When we hear the awful thud of a child's head, our breath catches. A prompt cry after the injury is reassuring. It is normal for a child to feel sleepy after hitting her head, and is even O.K. for her to vomit once or twice. The following is a list of signals that tell you that you need to talk with your pediatrician. If your child is (or has):

• Under six months of age
• Unconscious, even briefly
• Crying for longer than 10 minutes
• Vomiting repeatedly
• Bleeding from the ears or nose
• Rapid swelling just above the ear
• Unable to walk or talk normally
• Unequal pupil size
• Severe, worsening headache
• Neck pain
• Seizures
• Skull indentation or large bump
• Great force of injury (car accident, long fall, baseball bat, etc.)
• Acting strangely

If any of these symptoms or situations are present, call your physician right away. Your child may be fine, but you should be in touch with an expert. If they are unable to get up by themselves immediately after the head injury, don't move them. Call 911 and wait for emergency help to arrive.

If none of these symptoms are present, it is fine to let your child sleep, as long as you wake her every half hour for the first six hours after the fall. After this, awaken her at your bedtime and again four hours later to check on her status. If at any time your child seems to develop a suspicious symptom, call your doctor.