Baby Hit Their Head: Should I Worry?

Most infant head bumps are no big deal, and when a baby or newborn hits their head, you don’t usually need to worry.

However, if the baby has a cut that’s bleeding uncontrollably, a bulging soft spot, a dent on the skull, a large bruise, or is vomiting, call 911 or take them to the emergency room.

This article discusses the common signs of mild, moderate, or severe baby and toddler head injuries. It covers what to do at home, when to call your healthcare provider, and how to prevent these injuries.

Symptoms of Types of Head Injuries

Most parents panic when a baby hits their head, but most of the time, it isn’t anything to worry about. Head injuries in little ones are often mild. Here’s how to know if your baby is okay after hitting their head.

Mild

A mild head injury can be painful or uncomfortable, but otherwise isn’t anything to worry about. There will likely be tears and possibly a large bump or “goose egg,” bruising, and mild bleeding.

A head injury is considered “mild” if it’s closed. This means there’s no fracture, concussion, or other brain injury.

A mild head injury typically does not require medical attention unless the bleeding won’t stop.

Moderate

A moderate head injury should be evaluated by a pediatrician. If your baby hits their head and has any of the following symptoms, call your child’s healthcare provider:

• Hard to wake up
• Not behaving normally—for example, your child who was walking now can’t balance themselves
• Seems particularly fussy
• Vomits more than one time

A concussion is a moderate head injury that occurs when a forceful blow to the head causes soft brain tissue to bounce against the hard skull. That shakeup can damage brain cells, usually for just a short time.

Signs of a concussion include:

• A bump or bruise (contusion) on their head: This may appear oval in shape and is sometimes referred to as a “goose egg.” Some bumps can be very large, but they don’t necessarily indicate a major injury.
• Irritability
• Vomiting
• Lethargy
• Sensitivity to light and noise

If you suspect your baby may have a mild concussion, call their healthcare provider.

Severe

A severe head injury warrants immediate medical attention. Call 911 if your baby hits their head and:

• Has a seizure
• Loses consciousness, even for a second
• Has a large cut to the head (This may need stitches.)
• Has profuse bleeding that can’t be stopped after applying firm pressure for several minutes
• Has drainage from the ears or nose (This is usually blood or clear fluid.)
• Has swelling/bruising along the head (It could indicate a skull fracture.)
• Has a swollen soft spot (The soft spot, or fontanelle, is the space between the plates in your baby’s skull that fuse together as they get older.)
• Does not move their neck normally
• Seems seriously hurt
• Has a broken bone
• Has breathing difficulties
• Has a seizure
• Is pale
• Has a dilated pupil (The dark circle in the center of the eye appears larger in one eye than the other.)
• Is unable to suck or nurse
• Stares blankly
• Cries excessively
• Has bruises under the eyes and behind the ears (These can signal a serious skull fracture.)

Treatment

While panic may be your first reaction when your baby takes a tumble, try to stay calm. Mild injuries can be treated at home, while more serious injuries require medical attention.

If your baby hits their head, take these steps:

• If your baby is alert and crying (a completely normal reaction, given that your baby is probably startled and may have some pain), hold your baby and try to soothe them.
• If your child has a goose egg, apply a cold compress for about 20 minutes every three to four hours. Even larger bumps may simply be a sign of a mild head injury. If any signs of a more serious head injury occur, such as losing consciousness or repeated vomiting, contact your child’s healthcare provider.
• If there’s bleeding (and because the head is full of blood vessels near the surface of the skin, there may be a lot of blood), apply pressure with a clean cloth for about 15 minutes.
• Ask your child’s healthcare provider for guidance on giving your baby pain relievers, such as acetaminophen.

For more serious head injuries, your baby may admitted to the hospital for observation, testing, and treatment.

A period of observation is typically used for moderate head injuries in babies to determine whether a cranial computed tomography (CT) is needed. A traumatic brain injury may require neurosurgery.

Even a moderate head injury can cause symptoms that last several weeks. Your child will likely require more frequent pediatrician visits for monitoring. If symptoms persist beyond six weeks, more testing may be needed.

Prevention

Babies hit their heads for a variety of reasons. Most (around 90%) are minor and are due to falls and spills that occur every day in even well-supervised households. But others are the result of more serious incidents. You can help prevent head bumps by looking out for the situations most likely to cause them.

