When to Call the Doctor after your Child Hits Her Head

Young boy with swollen forehead after a fall

Young boy with swollen forehead after a fallWhen 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.

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 or prolonged irritability
  • Vomiting repeatedly
  • Bleeding or other liquid draining from the ears, mouth, or nose
  • Rapid swelling just above the ear
  • Bruising around the ear or eye
  • Unable to walk or talk normally
  • Acting strangely or drowsy
  • Unequal pupil size
  • Severe, worsening headache
  • Neck pain or stiffness
  • Seizures
  • Skull indentation or large bump
  • Great force of injury (car accident, long fall, baseball bat, etc.)
  • Worsening symptoms or symptoms improve then worsen

An illustration of a concussion, a violent jarring or shaking that results in a disturbance in brain function

What next?

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

What else?

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 immediately.

Did the information in this article help to answer your questions? What else could we include here to help other parents who are wondering if they should call a doctor after their child has hit their head?

Reviewed by: Khanh-Van Le-Bucklin, Liat Simkhay Snyder
Last reviewed: July 02, 2010
Dr. Alan Greene

Article written by

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

 

Comments

  • Beth

    Does it matter where the child hits her head, whether front, back or side?

    • Alan Greene

      Beth, hitting the head in different locations can cause different injuries and different symptoms – but the same rules apply for when to be concerned and to get checked.

  • Marisa

    Dr. Greene, my 4 yrs. old daughter fell off the chair, hit head on the side of the desk and he cried for a couple of minutes. Couple of hours later, my husband gave her a piece of watermelon, she put it in her mouth and threw up. She said that her head hurts. Then couple of hours later, she had a low fever so I gave her tylenol. What should I do? Should I bring her to the ER?

    • Alan Greene

      Marisa, vomiting once after a fall is normal for kids who didn’t lose consciousness with the fall. So is a headache. But kids who vomit repeatedly, or whose headache is severe or keeps getting worse should be checked right away.

      • Marisa

        Thank you Dr.

        • Alan Greene

          You are most welcome.

  • Nicole Benenati

    Daughter fell off bike big lump in back of head and bad headache her pupils are fine should I be worried she is 10

    • Alan Greene

      While most kids who fall off a bike end up fine, a fall off of a bicycle can be enough force to cause a head injury of concern. It’s a good reason for bike helmets and for contacting doctors.

  • Andrea Hanover

    My 6 month old was hit on the head by a walnut that fell out of a tree. I did not see the walnut hit her but after seeing another one though I shouldn’t have her under this tree. Picked her up and she had a mark on her head (the nasty green stuff) and a little dent. It was literally right beside her soft spot. She acted fine and smiley and playful. Now reading this it said if dent to call doctor. She obviously didn’t cry that hard pro would have noticed. When she fussed I though she was just bored. (She is an attention hog:)) should I call dr???

    • Alan Greene

      The type of dent (or skull indentation) I wrote about in the article would be a sign of a skull fracture. I’m not surprised that a falling walnut could leave a soft tissue dent. And a baby acting fine and smiley and playful afterwards is certainly a great sign. Thankfully the soft spot is well-designed to protect babies (http://www.drgreene.com/qa-articles/soft-spots/)

  • Chandni Babar

    my 18 months old son hits his back side of head several time on cement floor. I m worried about him kindly give me some useful advise.

    • Jess

      A chiropractor can take x-rays to see if there is any misalignment and adjust according to whatv is needed by what the x-ray reveals.

    • Alan Greene

      Chandni, when kids keep banging their heads against something hard it’s often concerning to parents. Here’s an article I wrote about head banging that might be helpful for you: http://www.drgreene.com/articles/head-banging/

  • Alan Greene

    Priscilla – It’s scary when our kids get injured. A good rule of thumb is when parents are not confident that it’s safe to wait to take a child to a doctor, then it’s a good idea to take the child in.

