Almost all children will bump their heads, especially when they are
babies or toddlers and are just learning to roll over, crawl, or walk. These
accidents may upset you, but your anxiety is usually worse than the injury.
Most head injuries in children are minor.
Head injury occurs more
often in young children than adults. When compared with adults:
Young children cannot control the movement of
their heads as well as adults.
Their heads are larger in relation to their
bodies.
Their neck muscles are not as well developed.
Young children's legs are relatively shorter in
proportion to the rest of their bodies. This makes a child's center of gravity
closer to the head than an adult's center of gravity.
Young
children are more likely to have an accident or fall as they learn new skills
such as walking, running, and jumping.
Bumps, cuts, and scrapes on the head and face usually heal
well and can be treated the same as injuries to other parts of the body. A
superficial cut on the head often bleeds heavily because the face and scalp
have many blood vessels close to the surface of the skin. This bleeding is
alarming, but often the injury is not severe and the bleeding will stop with
home treatment. See
how to stop bleeding. When bleeding does not stop with home treatment, visit
a doctor because a young child can lose a large amount of blood from a deep cut
on the head.
The most common serious head injuries in young
children are caused by falls and abuse (inflicted head injuries). Serious head
injuries may involve injuries to the brain. The more force that is involved in
a head injury, the more likely it is that a serious injury to the brain has
occurred. If there has been a
high-energy injury to the head, there is a greater
likelihood that a serious injury has occurred. When a high-energy injury
occurs, it is even more important to assess the child for
signs of a serious head injury.
Shaken baby syndrome is thought to occur when a baby
is violently shaken, thrown, or slammed, causing the baby's head to move
forward and backward rapidly. This movement causes the brain to hit the sides
of the skull forcefully, leading to bleeding in the eyes and injury and
bleeding in the brain. Brain injury and bleeding can cause increased pressure
in the brain. Increased pressure in the brain can lead to serious, permanent
brain damage. Babies who have trouble breathing or who stop breathing during an
episode of being shaken, thrown, or slammed may have more brain damage.
Following an injury, it can be difficult to tell the difference between a
mild traumatic brain injury (concussion) and a more serious brain
injury. Watch the child carefully for 24 hours after a head injury to see
whether he or she develops any signs of a serious head injury.
When a head injury has occurred, look for injuries to other parts of the
body. The alarm of seeing a head injury may cause you to overlook other
injuries that need attention. Difficulty breathing, shock, spinal injuries, and
severe bleeding are all life-threatening injuries that may occur along with a
head injury and require immediate medical attention.
Injuries to the spine, especially the neck, must be
considered when a head injury has occurred.
Many head injuries can
be prevented. Use car seats, seat belts, helmets, and
make your home safe from falls to prevent an injury. Establish good safety
habits early so your child will continue them when he or she is older.
Review the Emergencies and Check Your Symptoms section to determine if
and when your child needs to see a doctor.
Inability to move part of the body (paralysis), such as an
arm or leg
Severe pain in the neck or back
Signs of a serious head injury:
Confusion or not acting normal. A child with a head injury
may be very fussy, fretful, or may cry constantly.
Difficulty
waking up or extreme sleepiness
Difficulty speaking or slurred
speech
Loss of vision in one or both eyes,
changes in the size or shape of the pupils and the
reaction to light or abnormal eye movements, such as jerking motions or the
eyes not working together
Dizziness, vertigo, or unsteadiness that prevents standing or
walking
Persistent nausea and vomiting
Severe stiff neck
Check Your Symptoms
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
child's symptoms.
Does your child have
mild bleeding from the scalp after applying direct
pressure 3 times for 10 minutes each time (30 minutes total), but bleeding does
not stop?
Call your child's health professional today if you answer "Yes" to
the following question.
Has your child had unsteadiness after a head injury that makes it hard
for him or her to stand or walk?
You may wait to see if your child's symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to
any of the following questions.
Inability to move part of the body (paralysis), such as an
arm or leg
Severe pain in the neck or back
Signs of a serious head injury:
Confusion or not acting normal. A child with a head injury
may be very fussy, fretful, or may cry constantly.
Difficulty
waking up or extreme sleepiness
Difficulty speaking or slurred
speech
Loss of vision in one or both eyes,
changes in the size or shape of the pupils and the
reaction to light or abnormal eye movements, such as jerking motions or the
eyes not working together
Dizziness, vertigo, or unsteadiness that prevents standing or
walking
Persistent nausea and vomiting
Severe stiff neck
Check Your Symptoms
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
child's symptoms.
Does your child have
mild bleeding from the scalp after applying direct
pressure 3 times for 10 minutes each time (30 minutes total), but bleeding does
not stop?
Call your child's health professional today if you answer "Yes" to
the following question.
Has your child had unsteadiness after a head injury that makes it hard
for him or her to stand or walk?
You may wait to see if your child's symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to
any of the following questions.
Other injuries:
Go to the Related Information section of this topic.
