Head injuries are common as children begin to explore their environment, but severity can range dramatically from a minor bruise to a serious medical event. Maintaining composure is important, as a calm response allows for a clearer assessment of the situation. This guidance provides actionable steps for observing your baby and understanding when a head bump requires immediate medical intervention versus at-home monitoring.
Immediate Actions After Impact
The moments immediately following impact require assessing the baby’s state and addressing the injury site. First, observe the baby’s immediate reaction; a strong cry that starts right away suggests the baby did not lose consciousness, which is a positive initial sign. Gently move the baby to a quiet, safe space to calm them and begin a physical inspection of the head.
Visually and manually check the point of impact for any cuts or deformities. Look carefully for deep lacerations that bleed profusely or any visible dent or bulging in the skull, particularly around the soft spots (fontanelles) in younger infants. If the skin is intact but swelling appears, immediately apply a cold compress to reduce inflammation and pain. A cold pack wrapped in a thin cloth can be held gently against the bump for up to 20 minutes.
Signs of a Minor Bump
Most falls result in a mild head injury requiring observation but not an emergency room visit. A brief, loud cry lasting only a few minutes is typical, often stemming from shock rather than severe pain. Following the initial upset, the baby should quickly resume normal behavior, such as showing interest in toys, smiling, and engaging with caregivers.
A visible, raised, and soft lump, often called a “goose egg,” is a common symptom of a minor head injury. This swelling occurs when blood vessels near the surface break, causing blood to pool and create a bruise. If the baby is otherwise acting normally—feeding well, tracking objects, and alert—the injury is likely superficial. However, continuous monitoring for delayed symptoms is necessary for at least 24 to 48 hours.
Urgent Warning Signs
Specific symptoms appearing after a head injury indicate a serious underlying issue and require an immediate trip to the emergency room or a call to emergency services. These signs may suggest a concussion, skull fracture, or internal bleeding.
- Loss of Consciousness: If the baby was dazed, unresponsive, or passed out for any length of time immediately after the impact.
- Repeated Vomiting: While vomiting once may occur due to crying or stress, repeated or projectile vomiting signals increased pressure within the skull.
- Inability to Wake: If the baby is excessively drowsy, lethargic, or cannot be easily woken up from sleep, seek emergency medical care immediately.
- Seizure Activity: Any sign of a seizure, such as uncontrolled shaking, twitching, or stiffening of the body, demands immediate emergency attention.
- Fluid or Blood from Ears or Nose: Clear or bloody fluid draining from the ears or nose can indicate a fracture at the base of the skull.
- Unequal Pupil Size: Noticeable differences in the size of the baby’s pupils is a sign of pressure on the brain.
- Bulging Soft Spot: In infants, a bulging fontanelle present when the baby is calm and upright may signal an increase in intracranial pressure.
Monitoring Behavioral and Sleep Changes
Symptoms of a serious head injury can sometimes be delayed, making monitoring behavior over the following 24 to 48 hours important. Pay close attention to subtle shifts in the baby’s temperament and daily routines, as infants cannot verbally express discomfort or cognitive changes.
Unusual irritability or persistent crying that cannot be consoled is a significant behavioral change. Conversely, listlessness, lack of interest in favorite toys, or refusal to feed are also concerning. In older babies, watch for new problems with balance or coordination, which may signal a neurological issue.
It is generally safe to let a baby sleep after a head bump, provided they are not showing urgent warning signs, but careful monitoring is still needed. Caregivers should ensure the baby is easily rousable, meaning they can be woken and will briefly acknowledge their surroundings or move. If the baby seems unusually sleepy or difficult to wake, this is an emergency situation. Observation for any worsening symptoms should extend for two days.