As careful as you are when it comes to your baby’s safety and well-being, accidents like head injuries are bound to happen.
An occasional small bump or bruise is inevitable, but if your baby suffers a fall or receives a blow to the head, there are some important warning signs you should watch out for and know when to bring him to the emergency room to get thoroughly checked out.
Head Injuries in Young Children
According to Dr Chong Shu-Ling, Staff Physician, Department of Emergency Medicine, KK Women’s and Children’s Hospital (KKH), the Department of Emergency Medicine at KK Women’s and Children’s Hospital sees an estimated 28,700 children presenting with injuries of all severe, in a year.
“This makes up about 15 – 17 per cent of all children seeking medical attention in the Emergency Department”, she says.
For example, among children aged 2 years and younger brought to the KKH’s Children’s Emergency with head injuries, almost 90 per cent of these occur in the home, and up to half of these happen in the bedroom.
In most cases of childhood injury, the injury is minor, and the child recovers fully after receiving first aid or medical treatment.
In a few cases, the injury is severe and can cause permanent damage or even death — such as the unfortunate incident where an eight-month-old baby boy in Pasir Ris died after falling from his pram.
Nursing Management of a Child With Head Injury
If your bub has an injury to his head, you should try to remain calm, console him, and then tend to his injury before determining whether or not to bring him to see a doctor.
Observe the following symptoms and manage them accordingly:
Apply direct pressure on the wound for several minutes using a clean cloth or bandage.
Don’t be too alarmed at the blood because there are more blood vessels around the face and head, so it may just look worse than it is.
Due to broken blood vessels under the skin, a large swelling can form a bump — also known as a “goose egg” — which can quickly go down if treated with an ice pack and some pressure.
If you don’t have an ice pack, you can also use a bag of frozen veggies from your freezer, which will help ease any discomfort and reduce inflammation.
It’s handy to have a first aid kit at home in case of emergencies like head injuries
After gently rinsing the area with mild baby soap and warm water, apply some antibacterial ointment and cover it with a bandage to prevent infections.
Your baby might vomit after getting a head injury just because he is feeling upset about the whole ordeal and hurting — which is perfectly normal unless there is persistent vomiting over the next 6 to 24 hours.
To soothe him, you can continue breastfeeding, or if he’s over 6 months old, you can offer him clear liquids.
In the case of a concussion
If your baby received a serious blow to his head or was knocked unconscious, even if it was just for one minute, he could have a bruise to the brain, otherwise known as a concussion.
In this scenario, it is recommended that you try to keep your baby awake for the first hour or so and if he’s crying and not acting like his usual self, this could mean he is feeling dizzy or confused.
If he falls asleep, check his skin colour and breathing pattern — if it appears to be normal, there’s no need to wake him.
But if he looks pale or his breathing seems irregular, rouse him gently from his sleep — if he fusses and tries to go back to sleep, everything is fine, but if you can’t wake him up, bring him straight to the emergency room.
What are the important signs and symptoms to watch out for if your baby has had a head injury?
Baby Falls From Bed
When your baby falls from the bed, it’s not necessarily a sign that they’re at risk of falling out of the bed. They could have just rolled over on their stomach and fallen off.
If you’re worried about your baby falling out of bed, there are a few things you can do to make sure everything stays safe:
- Get a mattress that fits snugly against the sides of the crib. This will keep your baby from rolling over onto their stomach and falling out of bed.
- Make sure there aren’t any loose blankets or toys in the crib. These can get caught under your baby’s arms and cause them to roll over onto their stomachs.
- Put locks on all sides of the crib so your baby won’t be able to climb out (or jump out) when you’re not looking.
What to Check When Baby Falls off Bed
You should do a few things when your baby falls off the bed. First, check to make sure he hasn’t hurt himself. If he’s crying and seems okay, you don’t need to rush him to the emergency room. However, if he’s not moving or crying, pick him up and shake him gently. If he doesn’t respond, then call your local help hotline number immediately.
Second, check his breathing. If he isn’t breathing or taking shallow breaths, bring him to the emergency room immediately.