    Usually getting hit on the side of the head with that amount of force doesn’t cause damage inside the head, but on the surface. Still, the combination of having a cut, big bumps, and feeling weak and dizzy with an unusual headache, suggests taking a closer look. It was enough force to leave a mark, and it certainly hurt and surprised her.

    But it was also bedtime. For some kids, a surprise bonk may be an occasion to get more time together rather than having to go to sleep.

    For some 7-year-olds, how they are acting (seeming confused or weak) may be more important than what they are saying (“I’ve lost my memory” or “I feel weak”).

    You know your daughter best! Having read the list of warning signs in the article above, your mother’s intuition is a good guide.

  • Ashley Martinez

    I dr my son is 2 we were over my aunts house yeasterday and he was playing with his cousin he fell and hit his head hard it sounded ugly he cried for about 15 minutes and I put some iceon his forehead cause he got a bump when we got home 2 hours later he fell asleeo but he woke up in the middle of the night and has a fever should I be worried do I have to call his dr ? Please let me know thank you

    • Alan Greene

      Fevers and normal falls at age 2 are most often unrelated. It’s best for someone to call the doctor if it is a fall they would call for or if it is a fever they would call for – but not just because a fever and a fall happened on the same day.

  • Mari Gonzalez

    My son fell from a spinning computer chair and hit the front of his head. There was a very loud sound but he has no ice. His cry was not a usual loud cry but more like a kittens meow. I applied ice and held him and within ten minutes he was asleep. He’s three and never naps and this happened in the morning about two hours after he woke from a full nights sleep. Everything I read says not to worry, but here I am….. worried.

    • Alan Greene

      Mari – as parents, of course we worry when our little ones hit their heads and act differently. Thankfully, their heads are built to withstand common falls, and some sleepiness afterwards is normal. And other signs (as in the article above) typically develop if there is more to do.

  • Tiffany

    My son is 7 and came in today complaining that his head hurt when laying down. I felt it and he has a flat spot on the back, top part of his head. I am pretty sure it hasn’t always been there. Me nor him can remember him hitting his head the past day or so. Any ideas on what it could be?

    • Alan Greene

      Tiffany, a recent blow hard enough to change the shape of the skull isn’t likely to go unnoticed or unremembered at age 7. Many kids do have a flat area at the back of the head that goes unnoticed because it is covered by hair. Asking a child’s pediatrician can help determine how long it has been there, since checking a child’s head shape is a part of early well-child exams.

  • Jessica Callis

    My 6 yr old was elbowed in the forehead during some rough housing this evening, she only cried for maybe 2 minutes but there is a small dent in her forehead. She went back to playing right away and doesn’t seem to have any symptoms other than tenderness where the indention is. Should I be concerned about the indention?

  • Mrs.Sanneh

    My 21 month old hit the side of his head right before his ear, on the edge of his bedroom dresser, he cried a bit. I put ice on it. But I’m so scared because of the small bump appeared. should he be seen by our doctor or go to a children’s emergency hospital?

  • Leanne

    My 2 year old son fell at grandma’s house last week and cut his head pretty deep. Behind the crown of his head. She took him to the hospital where they didn’t want to do stitches because they would have to shave his head. I just noticed Now there is a bump bigger than a marble that wasn’t there the other day, the wound seems bigger and has wet blood. I want to take him to the ER now but My husband says wait until the morning. Should I be as concerned as I am?

  • weem

    My son just fell down the entire flight of stairs (carpeted), and hit the back of his head against the corner of a wooden shoe rack. He cried for about 10 minutes and we took him to ER. He seemed ok except he gets really angry since the fall. He starts hitting me repeatedly when he gets angry, and he won’t tell me why he’s angry when he’s calmed down. Could the fall affect his behavior?

