How To Tell If A Bump On The Head Is Serious

Every parent understands why there should be no more monkeys jumping on the bed… but when should mama call the doctor if they bump their head? All making myself giggle aside, now that my twins are walking, the bumps and bruises are visiting often. And then of course there are my three big kids – at least one of who gets a “strawberry” (that would be my three year old today) once a week or so. Breezy Mama turned to Dr. Vincent Iannelli– a pediatrician and author of The Everything Father’s First Year Book — to find out when a child bumps their head (on a toy, the dining room table….again…falling backwards, etc.), when to call 911, when it’s safe just to call the pediatrician, signs to be cautious of and how to treat a minor bump on the head.

Under what circumstances after a child bumps their head should a parent dial 911?

A parent should seek immediate medical attention if their child has a head injury, even if it seems like a minor bump, and they are unconscious, or if they are having seizures, seem confused, don’t remember getting injured, are vomiting repeatedly, are bleeding a lot, or won’t stop crying, etc.

You might also call 911 or seek immediate medical attention if the cause of your child’s bump seems like a serious accident, for example, an infant or toddler who fell more than 3 feet, an older child who fell more than 5 feet, or any child who was hit by a car or was ejected from a car, etc. Even if they seem fine, because they are severe mechanisms of injury, these children would be at risk for serious head injuries.

When should it be a call to the pediatrician vs. emergency?

Signs of a more mild head injury for which a parent might call their pediatrician instead might include a very brief loss of consciousness or no loss of consciousness in a child who cried for a brief time, but was consoled after an appropriate amount of time and who now seems totally fine and is behaving normally.

After a child bumps their head but seems fine, what are some after symptoms that should be cause for concern and time to call the Dr.? For example, a few hours after the bump, what should parents keep an eye out for?

The biggest red flag symptoms that might indicate a child has a worsening head injury include recurrent vomiting, a severe headache, especially if the headaches are getting worse, unusual behavior changes, and being very drowsy or hard to wake up, etc.

What treatment will the child receive?

With signs that a child’s injury might be getting worse, once stabilized, they will likely have a CT or MRI to make sure that they don’t have more serious head trauma.

For minor bumps, what is the best way to treat a bump on the head?

Once you have assured yourself that your child doesn’t have a more serious head injury, home management for a bump on the head might include giving your child an age-appropriate dose of pain medication and applying an ice pack to the bump.

Any tips for preventing bumps on the head?

Keeping your home well childproofed, including putting gates on stairs and using window guards, can help prevent many head injuries. Also encourage your kids to wear helmets when riding their bike and playing sports, etc., and when little, don’t leave them where they can fall.

Most importantly, don’t wait too long to take preventable steps to prevent head injuries. For example, many parents get more careful about falls once their infant has begun rolling over, but if you aren’t careful, your child’s first roll will be off the bed and onto a hard floor.

Anything else you’d like to share?

You usually don’t have to wake up kids after they have a head injury or try to keep them up through naps or past their bedtime. Especially in young children, since irritability is one of the signs you are looking for that might mean they have a serious head injury, making them tired and irritable is likely not a good idea. You can certainly check them every four hours or so to make sure they are sleeping comfortably though.

Here is an article on head injuries I wrote:

http://pediatrics.about.com/od/firstaid/a/509_head_injury.htm

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About Dr. Vincent Iannelli

Vincent Iannelli, M.D., is a board certified pediatrician and Fellow of the American Academy of Pediatrics and is the author of The Everything Father’s First Year Book, which is now in its updated, second edition. He has written about childhood head injuries and concussions as the pediatrics guide at about.com.

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