We’re often told that letting a child sleep after a fall could have dangerous repercussions. Learn what warning signs to look for after head trauma.
I remember it like it was yesterday. I was folding laundry on the couch while zoned into an episode of Dr. Phil. My son, who was just nine months old at the time, was playing with his toys on the floor next to me. Not a moment later, I hear his high-pitched scream and a goose egg forming the size of a golf ball. He had fallen and smacked his forehead on the coffee table.
Each year, approximately 62,000 children sustain brain injuries requiring hospitalization as a result of motor vehicle crashes, sports injuries, physical abuse, falls, and other causes, according to the Brain Injury Association of America. Babies are particularly vulnerable to falls as they are learning how to stand and walk.
Like many babies who sustain head injuries, my son suffered no long-term effects from his fall. However, I had decided to keep him awake for several hours following the incident to be safe. I also made a call to the pediatrician to see if I should bring him in. She recommended keeping him home to rest but checking on him every couple of hours throughout the night to make sure he responds normally.
Sleep or No Sleep
If your baby is under one year of age and has suffered a fall, contact your doctor for advice on how to proceed. A small bump to the head that doesn’t bother the baby for long is usually nothing to worry about. Apply a cold compress to the lump and allow your baby to nap.
If your baby has a more serious head injury, keep him awake and seek medical help. Remember that not all head injuries are visible from the outside. Internal head injuries may involve the skull, blood vessels, or brain.
Call for an ambulance immediately if your baby:
Has a seizure.
Of course, you’ll also want to trust your instincts. If something seems off, get medical attention for your baby.
What the Experts Say
“Babies normally retreat into sleep after trauma, which makes the unusual admonition to “watch for a change in consciousness” an anxiety-producing instruction for the parent. If a head injury occurs near night or nap time in an already tired child, you may be confused about whether the drowsiness is due to the injury or whether it’s just time for sleep to naturally overtake the child. Let baby fall asleep, but awaken yourself every two hours and do a baby check.”
– The Baby Book, William Sears, Martha Sears, Robert Sears, James Sears
“If your child has fallen, be alert for signs of head injury. Loss of consciousness, onset of vomiting, bleeding from the ears, nose, or mouth, lack of eye response, or one pupil noticeable larger than the other are symptoms of a possible problem after a fall. If one or more of these conditions follows a fall by your child, you should get prompt medical attention.”
– Your Baby & Toddler, Anne Marie Mueser, Ed.D.
“Let the child sleep if there are no other signs or symptoms of internal head injury and it is a normal bedtime or naptime. If the child is acting normally before the regular bedtime or naptime, let the child sleep for up to 2 hours without waking her up. After 2 hours, wake the child. Check to see if she wakes up as easily as usual. Get medical care if your child is not acting normally.”
– First Aid for Families, American Academy of Pediatrics
“The need to keep an injured child awake is a fantastic myth that has been perpetuated by some really bad television. It’s not the falling asleep that is important; it is whether a child can be woken easily, and whether his sleepiness is normal for that time of day.”
– If Your Kid Eats This Book, Everything Will Still Be Okay, Lara Zibners
“Chances are, your child is going to spend some time (other than Halloween) looking like a unicorn – with a prominent bump on his head. Many times, that’s okay; the goose-egg swelling is a sign of normal blood clotting beneath the skin at the site of the injury. Nonetheless, you’ll need to keep a close eye on your child during the forty-eight hours after a head injury because it can take that much time for damaged veins to leak and cause swelling in the brain.”
– You: Raising Your Child, Michael F. Roizen, Mehmet Oz
Baby Care After a Fall
If your baby has suffered a fall, monitor his behavior. It’s not uncommon for babies to act sleepy after a trauma, and this doesn’t necessarily mean that something is wrong. If your baby is breathing and acting normally, allow him to sleep but wake him up at regular intervals to see how he responds. Also look for signs of a possible concussion, such as vomiting, sensitivity to light, irritability, or difficulty with coordination or balance.
It’s normal to be concerned after your child has suffered a fall. You may want to keep him awake and possibly bring him to the hospital. As injuries can vary in severity, it’s important to use your best judgement and take advice from your child’s pediatrician. Most importantly, remain calm and deal with the situation with a clear, level head.