and you should call their doctor or consider seeking immediate medical attention.
Types and symptoms of fall-related head injuries
The term 'head injury' encompasses the entire range of injuries, from a small forehead lump to a traumatic brain injury. Most short-fall-related injuries among babies fall under the 'mild' category.
Mild head injuries
Mild head injuries are considered closed, meaning they don't involve any skull fractures or underlying brain injury. In these cases, swelling and a large 'bump' or bruise on the skin may appear without any further symptoms.
If your baby's fall resulted in a cut or laceration, there may be significant bleeding that requires medical attention to clean and suture the wound, even if there's no brain or skull injury.
After a bump to the head, babies can experience a headache and discomfort. However, at this age, it's difficult for them to communicate this feeling. It might surface as increased fussiness or difficulty sleeping.
Moderate to severe head injuries
Moderate to severe brain injuries represent the minority of those related to infant falls. They can involve:
skull fractures
contusions (when the brain is bruised)
concussions (when the brain is shaken)
bleeding in the brain or around the layers surrounding the brain
Concussions are the most common and least severe type of traumatic brain injury. A concussion can affect multiple brain regions, causing problems in brain function.
Signs of a concussion in children can include:
headaches
loss of consciousness
changes in alertness
nausea and vomiting
While super rare, more severe injuries can involve swelling, bruising, or bleeding around or inside the brain.
Skull fractures may be minor, with no other resulting injuries or symptoms, or they may be associated with injury to the brain. If a caregiver suspects any of these, they should seek emergency medical attention for the child. These are the most serious circumstances that require emergency medical attention.
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.
How — and when — to 'watch and wait'
In most cases, 'watch and wait' (with lots of extra TLC) is the most appropriate course of action after a baby's minor head bump.
Keep the symptoms of a more serious head injury in mind, watching for any changes in behavior or neurological deficits within 48 hours of the accident.
Other ways to care for your injured little one during the watch-and-wait period:
Apply ice as 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.
When to call your child's pediatrician
You know your baby best, so if you're even remotely worried, don't hesitate to call your child's pediatrician for expert advice on what to do next. They might want to evaluate your baby out of precaution and to document the injury for their medical record.
Call your pediatrician or seek immediate medical attention for any fall if your baby is under 3 months old. If they are under 2 years old and fell from a height or have significant swelling or bruising on the back or side of their head, you should also call.
To evaluate for a head injury, the pediatrician or emergency room doctor will likely ask you about how the injury occurred, what your baby was doing before the injury, and what symptoms your baby experienced after the injury.
They might also do a series of neurological exams — looking at your baby's eyes and responses to voice and touch — and a general physical exam, too.
If something in this exam triggers concern of a serious brain injury, the doctor may order an imaging test such as a CT scan. CT scans are usually only performed when there's evidence of a severe brain injury.
Although uncommon, the doctor may advise you to go to the nearest emergency room for more immediate evaluation, diagnosis, or critical care. Or, they may want to observe your baby for a few hours during a medically supervised 'watch and wait' period.
Treating a baby's head injury
Treatment for head injuries depends on their severity. In mild cases, ice, rest, and extra cuddles are the best medicine. (These are not bad treatments for adult head bumps, either.)
Your baby's pediatrician might advise frequent monitoring and activity restrictions after a concussion.
For more serious injuries, it's important to follow a doctor's directions. Usually, only severe traumatic head injuries require critical hospital-based intervention that can include medical and surgical treatments as well as physical therapy.
Outlook of childhood head injuries
Most minor bumps to the head in young children don't pose any risk of long-term complications.
But there is a body of research that does bring to light long-term concerns with even minor traumatic brain injuries. In a 2018 study of children diagnosed with a traumatic brain injury from mild to severe, the American Academy of Pediatrics (AAP) found 39% developed neuropsychiatric symptoms up to 5 years after the injury, such as:
headache
mental disorder
intellectual disability
depression
anxiety
seizure
brain injury
That's why it's so important to help prevent more serious accidental falls that could affect your little one's health, growth, and development.
Tips to prevent head bumps and injuries
While a minor head bump is bound to happen from time to time, here are a few tips to help keep your baby out of harm's way.
Always have your baby ride in an appropriate car seat for their age and size.
Install and secure baby gates on the top and bottom of the stairs.
Never leave babies unattended in the bathtub.
Always keep a hand on your baby on the changing table.
Firmly secure furniture to the walls.
Don't sit or leave your baby up on countertops.
Avoid using infant walkers with wheels.
Be cautious at playgrounds that don't have softer surfaces.
Watch for wet areas on hard floors (especially around pool and bath surfaces).