Third, check for signs of a head injury:
- bleeding from the ears or nose
- changes in behaviour
- weakness in arms or legs
- loss of consciousness
- uneven pupils (if your baby is old enough).
If you see any of these symptoms, head to the emergency room without delay.
Baby Vomiting Due to Head Injury
If your baby is vomiting, it could be due to a head injury. If you’ve noticed your baby vomiting several times in a row and have been unable to determine the cause, it might be time to take them to the doctor for an evaluation.
A baby who has suffered a head injury may vomit. The vomiting is caused by the baby’s body’s attempt to quickly remove toxins that have entered the bloodstream. Alcohol, drugs, and medication are all capable of causing vomiting when present in the bloodstream. The amount of vomiting depends on the type and substance the child ingests.
If your baby has a head injury and is vomiting, they may also be exhibiting other symptoms, such as:
- Lack of consciousness
- Irritability or lethargy
- Loss of balance or coordination
- Changes in breathing pattern (shallow breathing, rapid breathing)
Child Head Injury: When to Worry
Since your baby is still unable to talk or tell you if he is feeling any pain or other symptoms, it is vital that you keep a close eye on your little one after he suffers from any head injuries.
According to the KK Women’s and Children’s Hospital (KKH) and some medical professionals, if your little one shows any of the following signs and symptoms, you should immediately bring him to the emergency department:
- Any unusual behaviour that is not considered normal for your baby
- Your baby suddenly has seizures, convulsions or fits
- He is unusually drowsy or seems to be sleepy all the time
- You are unable to wake your baby up from his sleep
- There is persistent vomiting
- There is bleeding or watery discharge from his ears or nose
- You’ll see a gaping cut on your baby’s face, which might require stitches
- The bleeding doesn’t stop after five to ten minutes of applying pressure to the wound
- Your baby is inconsolable and doesn’t stop crying
- He landed head-first onto a hard surface (such as the floor)
- You notice he has crossed eyes or rolling eyes
- One pupil (of the eye) appears larger than the other
- His skin tone changes in colour, for example, he becomes paler or even turns blue
- There are twitches on one side of his body involving a whole limb
- He appears to be off balance while sitting, crawling or walking
Never leave your baby unattended, especially if he or she is on a high piece of furniture
How to Prevent Head Injuries
Although accidents can happen, parents and caregivers must take all necessary precautions to avoid any unfortunate incidents from occurring.
So what can you do to prevent your precious little one from getting any head injuries?
1. Do not leave your baby unattended, even if it’s only for a few seconds, especially on a high surface (such as your bed, the diaper changing station, or a baby high chair), or inside a baby crib that doesn’t have proper barriers.
2. Avoid using the sarong cradle or yao lan, as KKH reports that head injuries, skull fractures and even deaths have occurred when infants fall out or when the springs or attachments of the cradle break.
3. Refrain from letting your infant use a baby walker because, according to KKH, they can topple over — many such falls that caused head injuries and even deaths have also been documented locally and overseas.
4. Do not shake your baby violently when frustrated or angry because this can cause severe and fatal internal head bleeding.
5. Make sure your baby’s high chair is sturdy, and always use the appropriate restraints to keep your bub safely secured when sitting.
6. Use an age-appropriate car seat for your baby and always buckle him in.
7. Baby proof all the potential danger zones in your house by installing safety gates at the top and bottom of any staircase and safety grills on all windows.
8. Always strap your baby into the stroller or onto the changing table, as you never know when he might be able to roll over.
9. Keep furniture away from windows so your child can’t climb up to open windows (even if they have window guards).
10. Place a soft play mat under your baby’s play gym or play area, so there is something to cushion his fall in case he tips over.
Should your baby have a head injury and you’re unsure what to do next, it is best to bring him to get checked by a healthcare professional just to be certain that everything is fine.
Has your baby bumped his head or had a fall before? What are your home remedies to cure a “goose egg”? Tell us in the comments section.
Updates from Pheona Ilagan
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