Children of all ages are notorious for falling and hitting their heads. In the first couple years of life, children frequently try to walk, run, and climb faster than their coordination allows. As a result, falls and head injuries are a recurrent event. The best way to avoid a head injury is to prevent it. As your child becomes mobile it is important to safety proof their surroundings. Be wary of sharp edges along counters, table tops, and fireplaces. Fix wall units and bookcases to the wall so that they cannot be pulled over. Monitor items that can be used to climb on like chairs, stools and sofas. Inevitably, your child will fall and hit their head. It may be off a chair or sofa or just walking down the street, but it will happen.

The Rules of Engagement:
1. Stay calm. Your child’s reaction will feed off yours. If you look scared they are going to be scared. If you start screaming and crying they are likely going to start crying. If you say “Oh, Boom” and start laughing and playing, they will likely start smiling and playing. If your child is crying, approach them calmly and comfort them.

2. Listen to your child. Your child will let you know if they are really hurt. If they are smiling and playing after they fall or hit their head then they are probably OK. If they are consolable in your arms and then want to eat dinner they are probably OK.

3. Assess the injury. Bumps on the head can look big, mean and grow quickly. After a head injury, it is not uncommon for your child’s head (especially the forehead) to swell. This bump or contusion is due blood that collects between their skin and their skull. This blood does not affect the brain or cause brain damage. The swelling continues to increase in the first 24 hours. And just like a bruise may change colors over several weeks until it finally resolves.

Treatment of a head injury:
1. Ice. Ice will decrease swelling. However most children who fall and hit their heads are between 1 and 3 years old and will not let you put ice one them. Do not worry. Just remember the swelling may get worse before it gets better. Do not fight with your child. Ice or no ice it will get better.

2. Pain Control. Give your child Tylenol or Motrin for the pain.

3. Monitor your child. It is not uncommon that your child feels sleepy or wants to take a nap after they fall. They may just be tired from crying or the injury occurred right near their normal bedtime. If they are sleeping longer than their normal nap, go in and check on them. If the head injury occurs at bedtime, let them go to bed as usual. However, a few hours later, jostle them to see if they are arousable. If they roll over or push you away then they are OK, they do not need to get up and walk around.

Call your physician if:
1. There is loss of consciousness
2. Your child vomits more than 2 times
3. Your child is lethargic or unarousable
4. There is a laceration or uncontrollable bleeding