Top of the pageCheck Your Symptoms

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.

Check Your Symptoms

Has your child had a head injury?
Yes
Head injury
No
Head injury
How old are you?
Less than 4 years
Less than 4 years
4 years or older
4 years or older
Are you male or female?
Male
Male
Female
Female

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Is the wound bleeding?
If you think the wound may need stitches, it's best to get them within 8 hours of the injury.
Yes
Bleeding wound
No
Bleeding wound
Would you describe the bleeding as severe, moderate, or mild?
Severe
Severe bleeding
Moderate
Moderate bleeding
Mild
Mild bleeding
Does your child have symptoms of shock?
Yes
Signs of shock
No
Signs of shock
Do you think there could be a spinal cord injury?
Yes
Possible spinal cord injury
No
Possible spinal cord injury
These could appear at the time of the injury or later.
Yes
Symptoms of serious head injury
No
Symptoms of serious head injury
Did a seizure occur after the head injury?
Yes
Seizure after head injury
No
Seizure after head injury
Did the seizure occur within the past 2 days (48 hours)?
Yes
Seizure occurred within past 2 days
No
Seizure occurred within past 2 days
Is there a wound that goes through the skull, such as a knife or gunshot wound?
Yes
Penetrating wound
No
Penetrating wound
Yes
Symptoms of skull fracture
No
Symptoms of skull fracture
Is there swelling anywhere on the head?
Swelling in certain areas of the head can be a sign of a skull fracture.
Yes
Swelling on head
No
Swelling on head
Is the only swelling a bump or "goose egg" on the forehead?
Swelling in any other area of the head, such as the temple area or the side or back of the head, could be more serious.
Yes
Only swelling is bump or goose egg on forehead
No
Only swelling is bump or goose egg on forehead
Did your child pass out (lose consciousness) after the injury?
Yes
Lost consciousness after injury
No
Lost consciousness after injury
When did your child pass out?
Within the past 24 hours
Loss of consciousness within past 24 hours
More than 24 hours (1 full day) after the injury
Loss of consciousness more than 24 hours ago
Was there a lot of force involved in the head injury?
Some examples are a fall onto the head from a height taller than the child, or a very hard blow to the head, such as in a car crash or a forceful sports injury.
Yes
A lot of force involved in head injury
No
A lot of force involved in head injury
When did the head injury occur?
Less than 24 hours ago
Injury occurred less than 24 hours ago
From 1 full day (24 hours) to 1 week ago
Injury occurred from 1 day to 1 week ago
More than 1 week ago
Injury occurred more than 1 week ago
Has your child vomited more than once since the injury?
Yes
Vomited more than once after injury
No
Vomited more than once after injury
Do you think that the head injury may have been caused by abuse?
A head injury caused by abuse is serious at any age, but this is especially true for babies.
Yes
Injury may have been caused by abuse
No
Injury may have been caused by abuse
Some symptoms may appear days or even more than a week after a head injury.
Yes
Other symptoms after head injury
No
Other symptoms after head injury
Are the symptoms:
Getting worse?
Symptoms are getting worse
Staying about the same (not better or worse)?
Symptoms are unchanged
Getting better?
Symptoms are improving
Has your child had symptoms for more than 2 weeks after the injury?
Yes
Symptoms for more than 2 weeks after injury
No
Symptoms for more than 2 weeks after injury

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

With severe bleeding, any of these may be true:

  • Blood is pumping from the wound.
  • The bleeding does not stop or slow down with pressure.
  • Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may be true:

  • The bleeding slows or stops with pressure but starts again if you remove the pressure.
  • The blood may soak through a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be true:

  • The bleeding stops on its own or with pressure.
  • The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Other symptoms related to a head injury that may appear later include:

  • Repeated episodes of feeling dizzy or lightheaded.
  • Changes in mood or personality. For a baby or toddler, you may notice this as the child being a lot fussier than normal.
  • Changes in the ability to concentrate and listen.
  • Ringing in the ears.

Symptoms of a spinal cord injury in a child may include:

  • Severe neck or back pain.
  • Being unable to move part of the body.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

Symptoms of a skull fracture may include:

  • Clear or bloody fluid draining from the ears or nose.
  • Bruising under the eyes or behind the ears.
  • Drooping of the face.
  • A dent anywhere on the head.

The symptoms of a skull fracture may appear at the time of the injury or hours or days later.

Symptoms of a serious head injury may include:

  • Passing out.
  • Becoming more and more drowsy, or hard to wake up.
  • Cannot stop crying.
  • A difference in the size of the pupils of the eyes.

Babies' heads are easily damaged, and their neck muscles are not strong enough to control the movement of the head. Shaking or throwing a baby can cause the head to jerk back and forth. This can make the skull hit the brain with force, causing brain damage, serious vision problems, or even death.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Do not move the person unless there is an immediate threat to the person's life, such as a fire. If you have to move the person, keep the head and neck supported and in a straight line at all times. If the person has had a diving accident and is still in the water, float the person face up in the water.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Head Injury, Age 4 and 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 a victim of 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.

Learn more

Watch

Preparing For Your Appointment

Related Information

Credits

Current as of: December 13, 2021

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine