Infant head injuries are always a source of fear for parents. Delicate heads can unfortunately get injured in a number of ways, as from a fall, during early toddling or crawling experiments, or more seriously if a baby has been abused by shaking. Except in the latter example, many times a baby will be just fine, even if he sustains a cut, bump or bruise, but there are warning signs to look for that would suggest greater injury, bleeding in the brain, or concussion, and all parents and infant caretakers should be aware of these.
First, should a baby be shaken, that child needs care immediately, even if that care means one parent might face consequences for committing this act. It is possible for part of the brain to detach if a baby is held and shaken repeatedly, and this can cause death. Other caregivers who suspect a baby has been shaken should call 911 right away.
In more normal settings, an infant head injury from falls may cause cuts or bleeding. Bleeding may seem profuse because there are so many blood vessels near the scalp. Pressure on the wound is important, but if the wound is more than a scrape and does not stop bleeding after several minutes of pressure, getting to a doctor for stitches might be necessary. Should bleeding stop on its own, a small bandage could be useful. When parents are unsure, it never hurts to at least call the pediatrician or doctor and get advice on whether to bring a baby to the doctor’s office or hospital, or to keep the infant home.
Cuts may occur with bumps or bruising suggesting that the infant head injury could potentially involve injury to the inside of the head. Since parents can’t see this area, the best thing to do is to observe a child for warning signals that all is not well. The first of these is loss of consciousness. Even if a child has been “out” for a few seconds only, loss of consciousness is always a potential sign of greater injury and the infant should either see a doctor or be taken to the emergency room immediately.
Another sign of a serious infant head injury is vomiting, especially more than once. Again, this should not be ignored and requires immediate care. Other signals of severe injury include pupils that are different sizes, inability to focus, seizure, twitching on one side of the body, poor balance or coordination, difficulty breathing, and paleness. Any of these symptoms alone are enough to warrant getting care right away, and parents should look for such symptoms to emerge not just in the first moments after an injury but for at least 24 hours after injury has occurred.
When these symptoms are not present, icing a bump or bruise can make sense. If parents feel this isn’t enough or are worried, they should definitely call their child’s doctor. Especially when children are in infancy, causes of head injury may be a little unusual, and the worry people may feel can make the situation more difficult.
Most pediatricians welcome the calls of parents, even if they occur in the middle of the night, such as right after a baby falls out of a parent’s bed. It always makes sense, when in doubt, to contact a doctor who can take parents through signs and symptoms and arrange to see them right away if needed, advise they head to the hospital, or suggest a follow-up the next day. On the other hand, should it be difficult to reach a doctor and a parent has noted some of the warning signs above, they should instead contact emergency services for more immediate help.