Your Child Hit Their Head Hard: Here’s What to Do and When

Content originally published on May 20, 2016 and last updated Nov. 28, 2023

Few injuries are scarier than a blow to young child’s head. As your child develops, their motor skills and sense of balance are still stabilizing as they learn to navigate in the world, which can result in bumps and bruises. Fortunately, most childhood head injuries look worse than they actually are, assures Dr. Alyssa Swick, pediatrician at Riley Children’s Health.

“The risk of an injury like a skull fracture is quite low in children, about 1%, after a minor fall, so most of these injuries can be managed at home,” Dr. Swick said. “However, this applies to children who are otherwise healthy. If your child has a prior head injury or surgery, or if they have a disorder that causes them to bleed or bruise easily, they should always be evaluated by medical personnel after a significant injury."

Assessing head injuries

The biomechanics of head injuries differ by age. Before kids are walking or cruising, a head injury is most likely caused by a fall from a changing table, for example. A toddler or older child with a head injury probably took a tumble, ran into something or was hit by a heavy object. Be prepared that some head injuries may seem worse because they tend to bleed a lot.

“There are a lot of blood vessels in the scalp, so even a small scrape can lead to a frightening amount of blood,” Dr. Swick said. “Still, if your child seems to be bleeding profusely, wipe the blood away, and if it the edges of the skin are still gaping apart, you should seek physician’s care to see if stapling or stitches are needed.”

A minor head injury can cause a bump, or a “goose egg,” which is a prominent area of swelling on the scalp that will typically improve on its own. You can apply an ice pack and offer your child over-the-counter pain medication like ibuprofen.

When a head injury is serious

If the swelling or bleeding continues, or your child is acting or behaving strangely, it’s time to consider emergency care. You might also call your primary care physician if your child can’t verbalize how they feel.

“If your child is under the age of two and can’t communicate as easily, it’s always good to have an evaluation by your physician. You may not need to go to the ER. The pediatrician’s office can help you triage these concerns,” Dr. Swick said. “Ultimately, you need to trust your instincts. If you feel like something’s wrong with your child, it’s never the wrong answer to check in with your pediatrician to make sure the injury they’ve received is nothing serious.”

However, if you’re concerned that someone may have purposefully injured your child, it’s important to seek care immediately.

“If you suspect your baby has been shaken or your child has been intentionally injured, these concerns should be evaluated immediately in either the ER or your pediatrician’s office—these concerns should not be monitored at home," Dr. Swick said.