Baby Head Injuries: When to Worry

Michele Meleen
Medical information provided by Dr. Rebecca Dixon, M.D.
Baby having head bandaged at hospital

Infant head injuries are uncommon and often require medical attention from a trained physician. There are several signs to look for when determining whether to treat at home, make a doctor's appointment, or head to the emergency room (ER).

Signs Your Baby Needs Immediate Medical Attention

Symptoms of a serious head injury can arise hours or days after the injury occurred, according to Riley Children's Health pediatric hospitalist Dr. Rebecca Dixon. Internal head injuries usually cause behavioral changes within the first 24 to 72 hours, while external injuries could display an infection days later.

Symptoms of Serious Head Injuries

If a baby or child experiences lethargy, vomiting, unconsolable irritability, or seizures after a head injury, you should immediately call 911. These are all signs of serious head injuries, such as a concussion or shaken baby syndrome. To help prevent further injury, don't move your baby if possible.

Emergency Room Versus Doctor Visit

Older babies who sustain minor bruises or scrapes from a known accidental source and exhibit no signs of discomfort or change in behavior could do well with a doctor visit as opposed to an ER trip. After any fall, you should consult your child's primary care physician. Since the doctor knows you and your child, he or she can guide you on how to proceed with monitoring or care.

What to Expect at the Hospital

If you or an ambulance takes your baby to the hospital after a head injury, there are a few tests you can expect to have done. Results from these tests can be received within hours of arriving at the ER and help determine the seriousness of the injury:

  • Xray
  • CT scan
  • Eye exam, sometimes done after an Xray and CT scan to see if baby has retinol hemorrhages

Symptoms of Concern

If you notice a bruise or discolored mark on your child, it could be a harmless injury or the sign of something more serious. If your baby has a scrape or cut bad enough to need a bandage, you should take your child to his or her primary doctor for dressing.

A Healing Bruise That Turns Red Again

Bruises start out a purplish-blue color and move to a reddish-green color as they heal. If you see the bruise healing properly but it begins to turn red again, it could indicate an infection.

Unconsolable Irritability

An irritable baby could be described as one who does not calm down even after a parent or caregiver holds, rocks, feeds, or otherwise tries to soothe him. If your child experiences head trauma and displays extreme lethargy or increased fussiness without the ability to be soothed, these behaviors are cause for concern.

White or Stinky Discharge

Cuts and scrapes will look red, and both kinds of skin injuries could bleed. However, if the wound drains any fluid that looks white or has a bad odor, that is not normal and could signal an infection.

A Wound That's Warm

A lesser-known sign of infection is when a bruise or cut feels warm to the touch. If you're concerned about a wound, touch it or the area immediately surrounding it with your finger to see if it's hotter than other areas of baby's skin.

Uncontrollable Bleeding

The face and scalp are loaded with blood vessels, so cuts on these areas tend to bleed a lot. Test whether the bleeding is too much by holding a clean cloth or piece of gauze over the wound with pressure for five minutes. If the bleeding continues after you remove the gauze, you'll need to contact your child's primary doctor.

Putting Baby's Safety First

Loving parents and caregivers worry often about their baby's well-being and sometimes feel embarrassed contacting their child's doctor for every little thing. In the case of infant head injuries, it's always better to err on the side of caution and seek medical advice. Dr. Dixon suggests, "If you're worried enough to worry, just call your primary care provider."

Baby Head Injuries: When to Worry