Falls

There’s no shortage of ways babies can fall, but the height from which they fall doesn’t always correlate to the seriousness of the head injury. Research shows kids younger than 12 months are most apt to fall from a bed, their caretaker’s arms, or a child carrier. 

Regardless of how they tumble, falls are actually the leading cause of injury in kids. They make up more than 50% of nonfatal injuries in babies under the age of 1. 

The good news? Falls rarely lead to major head trauma. In one study, fewer than 3% of young children who had fallen from things like furniture or a stroller experienced a traumatic brain injury (an injury that causes damage to the brain).

You can prevent falls by taking the following precautions:

• Never leave your child unattended in a bathtub or on an elevated surface such as a bed, changing table, or sofa.
• Properly strap your baby into infant products like swings, strollers, high chairs, bouncy seats, etc.
• Block off stairs with baby gates.
• Don’t place a baby in a child carrier or bouncy seat on a tabletop. When your baby is in them, keep them on the floor. 
• Keep doors to decks and balconies locked. When the door is open, use a baby gate and make sure deck/balcony furniture is not up against a railing.
• Lock windows or use window guards. Keep furniture away from windows so kids can’t climb up to the window’s edge.
• Use a nonslip mat in the bathtub and make sure your child remains seated while being washed. 
• Don’t try to multitask, for example, carrying your baby and the laundry, groceries, etc., at the same time.
• Always be mindful of your footing when you’re carrying your baby. A lot of head injuries occur when babies are accidentally dropped from their caretakers’ arms.
• Anchor items like bookcases or dressers to the wall to prevent them from toppling should your baby try to climb on them.

Accidental Impacts

Your baby toddles into a wall, whacks their head on the side of a crib, or gets hit in the head by a flying object thrown by a sibling.

These accidental bumps rarely cause major head injuries, such as a concussion. Still, you can help prevent them by installing corner and edge guards on tables and other furniture with sharp edges.

Crashes

Car accidents—where the child is a passenger or struck as a pedestrian—and bike accidents are other causes of head injuries in children. Some of these injuries may be severe, some not.

The best way to prevent injury in a car crash is to make sure your child is always secured in a rear-facing car seat. Your child should remain rear-facing until they reach the height or weight limit recommended by your car seat’s manufacturer.

It is also important to make sure your child’s car seat is properly installed. If you’re not sure, call your local highway patrol or family resource center to find out about free car seat safety checks in your area.

Child Abuse

There are roughly 1,300 reported cases of abusive head trauma (AHT) in babies every year in the United States. AHT occurs when a child is violently shaken, for example, or when their head is beaten against a hard object, like a wall. One-quarter of babies with AHT will die.

The first step in preventing AHT is making sure you understand the reasons why your baby is crying and recognizing when you are feeling frustrated so you can remove yourself from the situation. If you feel angry or distressed, it’s okay to lay your baby down in a safe place and walk away for a few minutes. Call a friend or family member if you’re feeling overwhelmed and need help.

Your child’s healthcare provider can talk to you about counseling, childcare, and other resources in your area. If you feel you may harm your baby, call the Childhelp National Child Abuse Hotline at (800) 422-4453. 

Never leave your baby alone with someone who has a history of violence or is easily frustrated. If you feel something is “off” with a care provider, trust your instincts and find someone else to care for your child.

Outlook

Because babies lack balance and physical dexterity, accidental knocks to the head are nearly inevitable as they grow and become mobile. Whenever your baby takes a tumble and hits their head, it’s understandable to worry about things like concussions and other brain injuries.

Luckily, very few head injuries in young kids are serious, and many can be prevented with proper baby-proofing. Should your baby take a bad tumble, be on the lookout for the signs and symptoms of a head injury and get medical help when appropriate.

If your baby has a more serious head injury, be sure to follow the healthcare provider’s instructions and to keep your follow-up appointments. If you have any questions or concerns, do not hesitate to call the pediatrician for guidance.

Summary

A baby can get a bump on the head due to a fall, another accident, or from an abusive situation. Mild injuries may include a lump, minor bleeding, or mild concussion. Moderate or severe injuries include concussions and head injuries.

Call your child’s healthcare provider or seek emergency care if they have symptoms such as loss of consciousness, vomiting, difficulty waking up, or a change in behavior.