  • weem

    I forgot to mention that he also has a cut about 3-4 inches long on the back of his head as well as some swelling. The wound is not deep enough to create open wound though…and it’s been 2 days now since the accident

  • Deanna

    My 3 year old fell off the kitchen stool today while having lunch and hit her head very hard on the hardwood floor.
    Usually I wouldn’t be so upset , except for the fact that she hit her head yesterday as well.
    ( falling off the sofa onto the same hardwood floor ) Both of these falls caused lumps, but todays fall was just such a hard hit and she seemed to get very drowsy and right now she is sleeping on my lap, and she doesn’t usually take a nap. I am very concerned and wonder if she should have an X-ray in the ER ?

  • Deanna

    Is ok for your child to sleep after hitting their head

  • Tara

    My 3 yr old son threw a temper tantrum in a grocery store earlier today, he threw himself on the floor and swung his head back and hit it on their hard floor as well. He’s had a runny/snotty nose the past couple of days and now when his nose runs there’s also blood in the “snot” coming from his right nostril. He’s fallen and hit his head harder than that before and nothing like this has happened so I was/am worried. I planned to call his doctor in the morning, unsure if I should have just taken him to the Er.

  • Laney

    Dr Greene, my 18 month old fell out of a shopping cart while he was standing on the side where the groceries go. He landed on his back, therefore hit his head. He seems to be acting fine since he fall. Bt I’m still worried.

  • charlotte

    My 5 year old son. Slipped and fell while dancing in the living room and hit his head on the end table. He didn’t get up, I had to pick him out of the floor. He cried for 15 mins or more and he has never cried about anything like that before. I immedially put ice on it and gave him motrin for the headache. When I took the ice of his head, he had a pretty big knot with an indent in it, I’m not sure if its just tissue intend or not because he won’t let me touch it He has been complaining with his stomache hurting now. I’m aweful worried now.. Should I do anything else?

  • Brandy

    My 19 month old fell off the sofa earlier. He was unresponsive for a few seconds, had crazy eyes, shallow breathing, and kinda limp. I took him to ER where I was told to watch him and he should be fine. He seems normal, eating playing, and went to sleep with no fuss. I tried waking him by changing his diaper and he didn’t really wake only groaned a little and then back to sleep. Should I take him back to ER?

  • PaulG.

    my daughter bump her head, and after few hours she had a fever,, is it something to be worried? please reply as soon as possible,, please..

  • nadia fertil

    My daughter, 12, hit the back of her head while washing her hair in the tub under the faucet. I heard a loud thump from outside the bathroom. I noticed a lump applied ice and gave her 1 tylenol. The next day she complained of a headache and feeling sleepy. I am thinking of taking her to her pediatrician for a check.

  • Samantha Edward

    Hi anyone here to ask a question please?

  • Valentina

    Hi my 8 year old daughter fell at home this morning and hit her head on the left side.
    I didn’t see the fall.
    She was ok during the day but she seemed to have lost her short memory- she kept asking the same things many times and she never remembered the fall.
    She did not lose consciousness after the fall.
    This evening she complained her head was hurting on the right side when she turned to the left, and on both sides when she turned to the right.
    Her memory is still not perfect.
    She has now gone to bed.
    Should I worry?
    Thanks for helping!

  • Albakaur

    Hello Dr Greene,

    My 33 month old twins were getting pictures taken on my husband 18 wheel truck trunk ,all of a sudden they were falling, my husband held one and the other twin fell and hit the concrete, he cried and got a goose egg on his forehead between his eyes and of course scratches but was conscious and acting totally normal , I didn’t see his fall but my husband told me he heard the hit. I rushed him to ER , they examine his coordination, decline to X-Ray his head since he looked normal. I am extremely concern since my husband heard the hit, the outside doesn’t worry me. Today daycare call me since I asked them to observe him closely n got a call from teacher telling me while he was at the table he looks he was about to fall asleep but when asked if he was ready for nap he got back to the activity. Is he okay? Is he going to be okay? I am afraid something bad can happen to him. He eats , talks n acts normal to me. Thanks for your response

  • Irene Ong

    Hi Dr. Greene, my car hit the curb today when trying to manoveur a sharp corner.When this happened, my 8 months old was in the car strapped to his car seat. I am now very worried if the impact will cause any hurt to his brain as he seems to be in a shock and cried halfway through the journey. There’s no bump on his head but I just worried. Should I bring him to a doc?