If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.
Home Treatment
Any child who has hit his or her
head should be watched for several days after the injury. Home treatment can
help relieve swelling and bruising of the skin or scalp and pain that occurs
with a minor head injury.
If your child had an accident, try to remain
calm and speak to your child in a calm, relaxed voice. This will help reduce
your child's fear and allow you to assess the situation.
If your
child has a cut that is bleeding, apply firm pressure directly over the cut
with a clean cloth or bandage for 10 minutes. See
how to stop bleeding. If the cut is deep and may have penetrated the skull,
emergency treatment is needed.
Check for injuries to other parts of
the body, especially if the child has fallen. The alarm from seeing a head
injury may cause you to overlook other injuries that need
attention.
Apply
ice or cold packs to reduce the swelling. A "goose egg" lump may appear
anyway, but ice will help ease the pain. Always keep a cloth between your
child's skin and the ice pack. Do not apply ice for longer than 15 to 20
minutes at a time, and do not let your child fall asleep with the ice on his or
her skin.
If your child is seen by a doctor
Be sure to
follow the instructions given to you by your child's doctor. You may need to
watch your child closely for the next 24 hours or longer. Here are some general
instructions:
Check for the following signs of problems
from a head injury every 2 hours for the next 24 hours.
Call 911 or go to an emergency room immediately if you notice
changes and cannot wake your child (unconsciousness). Seek medical care if your child has
any symptoms of a serious head injury, such as:
Confusion or not
acting normal, such as extreme fussiness or crying that cannot be
comforted
Abnormally deep sleep, difficulty waking up, or extreme
sleepiness
Vomiting
Symptoms that affect one side of
the body more than the other side, such as weakness or problems moving an arm
or leg
Loss of vision in one or both eyes,
changes in the size or shape of the pupils and the
reaction to light or abnormal eye movements, such as jerking motions or the
eyes not working together
Continue to check on your child often during
the night. If your child had a head injury right before going to bed or taking
a nap and falls asleep soon afterward, check him or her for changes in color or
breathing, or twitching arms or legs. You do not need to try to wake your child
unless you notice changes.
Do not give any medicine, including
nonprescription
acetaminophen, such as Tylenol or Panadol, to a child
you are watching for signs of a more serious head injury unless your doctor
tells you to.
Symptoms to Watch For During Home Treatment
Use the Check Your Symptoms section to
evaluate your child's symptoms if any of the following occur during home
treatment:
Moderate bleeding has not stopped after 10
minutes of direct pressure.
Bruising or discoloring develops
around the eyes, behind the ears, or on the scalp.
Moderate to
severe swelling develops on the face or scalp.
Confusion or not
acting normal, such as extreme fussiness or crying that cannot be
comforted
Abnormally deep sleep, difficulty waking up, or extreme
sleepiness
Vomiting
Symptoms that affect one side of
the body more than the other side, such as weakness or problems moving an arm
or leg
Loss of vision in one or both eyes,
changes in the size or shape of the pupils and the
reaction to light or abnormal eye movements, such as jerking motions or the
eyes not working together
Your child's symptoms become more severe or
more frequent.
Prevention
Each new learning stage for your baby
requires increased attention on your part to prevent an injury. It may surprise
you how fast your baby can move from one stage to the next. Being aware of your
baby's abilities and what skills he or she is likely to develop next will help
you prevent injuries.
Always be gentle with your baby. It is
important to protect your baby from a brain injury.
Shaking or slapping a baby in anger can cause an
injury to the brain. If a baby has been shaken or slapped, it is your
responsibility to notify your doctor.
Be aware of your baby's risk
of falling. Watch your baby carefully.
Never leave your baby alone in high places, such as on a
tabletop, in a crib with the sides down, or even on a bed or
sofa.
Do not leave your baby alone in any infant seat or "sitting"
toy, such as a swing or jumper. Use all the safety straps provided.
Take steps to prevent falls:
Use
stair gates to block stairways. Use gates at the top
and bottom of the stairs, and use the gates properly.
Do not use
baby walkers. Walkers have caused many injuries and are not safe even if the
baby is watched closely.
Keep your baby away from elevated porches,
decks, and landings.
Watch your toddler when he or she is outside.
Uneven grass, sloping lawns, and hills may increase your toddler's risk of
falling.
Practice good safety habits early so your child will
continue them when he or she is older:
Place children in an approved
child car seat when traveling in a motor vehicle.
Follow the manufacturer's directions for installing and securing the
seat.
Have your children wear helmets whenever necessary, such as
when they are passengers on a bike or riding a tricycle on their
own.
Set a good example by always using your seat belt when
traveling in a motor vehicle. Wear a helmet and other protective clothing
whenever you are biking, skateboarding, skiing, motorcycling, skating,
kayaking, horseback riding, or rock climbing.
Do not keep guns in
your home. If you must keep guns, lock them up and store them unloaded and
uncocked. Lock bullets in a separate area.
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