Head injury in children

Safety • Mar 29, 2010

Head Injuries in Children | When Should Parents Worry?


All parents have hard and fast rules for their kids. In our house, we have some pretty clear rules about helmets. As a pediatric orthopedist, I’ve seen enough head injuries to know I’d rather prevent them.

But as much as we’d love to wrap our kids in bubble wrap and protect them from every tumble, we know we can’t (and bubble wrap has its own set of hazards). Babies fall. Soccer players take some pretty tough headers. Cross country runners can trip. Here are my thoughts on when to watch a head injury and when to seek help immediately

What to Watch for After Head Injuries

If your child takes a hit to the head, cries for a minute, but then goes right back to playing, you can probably breathe easy. Even if that knock results in a goose egg, you’re usually okay. Those goose eggs are really just big bruises. In those instances, you want to pay attention to how the injury feels to the touch. Goose eggs can be hard or soft, depending on the surface the child hit, and can resolve within a matter of minutes. If it starts to feel squishy, you move into the next category: seek help.

When Should You Seek Immediate Medical Attention?

Kids will show you signs if there’s something wrong. They won’t act like themselves, they’ll be sleepy. They might vomit or refuse to eat or drink. If your child experiences any of those symptoms, loses consciousness or complains of a persistent or worsening headache, go to the emergency department.

When Should You Call Your Pediatrician?

Your child isn’t displaying the symptoms that would suggest a trip to the ER is necessary, but you feel like something is off. In that case, call your pediatrician. They will help you determine the best course of action, whether it’s a matter of keeping an eye on your child for a few hours or getting the injury checked out.


Seek Immediate Medical Attention if:


Worry less if:

Your child losses consciousness or appears confused or drowsy. He does not lose consciousness or has a less than 5 second appearance of being stunned
Eye changes including: changes in pupil size, blurry or double vision, or eyes not moving correctly (one or both eyes do not move appropriately when the child look up down, or to the side Pupils appear normal, eyes move normally and your child doesn’t complain of visual difficulty (double vision, blurred vision, inability to see fully out of one or both eyes)
Weakness on inability to move one or both arms or legs, walks with difficulty or clumsiness Wants to play shortly after injury, no weakness or changes in gait or coordination
Severe headache Mild headache or only complains of headache when you ask
Vomiting more than twice or late onset vomiting Vomiting once or vomiting than begins 3 or more days after the head injury
Clear fluid or blood draining from the nose or ears, constant slow drip of fluid from the nose Runny nose associated with crying, resolves once crying subsides
Bleeding from the scalp that won’t stop Bleeding that stops after 5 to 10 minutes of pressure and a cut less than one centimeter.
Crying that lasts more than an hour, irritability or restlessness Child is able to be consoled, calmed and easily distracted. It is okay if your child wants to be held and or is less active much like when he or she has a minor cold
Something about child just doesn’t seem right Your child is interested in playing, talking and acting just as he or she did before the fall

Sleeping with a Pediatric Head Injury

If your child was behaving normally after the injury, let him sleep normally. Don’t wake him up. Waking a sleeping child will make him more irritable and more tired. I tell parents if you feel like you have to check in on your child, you should take him to the hospital.

Preventing Head Injuries in Children

Back to our household rule on helmets. We require our children to wear helmets when they’re on anything with wheels, whether they’re riding the tricycle or in the carrier mom or dad is pulling behind an adult bike.

Make an appointment at Safety Stop to ensure your child’s helmet fits properly. At Safety Stop, they also sell helmets, offer home safety consultations and low-cost materials to help baby-proof your house, which will help soften those corners right at your child’s eye (and head bumping) level.

Disclaimer: This post was updated on 5/9/2018 to reflect current recommendations.


  1. 9-10 months ago I wrecked my bike without a helmet. At the time my parents were concerned because there was a huge knot on my head, and I could barely walk/talk any of that for about 20 minutes. At the hospital they told me I had a concussion and to stay off my bike, and not do any sports for 2 weeks, then to make sure to be careful for 6 weeks. Anyway, I went through all the scans they did, and they told me the knot was a pump knot, and it should go away soon. 2 weeks later it was still there and I went back for a check-up and they told me it was fine, and to just give it time. Well here I am 10 months later and I still have a noticeable sized pump knot on my head. When will it go away?

  2. Great question, thanks for posting it!
    Dr. Ross says she hasn’t heard the term “pump knot” but very frequently the bump or knot left on your scalp after you hit your head does take a long time to fully resolve (go away). Without actually seeing your head, she can’t address your specific concerns and would suggest talking to your doctor in person or by phone.
    Dr. Ross does tell me most of the time, the raised area is due to bleeding that occurs under the skin. That blood forms a clot made up of blood products and scar tissue. The body normally slowly absorbs that clot and the bump goes away. This can take many months. Sometimes the scar tissue never fully goes away and a bump remains. This is not dangerous but sometimes the appearance of the bump is bothersome. A plastic surgeon can improve the look but this procedure is normally just to make the area look better and thus is not covered by insurance.

