No matter how watchful a parent or caregiver you are, accidents happen, and it’s possible that an accident may involve your little one falling and hitting their head. If this should occur, you may fear that your baby has suffered a concussion. The mild traumatic brain injury (TBI) occurs when an especially intense blow to the head and neck or upper body causes the brain to slide back and forth forcefully against the inner walls of the skull, potentially altering brain function briefly and resulting in signs and symptoms of a concussion, according to the Mayo Clinic.
While it may be deeply unnerving to think your child is contending with a concussion, it bears noting that the injury is not uncommon. According to the Centers for Disease Control & Prevention (CDC), an estimated 812,000 children (age 17 or younger) were treated in U.S. emergency departments for concussions or other TBIs, alone or in combination with other injuries in 2014.
Given the prevalence of childhood concussions, parents and caregivers would do well to learn the common causes, symptoms and signs of a baby concussion, as well as the best way to address a potential TBI. Here’s what you need to know about this head injury in infants.
Common causes of a baby concussion
While older kids might suffer a concussion during playtime or sports practice, common causes of concussions in babies are falls from a bed, changing table or couch, notes Dr. Gina Posner, a board-certified pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California.
Concussion-causing accidents may also be spurred by learning to walk, a slip and fall in the bathtub, getting pushed by an older sibling or falling off a seat, notes Alex McLean Taylor, a neuropsychologist at Boston Children’s Hospital in Boston.
A mom from Portland, Oregon, named Melissa S. can attest to everyday moments leading to a concussion scare.
“My daughter fell out of a carriage at 6 months,” she says. “She also bonked her head really hard on the floor when I was changing her pants standing up. She has low [muscle] tone, and I underestimated her coordination. Just pulling up her pants made her fall forward. No red flags; I was just scared to death and wanted to make sure she was alright given she fell.”
For that reason, after both falls, the concerned mom took her daughter to the ER, where the little one underwent a physical exam.
“We were asked if she was tired/lethargic or if she vomited at any time after,” she says. “We were told both times to follow up with her pediatrician and to continue monitoring for any lethargy and vomiting.”
Symptoms and signs of concussion in baby
When you think of general concussion symptoms, issues like headache, confusion, nausea and dizziness may come to mind. Babies can experience all of these effects of a concussion, but injury signs will manifest differently than they do in older kids and adults, given the fact that they’re unable to communicate how they feel.
“After head trauma, babies with a concussion may suffer from loss of consciousness, fussiness, vomiting, or a change in their behavior,” explains Dr. Danelle Fisher, a board-certified pediatrician and vice chair of Pediatrics at Providence Saint John’s Health Center in Santa Monica, California.
Other baby concussion signs include:
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Listlessness, tiring easily.
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Irritability, crankiness.
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Change in eating or sleeping patterns.
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Change in the way they play.
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Change in the way they perform or act at school.
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Lack of interest in favorite toys.
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Loss of new skills, such as toilet training.
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Loss of balance, unsteady walking.
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Confusion or if the child is easily distracted and cannot do normal activities.
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Stares blankly.
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Delayed answering of questions.
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Slurred speech.
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Stumbling or clumsiness, uncoordinated or cannot walk a straight line.
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Cries very easily or becomes angry easily or exhibits extreme emotions.
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Problem with memory, repeats self, repeatedly asks questions, unable to recall words or objects.
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Loss of consciousness.
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Will not stop crying and cannot be consoled.
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Will not nurse or eat.
For Rachel R., a mom from Lake Wylie, South Carolina, whose 13-month-old suffered a concussion, the symptoms were quickly apparent.
“My daughter fell backwards from a dining room chair and hit the back of her head on the hardwood floor,” she says. “As soon as I picked her up, I knew she wasn’t OK. Her cry was different, she got cold and clammy, she was limp, couldn’t focus. We immediately went to the ER. We stayed for a few hours of observation and then left with a few really useful tips for care at home during recovery for the next few days: Absolutely zero screen time, no loud sounds/music and rest whenever needed.”
What to do if a baby or toddler has a concussion
Watching for key signs is a must when you’re dealing with a possible infant concussion. Here are a few recommendations when creating an action plan for baby after a head injury.
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Watch closely for symptoms: In general, babies who have had head trauma without the symptoms listed above should be watched closely for 24 hours afterward, explains Fisher.
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If there are no symptoms: Meanwhile, “Babies who do not exhibit those symptoms can nap and sleep at the regular times,” Fisher says. That said, the AAP says that following a head injury, you should check on your child every two to three hours to make sure he moves normally and responds to you.
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When to call the doctor: If your child experienced a blow that is more than a light bump, the American Academy of Pediatrics (AAP) recommends calling your child’s doctor, who will want to know when and how the injury happened and how your child is feeling.
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When to go to the ER: If any of the symptoms become apparent, the little one should be taken to the emergency room. And if your baby is sleepy at an unusual time — for instance, “they just woke up and then want to go to sleep” — they should be taken immediately to the ER.
If you do take your child to the emergency room, you can expect physicians to do a physical exam, and then, depending on the severity of the injury, run a diagnostic test, such as a CT or MRI, to check for bleeding.
Keeping your little one safe in the future
Whether your child has suffered a concussion or not, a scare is enough to take extra safety measures. Falls from high places, like tabletops, cribs with the sides down, beds or sofas usually happen once a baby is able to roll, but you never want to leave a baby unsupervised in a high area, Posner says.
Additional precautions you’ll want to take to guard against falls and head injuries, according to experts at the C.S. Mott Children’s Hospital in Ann Arbor, Michigan:
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Don’t leave a baby alone in any infant seat or “sitting” toy, such as a swing or jumper. Use all the safety straps provided.
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Use stair gates to block stairways. Use gates at the top and bottom of the stairs.
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Do not use baby walkers.
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Keep your baby away from elevated porches, decks and landings.
Other injury prevention safety tips: Because babies might also wiggle around during a diaper change, clip your little one into the changing pad. And when your little one is resting in a car seat carrier, don’t rest them above the ground, as they can fall off of tables and other surfaces.