  • Lori McCann

    My son is a bit older than the posts I’m seeing, 13, but I’ll ask anyway. While doing sprint drills during basketball, he ran into the concrete wall. He had slowed a bit, and his hands took some of the force, but he has a large knot on his forehead. when I arrived home, he was in bed, no ice. His dad put ice on it for “a few minutes” when they got home. He seems alert, no pupil dilation, but just wanted to be sure. He has ice on it now.

  • Ola Gustafsson

    Hi Dr Green My 5 year old just banged his head whilst standing up in his bunk bed he was lying crying on the floor for a good 5 min next thing he was sick all over his trousers and rug in his room, we therefore decided to take him in to see the local doctor and whilst driving there he was sick again in the car all over himself and the seat. Came in and he looked almost looked like someone who had too many pints down the local pub but he was still able to speak to the doctor in both English and swedish since he’s bilingual. They immediately referred him to the A&E unit at the childrens hospital where he stayed for observation for a few hours until the doctor was happy that he was eating again something light like a yoghurt and sipped on some juice. So I went to collect him and his mother and we stopped at a mc drive in where he got some nuggets and plain watter and then as we got back tonight he started hurling again just outside our doorstep. Since then he seems to be better and now fast asleep with his 32 weeks pregnant mother who’s so worried that she keeps waking him up every 30 minutes. Myself is on the couch as I have had a upset tummy for the last two days and with some fever. When phoning the health care in Sweden direct line now the seem to think that he’s got my virus passed on instead of what appeared to have been a slight concussion. What’s your professional view?

  • Sarah Elizabeth Johnson

    My nephew he is two years old going to be 3years old in march. Today he fell and hit the back of his head , he cried, and remain conscious. He is awake and moving about normally. He is playing with both of his pillow pets. I asked him easy question. He gives me the correct answers. I held up two fingers a good distance and asked him how many fingers I was holding up and he told me two and he was also holding two fingers up which he does normally. He told me what he was watching on TV for example : “Pirates” is his answer for “Jake and The Never Land Pirates,” I am trying to figured out is this is a good way to know if he has a head injury or not?

  • jayshree

    Dr Greene
    My Son is 5yr old and when at school ,a boy pushed him and he hit a side of a desk which was blunt .But he got hit just where the ear starts (near the temple)and the teacher said a vein near the ear till neck swelled for the while and subsided after ice was kept on it . and he has been complaining of head ache on&off since then .may be 10 times a week .. Please
    advice me what i could do to cure it ??

  • http://DrGreene.com/ Cheryl Greene

    There are so many great questions here and Dr. Greene can’t keep up with them all. So we’ve just added a new feature — Ask Dr. Greene! If you have a question, just go to http://www.drgreene.com/askdrgreene/ and submit your question.
    Dr. Greene would love to answer every question that is asked, but he can’t (so many great questions). He can answer one question a day and he’s decided to let our readers decide which question they would most like to see answered.

    Here’s how it works – Once a day Dr. Greene will answer the question with the most votes from readers. That means, you have a better chance of getting your question answered if you invite your friends to vote.

    Check it out — http://www.drgreene.com/askdrgreene/ — and let us know what you think.

