Head Injury, Age 3 and Younger

Overview

Almost all children will bump their heads, especially when they are babies or toddlers and are just learning to roll over, crawl, or walk. These accidents may upset you, but your anxiety is usually worse than the injury. Most head injuries in children are minor.

Bumps, cuts, and scrapes on the head and face most often heal well and can be treated the same as injuries to other parts of the body. A minor cut on the head often bleeds heavily. This is because the face and scalp have many blood vessels close to the surface of the skin. The blood is alarming, but often the injury is not severe and you can stop the bleeding with home treatment. When you can't stop the bleeding, visit a doctor. A young child can lose a large amount of blood from a deep cut on the head.

Some head injuries are more serious. This is called a traumatic brain injury (TBI). A TBI can range from a mild concussion to a severe head injury. Common causes of a severe head injury in this age group include falls and abuse (inflicted head injuries), such as abusive head trauma. This is also known as shaken baby syndrome.

Anyone with a head injury should be watched, especially from the causes noted above. If you think that any symptoms may be serious, see a doctor for an evaluation.

When a head injury has occurred, also look for injuries to other parts of the body. The alarm of seeing a head injury may cause you to miss other injuries that need attention. Trouble breathing, shock, spinal injuries, and severe bleeding are all life-threatening injuries that may occur along with a head injury and that need medical attention right away. Injuries to the spine, especially the neck, must be checked for when a head injury has occurred. Be sure to check for other injuries to the face, mouth, or teeth.

Many head injuries can be prevented. Use car seats, seat belts, and helmets. And make your home safe from falls. For example, never leave your baby alone in a high place, such as on a table or a bed. Establish safe habits early so your child will keep doing them when your child is older.

Self-Care

Many minor head injuries, such as bumps, cuts, and scrapes, can be treated at home. Home treatment can help relieve swelling and bruising of the skin or scalp and the pain that occurs with a minor head injury.

Always watch children for any problems after a head injury. If you think that any symptoms may be serious, see a doctor for an evaluation.

Talk to your child's doctor before you give your child an over-the-counter medicine for pain.

Follow these steps to treat a child age 3 or younger at home for a minor head injury (such as a bump, cut, or scrape).

1. Stay calm.

   If your child had an accident, try to stay calm and speak to your child in a calm, relaxed voice. This will help reduce your child's fear and allow you to assess the situation.

2. Stop any bleeding.

   Apply firm pressure directly over the cut with a clean cloth or bandage for 15 minutes. If the cut is deep and may have penetrated the skull, emergency treatment is needed.

3. Use ice or cold packs.
   • Apply cold to reduce the swelling if your child will let you hold a cold pack on the injury. A "goose egg" lump may appear anyway, but ice will help ease the pain.
   • Always keep a cloth between your child's skin and the ice pack.
   • Don't apply ice for longer than 15 to 20 minutes at a time. And don't let your child fall asleep with the ice on their skin.
4. Check for other injuries.

   Check for injuries to other parts of the body, especially if your child has fallen. The alarm from seeing a head injury may cause you to miss other injuries that need attention.

5. Watch for symptoms.
   • Call 911 or go to an emergency room right away if unconsciousness or seizure activity develops in your child.
   • Seek medical care right away, usually in the emergency room, if your child:
     • Develops a headache.
     • Begins vomiting.
     • Starts crying and cannot stop.
     • Becomes drowsy.
     • Begins acting in a way that is not normal.

Signs of possible abuse

Most injuries are not caused by abuse. But bruises are often the first sign of possible abuse. Suspect physical abuse of a child or vulnerable adult when:

• Any injury cannot be explained or does not match the explanation.
• Repeated injuries occur.
• Explanations change for how the injury happened.

You may be able to prevent further injuries by reporting abuse. Seek help if:

• You suspect child abuse or elder abuse. Call your local child or adult protective agency, police, or a health professional, such as a doctor, nurse, or counselor.
• You or someone you know is experiencing intimate partner violence (IPV).
• You have trouble controlling your anger with a child or other person in your care.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• Seizure.
• New or worse swelling or bleeding.
• New or worse headache. (A baby with a headache may cry and be fussy.)
• New or worse nausea or vomiting.
• New trouble waking up or extreme sleepiness.
• New or worse confusion or not acting normally.
• New or worse weakness in any part of the body.
• Symptoms occur more often or are more severe.

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