Babies inevitably fall learning to walk. Unsteady toddlers, in a hurry to explore their world, trip over (or bump into) whatever's in their way. Preschoolers climb where they shouldn't. Older kids collide on soccer fields and fall off bikes. And, despite your best attempts to keep them safe, accidents happen too. It's the unusual kid who gets through childhood unscathed by a knock to the head.

The good news is that frightening as they can be, most head injuries are minor and cause no ill effects. Still, it's important to know the difference between a bump that needs medical attention and a boo-boo that can be fixed with a kiss. Here, advice to help you assess the injury and keep your little one safe.

Recognizing a Mild Injury

Seeing your child hurt is upsetting but your own anxiety may be worse than that bump. Keeping your cool is important when determining the extent of the head injury. Remember, the majority of head injuries are external and only affect the scalp. The scalp is made up of multiple layers of tissue. Like a helmet, it protects the more delicate brain.

After a bump or bang on the head you may notice a large swelling or "egg" at the point of contact. This occurs when fluid or blood from the veins of the scalp, leak and collect. As scary as it seems, it's usually not a cause for concern and the bump will resolve on it's own in a week or two. Treat at home by applying an ice pack (a bag of frozen fruit or vegetables work well, too) to the affected spot for about 20 minutes. When applied within the first few hours following an injury, ice will minimize swelling. You can also give an over-the-counter pain reliever just be sure to administer the proper dosage for your child's age and size.

Rich in blood vessels, skin on the scalp often bleeds more than cuts to other areas of body. Wash the cut with mild soap and water. The sight of blood can cause parents to panic. Don't. When you panic, your child does, too. Most bleeding can be stopped by applying direct pressure with a clean cloth. A gaping cut whose edges don't come together by themselves requires stitches.

It's always a good idea to observe your child for at least 24 hours after a head injury in case any signs of more severe damage develop. If alert, conscious and behaving as normal (resisting an ice pack, for example, is actually a good sign), you needn't be concerned. Slight dizziness and headaches are not unusual either. Your child may complain of nausea and even vomit. Other changes in behavior can indicate an injury to the brain which can be dangerous. Keep a watchful eye on your child while she sleeps. Check in on her every couple of hours. If she is pale, or if you notice uneven breathing or unusual twitching, try waking her up. Shake her shoulders or sit her up in bed. If she's uncooperative and very sleepy, that's normal. Unresponsiveness can indicate a problem. Seek medical care as soon as possible. 

More Serious Signs

A brief, temporary loss of consciousness following a hard hit to the head is called a concussion. But this doesn't necessarily mean that the brain has been damaged. It is an indication that the brain centers for consciousness have been momentarily disturbed. Most concussions are mild. Others can be serious and require medical attention. Concussions can be triggered by other dangers including: internal bleeding, a fractured skull, brain damage, torn blood vessels, or even a blood clot in the brain.

Seek immediate medical attention if a child doesn't gain consciousness within a few minuts or if any of the following occur:

  • Repeating vomiting
  • Memory lapse
  • Having a seizure
  • Unclear or confused speech
  • Extreme tiredness
  • Difficulty performing simple tasks
  • Loss of balance

If you believe something is seriously wrong, trust your instinct. Call 911 or go to the emergency room.

An infant who experiences a blow to the head should always be examined by a medical professional regardless of exhibiting concerning signs. Play it safe, but remember that in most cases, a large dose of parental sympathy and a cold compress go a long way toward helping your little one recover.



American Academy of Family Physicians


College of Family Physicians Foundation