  • kg

    Dr Greene, my 2year old rolled dowm the stairs at in laws home yesterday. Took her to a&e for a check up but was fine afterwards. Again fine today but been sick after her milk this evening. Sleeping mow but could it be related? Unsure of what to do for the best? Please advise me. Thank you x

  • desirae

    my very active 3 Yr old hit the top of the head on my filing cabinet yesterday he had a small cut and small indentation on the top of his head there was some bleeding he cried for a while but is acting pretty normal I asked him if he is okay if his head hurt and he says no he’s just sleepydo you think I should take him and for a possible CT scan

  • Michelle davies

    5 yr old bumped back of head yesterday on corner of marble fireplace, big lunch lump appeared within 2 minutes of incident, child wouldn’t let parent tough lump and couldn’t sleep on back of head properly, his morning lump has gone down but child saying they got a bit of head ache ( don’t know if saying it because I asked if thy had headache) should I be concerned?

  • Sara

    My ten month old was pulled up to standing on a chair and her older cousin pushed it, she fell back and hit her head really hard, she cried for a bit but not too long, but when I picked her up and held her she was bleeding in her mouth, she didn’t hit her mouth or bite her lip or tongue. We took her to the ER and they did a CT scan, she had bruising and swelling in her brain and now shes been sleeping most of the day for the past two days, she normally only takes an hour nap, should i be worried about her sleeping?

  • Colton

    My 17 month old son hit his head on a fan, now he has a bump but before the bump became soft (swallow) it was hard and felt like a bone, it also feels like his skoal is indented and there is a bump above his ear. So when you feel the bumps it feels like there is an indentation with two bumps above and bellow, I am not sure if I should be worried because he isn’t acting any different, he is not acting sleepy, he didn’t really cry, and he is not bleeding.

  • Daisy

    My son fell off the sofa hit the back of his head did not loose conscious cried for 1 min he has a small bump to the back of his head I am worried since he is so young of any kind of fractures to injury to his brain he is only 3 years old

  • Megan Kibler

    My 2 yr old fell off couch hitting his head. Abt 3-4 hrs later when in bed complained belly hurt then 30 mins later woke up vomiting repeatedly. Now he’s sleeping peacefully no issues no lumps. Should I worry

  • kelli

    My oldest daughter (3) pushed her sister who will be 2 in a week off the back of the couch, she landed on her back but has a blood spot under her eye and its under the skin. She seems to be fine and she’s acting normal and it don’t seem to bother her. Should I call the doc or take her to ER ? I’ve been keeping an eye on her she seems fine.

  • Lacie

    I’m 15, and I just fell off of my swing backwards and hit my head really hard.. my head hurts, I have a small headache, and I feel a little sleepy..

  • Liz Larsen

    My daughter hit her head on the bathtub sink when she was bending over. She is about 4 years old. It was black and blue but went away after I put ice on it. My worry is there is no swelling and she hit it hard. My worry is that there is no swelling. Do I need to go to er. Please help or am I just being over protective.

  • BjandStephanie Cobb

    My daughter is 22m and she climbed onto the back of our couch and fell off landing on our carpeted floor. She cried for a long time and is very tired. It is her nap time anyway. I tried to keep her up and gave her a popsicle and some food. After the popsicle she cried some more until I let her fall asleep. Should I take her to the dr or just wait until after her nap? She seems to be breathing ok?

  • Amber

    My 2year old son ran into the wall playing outside 5 days ago nd he cried for about 2 mins than continued playing it swoll and went down a lil but its a lil soft and a blackish blue looking color im concerned what should I do?

  • Olivia Reynolds

    My daughter hit her face on the door hinge right below her eye thank God and the EMS came and saidshe was OK. Yesterday she smacked her head the back trying to climb on the arm chair of couch. Can dark gooey diareaha be a symptom of something wrong? Also she almost fell asleep in tub and by the time I put cream powder and a new diaper she was out!! I couldn’t wake her for twenty minutesso my hubby came home and got her to open her eyes. I also did about 15 mins ago she woke up for me and rolled over. Do u think she’s OK? Oh yea she is also 19 months

  • Pardeep

    My 2 yr son fell off the table and hit the back of his head really hard about two hours ago and he cried for few minutes but then he vomited and fell asleep. After one hr I tried to wake him he woke up and I saw that he can move his arms and legs properly and there is no kind of discharge from ears or nose but he is still sleeping… is this sleep ok

  • Love

    My daughter is six and she tried jumping onto the basket while it was in motion fell and hit the back of her head really hard on the concrete floor at Walmart. She cried of course but then was ok. That was on Tuesday late afternoon. Now last night before bed she told me that she forgot to tell me that her neck is really hurting. What do I do? Should I take her to get checked tomorrow or could she just be sore from the fall?

