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On Call: Bumps to the Head

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Q. If my child falls and hits her head, how will I know whether she needs to see the doctor?

A. At some point your child will fall and hit her head  -- all kids do, especially when they're learning to get steady on their feet as they walk. When my son Zachary was a toddler, we used to joke that he had a "wood magnet" in his head because every time he lost his balance it seemed like he flew right into the nearest piece of furniture.

Fortunately, the vast majority of head bumps don't require a trip to the doctor  -- just hugs, some ice if your child will tolerate it (wrapped in a towel), and close observation on your part.

If your child loses consciousness after a fall, however, even if it's only for a few seconds, you should take her to the doctor. She'll most likely be fine, but we like to examine these kids more carefully. Also, call the doctor immediately if:

  • There's a lot of bleeding. Because of all the blood vessels in the scalp, cuts on the head can bleed quite a bit and often need stitches.
  • The bump is large or has a soft feel to it. (If so, the doctor may want to see her.)
  • There's clear fluid coming from her ears or nose.
  • She has severe or persistent vomiting. (Nausea, and vomiting once, can be normal.)
  • She's excessively sleepy. Being groggy after a head bump is common and fine, but if it's hard to wake her or she doesn't perk up after a brief nap, that's not okay.
  • She has severe pain. Bumps to the head hurt, of course, but if your child has so much pain that she's inconsolable, it's not normal.
  • She feels dizzy or weak, or has trouble walking, talking, or seeing. Also be alert for changes in behavior, like unusual irritability.

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