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A Bump on The Head? When to Take Your Child to the Doctor

Posted on Mar 27, 2012 | 28 comments

Lauren Brave, M.D., Pediatrician, Palo Alto Medical Foundation Pediatric Urgent Care

A bump on the head is one of those painful yet common childhood experiences that can happen at any age – whether it’s the newly mobile baby rolling off the bed, the elementary school kid falling off the jungle gym, or the teenage athlete colliding with an opposing team member during a high school football game. Pretty scary stuff for parents – should you rush straight to the emergency room? If your child loses consciousness, even briefly, you should seek immediate medical attention. For many minor head bumps, however, careful observation of your child for the first 36 to 48 hours is the most important thing you can do. If you are at all in doubt, don’t hesitate to follow your instincts and consult your doctor.

My 13-month-old daughter has just started walking and has been close to falling and bumping her head a couple of times. If she falls and hits her head should I take her to the doctor?

New walkers, teetering near the sharpest corners of your furniture or on a hard concrete sidewalk, can be real heart-stoppers for parents. Fortunately, most baby head bumps are benign and your little walker will soon become steadier on her feet.

If your daughter does fall and bump her head, but is alert and responds to you, watch her carefully for the next 36 to 48 hours to see if any symptoms develop that could indicate a head injury. Changes to watch for include:

  • Inconsolable crying
  • Vomiting more than once
  • Unable to respond to you
  • Balance difficulties when trying to sit or walk

As children get older, they may be able to share or you may notice the following symptoms:

  • A sustained headache
  • Slurred speech or confusion
  • Dizziness
  • Numbness or weakness in the arms or legs
  • Amnesia from the event

If your child is exhibiting any of these symptoms, or has any significant swelling over the site of the injury, you should take her to the doctor.

If it is nap or bedtime and your daughter has none of these described symptoms, you can let her sleep, but check on her every two to three hours to make sure all is well. It’s also best not to give her any pain medication so that any pain or other symptoms are not masked.

My daughter fell off her bike and hit her head. Should she get a CT scan?

Getting a CT (computerized tomography) scan may seem like the best way to see what’s really going on inside your daughter’s head but it not always advisable as this does involve a dose of radiation which might not actually be necessary. Instead, your doctor will examine your daughter and ask about the specific symptoms she has. This is a much better indicator of how serious her head injury is and what treatment is best for her. CT scans are usually only administered for patients who are displaying symptoms that indicate a serious head injury.

My son hit his head on the goal post during a soccer game a couple of weeks ago. He’s still complaining of a headache. Is that normal?

Most likely, after this head injury, your son experienced a concussion. A concussion is actually a mild traumatic brain injury caused by an impact and the symptoms reflect this. Symptoms may include dizziness, nausea, fatigue and forgetfulness which can last anywhere from 15 minutes to a couple of weeks.

Recovery time from a head injury can vary greatly for each individual, so it is possible to still experience symptoms of a head injury long after the accident occurred. Children’s and teenagers’ developing brains, in particular, can take seven to ten days (or more) longer than an adult to return to normal after a head injury. Other possible head injury symptoms that can linger include being a little more tired than usual, more sensitive to lights, more emotional, or having trouble concentrating in class. Make sure that your son does not return to soccer before he is completely back to normal. After any significant concussion, a child should be examined by a doctor before returning to sports.

Although it is not possible to prevent all head injuries, there are several ways you can reduce the risk, including always having your child wear the correct protective gear (such as helmets and mouth guards) and knowing and adhering to the rules of the sport.

My 15-year-old son suffered from concussion when he collided with another player during a lacrosse game a couple of weeks ago – now the coach wants him back in the game. When is it safe for him to return?

It’s extremely important for him not to go back too soon and risk another head injury that could result in much more serious damage or, although rare, death. Just remember, ‘when in doubt, sit it out!’ The best treatment for concussion is rest from both physical and mental activity.

A child should never go directly back into the game after he or she has experienced a head injury and your son also shouldn’t return to sports until he is back to his baseline (his normal health before the injury). A five-day step-by-step progressive return to sports is now recommended by the American Academy of Pediatrics after any head injury. When your son is feeling completely back to normal and has no symptoms, he can increase his level activity, day-by-day in the following way:

  • Day 1: light aerobic exercise such as walking or using a stationary bike
  • Day 2: sport-specific drills and running drills
  • Day 3: add drills that involve resistance
  • Day 4: return to practice
  • Day 5: return to game and full participation

Your son will need to complete each step without experiencing any symptoms before he can move on to the next step. If symptoms persist beyond 48 to 72 hours, he should be assessed by a doctor.