  • Nia Machell

    My son(22 months) fell, like a butt first and then head on a tile floor and he cried for maybe two minutes and I found a small-ish bump in the middle of his head. And this was maybe half and hour ago and he seems fine, running and playing normally, and I applied and ice pack to it for 5 minutes and he stoll doesn’t seem to be effected. No he has no symptoms but I’m worried, yes I am a first time mother.

  • Frances Feal

    my 4 years old son fell off the bed he got up but he was bleeding through his nose the blood stop and hes conscious and walking fine he said his head hurt. I also keep him up for 2hrs… Should I still take him to the emergency room?

  • Fulori Bale

    My son who is 18 months old while playing fell & hit his forehead against a metal basket. He cried for a while & while comforting him I noticed a small bump. I’ve applied a damp cloth on his head to try & keep the swelling down. His asleep now & should I take him to the doctors when he gets up?

  • Justin Brearley

    My 6 year old daughter has just tripped half way down the stairs with such force she knocked open the baby gate and landed on the top of her head ,I expected mountains of blood and was and a serious injury ,
    She cried for 5 minutes we put a ice pack on the top of her head ,she seems fine now and has gone back playing ,no swelling or cuts ,could she have a cracked scull ?

  • Ashley

    My 12 month old likes to throw herself back when she gets mad…. But when she did, she hit her head on the orner of her bed.. She has a lump but beside the lump it is sunk in… It’s close to her bed time and she’s wanting to go to sleep but I don’t know if I should let her because of the head injury… Could u help me dr Greene

  • Shamara Wright

    Hello Dr Greene. My daughter is 7 years old and hit her head maybe 30 min to an hour ago. Im not with her now. She’s at my friend’s house for her son’s birthday weekend. She told me my daughter tripped and hit her head on the corner of the wall. She has a knot/bruise on her head. My friend said my daughter is ok. Ice was held on her head for a long time and the knot went down alot. She ate breakfast. My friend said my daughter is ok. They are on their way to Kings Diminion park. Is it ok if she go?? I read your article above. As long as she dont have any of those signs , she’s ok???

  • Nikki

    My 3yr old girls were goofing around and one fell face first on to a wood chair in my dinning room. Her eyebrow bruised almost instantly although not horrible it was noticeable. She does have some swelling where the bruise is. I gave her Tylenol and we applied ice for as long as we could. She ate her dinner both my girls were playing again normally after dinner my injured daughter can answer questions. My concern is should I allow her to fall asleep? It has been 3 hours since the fall swelling and bruising does not seem to have gotten any worse also should she be seen by a doctor? I usually am quick to panic and I don’t want to cause her any more trama by taking her in if its not necessary

  • Charrisse

    My 8 year old fell off her bike and hit her eye on the road. She did not go to sleep right away. Before she fell asleep her eye was swollen. When she woke up, her upper and lower lids were swollen and still are. There is a pus socket underneath her upper lid with little drainage. What should I do?

  • Emily Ebert

    My 2yr old just fell off the couch and hit her head on our hard wood floor. She cried for about 5-10 minutes and keeps saying ouch when she touches her head. I get worried cuz she was born with a bleed in her left temple. Right now she’s acting very quiet and a little tired but i think its from crying. Is there anything I should be doing besides keeping a close eye on her? When should i inform her pediatrician?