Few injuries are scarier than a blow to young child’s head. Fortunately, most childhood head injuries look worse than they actually are, assures Elizabeth C. Powell, MD, pediatrician and spokesperson for the American Academy of Pediatrics.
“Traumatic brain injuries, such as concussions, are rare among little kids,” says Dr. Powell. “The skull is very protective. Even if it’s fractured, unless there’s bleeding underneath, on the brain, you don’t do anything about it — the skull will repair itself.”
The biomechanics of head injuries are different by age, adds Dr. Powell. Before kids are walking or cruising, a head injury is most likely to be due to a fall from, say, a changing table. A toddler or older child with a head injury probably took a tumble, ran into something, or was hit by a heavy object, she explains. Whatever the cause of a head injury, how you assess whether your child should see a doctor or go to the emergency room is the same.
“First off, don’t panic if you see a lot of blood,” says Dr. Powell. “There are lots of blood vessels in the scalp, so even a small scrape or cut can create a scary amount of blood. This is actually a good thing, because it means external head injuries repair themselves easily.” If your child seems to be bleeding profusely after a head bump, gently wipe the blood away with a clean washcloth so you can see what’s going on. Chances are, the actual wound will be minor, but if the edges of the skin are apart, have a doctor decide if stitches are necessary.
Whether a head bump causes bleeding or not, the most important thing to do afterwards is keep an eye out for long-term changes in demeanor or behavior. “After banging his head, every child is a little ‘flat” for at least fifteen to thirty minutes,” explains Dr. Powell. “Some kids don’t perk up for an hour. But if a child isn’t back to behaving like himself after an hour, if he seems a little off, see a doctor.”
What sorts of post-head bump behavioral changes should a parent look out for? “A baby will be fussier than usual, or more sleepy. She may not want to eat,” explains Dr. Powell. “A toddler or older child may seem confused, say his head hurts, want to sleep a lot, or vomit several times.”
Besides keeping an eye out for troublesome symptoms, treat swelling and pain with an ice pack, an age-appropriate dose of acetaminophen, and rest. If your child develops a “goose egg” — an oval protrusion — don’t worry about it. “It’s just a swelling of the scalp caused by trauma to the skin and broken blood vessels,” explains Dr. Powell. It might take a while to go away, but it’s nothing to worry about.
“The most important thing parents should do when a kid bumps her head is trust their instincts,” adds Dr. Powell. “Overall, parents instinctually can tell if a child has a little boo-boo or something worse. But there’s nothing wrong with erring on the side of caution: If you aren’t sure, see a doctor.”