This blog post is contributed by Lauren Brave, M.D., a board-certified pediatrician in the Palo Alto Medical Foundation’s Pediatric Urgent Care Department.

Please note that we are unable to respond to personal medical questions through the comments feature below. For information about personalized health care, or if you need help in choosing a PAMF physician, please visit Becoming a PAMF Patient (http://www.pamf.org/findadoctor) or call 1-888-398-5677. If you are a PAMF patient, you can email your doctor securely via our My Health Online program. Thank you

28 Comments

  1. I was walking to my door and my shoe went in a pot hole and I was holding my 16 month old and went to protect her and I fell so hard that her back arched and she hit her head pretty hard on the assfault .
    She cried, but was alert . I”m consurned because she is making little cry noises in her sleep. Should I be concerned ? I would take her now but my knee is swollen from falling and we are in a up/ down stairs home. It”s been 9 hours now since she hit her head.

    • Sara,
      Thank you for visiting our blog and reading the articles. We do not provided personalized medical advice on this blog. Therefore, we suggest you contact your child”s doctor directly if you still have concerns and he or she can personally answer your questions and let you know if your daughter should be seen by a doctor. If you feel it is an emergency situation, you can take your child to an Urgent Care Center to be seen immediately. Best wishes to you and your daughter.

  2. My son is gonna be 2 in july and last week he was walking and tripped over his pants he fell down and hit his forehead, he got up and cried a little, but perfectly normal after the fall continued his day liike if nothing happened , wasnt fussy, or vomiting,perfectly fine,he has a little bump and a little bruise, im concerned is this something serious?

    • Hi Rita,

      This is a community blog and does not provide personalized medical advice. If you have a personal medical question, please contact your doctor directly to discuss. If you are a PAMF patient, you can also email your doctor with your questions securely via our My Health Online program. Thank you for visiting our blog and best wishes.

  3. My 5yr old fell off her friends back and hit the side walk..at first she cried and got a goose egg..but later the knot seem to go inward and is soft….other wise she is good and actin normal….is it normal to go inward…and be soft….???

    • Hi Tammy
      This is a community blog and does not provide personalized medical advice. If you have a personal medical question about you or a family member, please contact your doctor directly to discuss. If you or your child are a PAMF patient, you can also email your doctor securely via our My Health Online program with your questions. Thank you for visiting our blog and best wishes.

  4. Hi my 18 mth baby felt from the play crib earlier and she got a bump in her forehead its starting to get like pink and purple is that normal she’s hitten her self in the same spot like 4 times ….

    • Hi Lupita,

      This is a community blog and does not provide personalized medical advice. If you have a personal medical question about you or a family member, please contact your doctor directly to discuss. If you or your child are a PAMF patient, you can also email your doctor directly and securely via our My Health Online program with your questions. Thank you for visiting our blog and best wishes.

  5. Hey.!

    I was riding my cycle and i jumped over an unnoticed Speedbreaker, my head hit the road but i didnt feel much pain after it! theres swelling on the injured area, just after the fall i felt a little dizzy.! i came home and had a bath and i feel normal except theres a little pain on the lump.!
    Do i have to visit a doctor?

    • Hi Chirag,

      This is a community blog and does not provide personalized medical advice. If you have a personal medical question, please contact your doctor directly to discuss. If you are a PAMF patient, you can also email your doctor securely via our My Health Online program with your questions. Thank you for visiting our blog and best wishes.

  6. If a child hits an object and gets a minor cut should he/she be seen by a doctor

    • Hi Kim,
      This is a community blog and does not provide personalized medical advice. If you have a personal medical question, please contact your doctor (or your child’s doctor) directly to discuss. If you or your child are a PAMF patient, you can also email your doctor securely via our My Health Online program with your questions.

      Regarding your question about minor cuts, you may also wish to see this article on “Caring for Common Cuts and Scrapes.” It has tips from a PAMF pediatrician and answers some of parents’ commonly asked questions on the topic: http://www.pamfblog.org/2013/02/tips-on-treating-cuts-and-scrapes/.

      Thank you for visiting our blog and best wishes.

  7. Hi,
    My 6 year old daughter fell down and had hit her right forehead hard. She had a big swelling and the area had become purplish . she had no other symptons i had applied arnica on a hourly basis for 2 days and then had applied thromboforb till the swelling had considerably reduced. This was 6 months back but still i feel that her right forehead has a little swelling. She has no other visible problem and is her playful self. My question is there any injury still and do i need to be concerned about it? Will
    Be obliged if u reply . Thanks in advance.

