Head Bumps in Children
Your Child Hit Their Head – Now What?
By Darian R. Esfahani, MD, MPH, FAANS
It happens all too often – your toddler runs towards you, excited, only to trip and fall face-first to the ground. They cry for a few minutes but then calm down. Later that evening, during bath time, you get a closer look. Is that a bump on their head?
Head trauma is the most common form of injury in young children. But when should you be worried? Dr. Darian Esfahani, a board-certified Pediatric Neurosurgeon at the Kaiser Permanente Los Angeles Medical Center and Assistant Professor at the Kaiser Permanente Bernard J Tyson School of Medicine, shares his advice.
Minor Bumps are Very Common
Children, and especially toddlers, hit their heads often. This is not only because they are learning to walk and assess risk but because their heads are much larger relative to their body than adults. Low-force injuries, such as a fall from standing height or being hit by something soft, like a toy, are usually low risk. If your child had only a light bump to the head, acts normal soon after the accident, and doesn’t have any of the higher risk signs below, it’s probably okay to monitor them.
Dangerous Signs and Dangerous Injuries
The American Academy of Pediatrics recommends contacting a healthcare provider for guidance for all but a light bump on the head. Loss of consciousness, worsening headaches, vomiting, seizures, drowsiness, weakness or numbness of the arms or legs, balance problems, swelling or significant bleeding, a visible skull dent, or leakage of watery fluid or blood from the ears all warrant evaluation by a professional. Higher-risk injuries, such as a fall from a height higher than standing, motor vehicle accidents, or injury from a sharp object, also warrant examination. Similarly, parents of children with existing medical problems, especially brain and bleeding disorders, should have a lower threshold to seek evaluation.
When In Doubt – Bring Them In
Trust your instincts. If, after the injury, your child is slow to return to normal, acts strangely, or something just seems “off,” this may be a reason to give a healthcare professional a call. What about urgent care or the emergency room? If you see one or more of the concerning signs above, your child appears to be getting worse, or a healthcare provider is slow to get back to you, it may be time to bring the little one in, or, if needed, call 911. Safety first.
An Ounce of Prevention
Just because head injuries are common doesn’t mean they can’t be prevented. For babies and toddlers, this means window guards, gates on stairwells, strapping into strollers, and constant supervision. Car and booster seats must be used every time a baby or young child rides in the car. For older children, the importance of wearing a helmet (correctly) when on a bicycle cannot be overstated; head injuries in children whose parents let them ride unhelmeted make up a staggering number of ER visits.
As a parent, head bumps are, understandably, stressful and a source of anxiety and guilt. They are also very common. For minor head bumps, however, the vast majority of children do well without long-term problems. If you ever feel uncertain about a head injury, practice caution and contact a healthcare provider for a professional assessment. Exercise good prevention and judgment, and trust your instincts!
ABOUT THE AUTHOR
Darian R. Esfahani is a double-board certified pediatric neurosurgeon at the Kaiser Permanente Los Angeles Medical Center and assistant professor at the Kaiser Permanente Bernard J. Tyson School of Medicine. Dr. Esfahani is the author of over seventy-five publications and presentations and is Co-Director of the Southern California Permanente Medical Group Pediatric Neurologic Oncology Tumor Board and Pediatric Neurovascular Clinic.
Cover Photo by Karolina Grabowska