    • Hi Rumpa,

      This is a community blog and does not provide personalized medical advice. If you have a personal medical question, please contact your doctor (or your child’s doctor) directly to discuss. If you or your child are a PAMF patient, you can also email your doctor securely via our My Health Online program with your questions. Thank you for visiting our blog and best wishes.

  8. Hello doctor, my 16 months girl baby sliiped from bed and fell down while playing. I couldnt recognize the exact place of injury but I found her lower back head is swollen . is it to be worried or should I take her to doctor?

    • Hi Benazeer,

      This is a community blog and does not provide personalized medical advice. If you have a personal medical question or concern for you or a family member, please contact your doctor directly to discuss – or if it is a medical emergency, seek immediate medical attention. (If you are a PAMF patient, you can also email your doctor securely via our My Health Online program with your questions.) Thank you for visiting our blog and best wishes.

  9. Hello. i am new mom and my seven month old daughter was just playing with her formula can and rolled off the bed with the formula and now has a scratch/ bump on her left side of her head. she cried for a minute or so and was alittle cranky and fell a sleep and hour later . i am concerned should i take her to the ER?…

    • Hi Zara,
      This is a community blog and does not provide personalized medical advice. If you have a personal medical question or concern for you or a family member, please contact your doctor directly to discuss – or if it is a medical emergency, seek immediate medical attention. (If you are a PAMF patient, you can also email your daughter’s doctor securely via our My Health Online program with your questions.) Thank you for visiting our blog and best wishes.

  10. Hi,

    I’m sorry that no one seems to read your disclaimer.

    Thanks for the article!

    • Hi Seth,
      Thank you for your comment and understanding. We’re glad to know so many people have found this article useful – and we encourage them to speak with their doctor about their (or their children’s) personal medical questions or seek immediate medical attention if it is an emergency. Best wishes and thank you for visiting our blog!

  11. Hi!
    My 18 month old fell out of a shopping cart yesterday, head first and hit his forehead. I rushed him to the ER to get him examined, they said he’d be alright but to wake him occasionally to see if he responds normally.

    On top of this horrible incident he has a cough and an ear infection.
    One of the things they told me to look out for was clear or bloody fluids coming from his ears and nose. Unfortunately today he obtained clear fluids from his nose, that could potentially be snot. Should I associate the clear snot type fluid from his nose with the incident or could he be getting a cold?

    HELP! Thank you!

    • Hi Savannah,
      This is a community blog and does not provide personalized medical advice. If you have a personal medical question or concern for you or a family member, please contact your doctor directly to discuss – or if it is a medical emergency, seek immediate medical attention. (If you are a PAMF patient, you can also email your daughter’s doctor securely via our My Health Online program with your questions.) Thank you for visiting our blog and best wishes.

  12. I’m 17 but when I was like 15-16 I was playing basketball with a group of friends when I went to lay up my friend Clayton blocked my and the way he did it caused me to fall like 6-7 ft off the ground and when I fell on my back I hit the ground but my head got wip-lashed on the concrete hard. Everything went black for at least a second then I had a massive headache for the rest of the day, but after a couple of days of aspirin, ibuprofen, and an ice pack on my head the pain wasn’t there anymore but there was a fairly big bump were my head got whiplashed almost like a knot but unlike a knot it didn’t go away, now I’m 17 and I still got it and it almost feels like it’s part of my school now but it couldn’t be could it or what is it and should I consult someone??

    • Hi Michael,
      This is a community blog and does not provide personalized medical advice. If you have a personal medical question, please contact your doctor directly to discuss – or seek medical attention if it is an emergency. Thank you for visiting our blog and best wishes.

  13. I’m 21 years old an when I was in 3rd grade I hit my head against a wall so hard it knocked me down an I passed out. I never got it checked out an I still have the bump on my head, and also a lot of other bumps.. I’ve been having a lot of headaches around those areas, should I go to the doctor about it?

    • Hi Kayla,
      This is a community blog and does not provide personalized medical advice. If you have a personal medical question, please contact your doctor directly to discuss – or seek medical attention if it is an emergency. Thank you for visiting our blog and best wishes.

  14. My daughter hit her head on the bars of a bed and within a few minutes a large golf ball shaped bump was on the middle of her head why is that I’m really concerned?

    • Hi Mary,
      This is a community blog and does not provide personalized medical advice. If you have a personal medical question, please contact your doctor directly to discuss – or seek medical attention if it is an emergency. Thank you for visiting our blog and best wishes.

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