  3. my baby is 2.5yrs old around a month before he had a fall and there was a bump.He did cry ,and didn’t allow me to put an ice pack he later went to sleep. I find his activities to be normal but still there is bump on his head and sometimes he says purple colour to be black and yellow to be blue.
    Please let me know what must I do

  4. you know, these things are terrible! Two out of my three sweet boys has had one after age two and before age four. And they swell up so darn fast and are such a yucky color your heart skips and you are in panic mode…. It looks so much worse than it actually is, and I know this, but I can’t accept it. And little ones always seem to get them by running right into the corner of a bloody wall. It is something I will never be able to get used to.

  5. I hit my head yesterday on a cabinet. I did not pass out and was stunned for about a moment. There was no server dizziness or nausea that occurred. The bump was small and it is going down. The bump is right on the edge of my hair line and has a small red line that is on the top. I have slept one night and woke up with no issues. The only thing is that my bump is very sensitive to the touch. I have no major head aches or even mild ones. Just the pain of touching the bump and the discomfort afterwards. I know it sounds like I am answering my own question of “is there something wrong” but, you read so much online about the rare cases that I do get a bit nervous. Do you think there is anything to really worry about?

  6. our granddaughter has suffered abuse while in her mothers custody. doctors seem to avoid answering the question, and it seems one of liability.

    the mother receives the child and gives bath in morning and not a mark on the baby, no claim of anything wrong.

    the mother and step grandmother have stated that during the second bath of the day at supper time, they noticed multiple goose eggs on the top of the head and along the front hairline. they claim they are skin colored.

    when we pick the baby(18 months) up roughly 36 hours after the suppertime bath. all the goose eggs have turned to bruises, and their are 2 black eyes. Medical professions claim they cannot give any time frame on the bruises, not even by coloring.

    when we picked her up, we immediately took her to the hospital which was roughly 45 mins. the mother is claiming that the black eye was received sometime after we picked her up and there were 2 of us picking up the baby to protect ourselves……

    any time frames i can use…….this one of four events……please give me info or send me to the right spot

  7. i banged my head with i tap it was a bit painful for 5 mins then the pain disappeared . within 24 hours had mild headache for 2 hours then it was gone do you think i should see a doctor. or its just anxiety ?

  8. Excellent website you have here but I was curious if you knew of any
    forums that cover the same topics discussed in this article?
    I’d really like to be a part of group where I can get feed-back
    from other experienced people that share the same interest.

    If you have any suggestions, please let me know.
    Appreciate it!

  9. My son is 22 months old and he bumped his head almost a week ago playing with his sister. He did cry for about 2-5 minutes but he was so anxious to go back to playing but now he has a knot that hasnt gone down yet i mean it has some but its still a knot and its hard i been putting ice on it but of course he doesnt wont me to touch it but he doesnt complain about pain when i touch it

  10. My now 18m child fell off the couch, about 8 months ago and bumped his head on hardwood flooring. He had a nice goose eggon his forehead for a few weeks. But then about 3 months ago he bumped his head on the corner of the wall in the same spot. The lump is still visible, especially when he raises his eyebrows. He seems like a normal kid. He is developing quite well. But will the lump ever go away or is he “permanently scarred? “

  11. Hi. My daughter who is 2 feel and got a pretty good size goose egg on the right side if her forehead. I was freaking out she cried less then 3 minutes her goose egg did not show up until I took her into the other room where i freaked out and her dad had to take her from me. No bleeding, she let me hold ice on and off for an hour. She was up watching cops with her dad as she calls it , “bad boys”. She was responding just fine also laughing abd being silly. I would say maybe a week after she was running at school wasn’t looking and ran into the pool. Mind you when she got her goose egg there was no bruise, after her incident with the pool it was a little green skin colored bruise. She is sleeping now and I notice i can fill a slight bump where her goose egg was a few weeks ago when the rest of her forehead is smooth. As a first time mother I don’t know if I should take her to urgent care? I am worried. I have pictures of her goose egg before and after icing for an hour.

  12. About 7hrs ago i was on the swing with my brother we were spinning around and then we hit eachother on the side of of our heads. We hit pretty hard. I have little pain right now, i just wanted to know if i should worry about it.

  13. I hurt my head very badly and it’s time to go to bed a had a couple of concussions in just a year and I heard that it would be more easy to get another one much worse and I domt know if I should go to bed or not.?

  14. My 2 yr fail of one of the toys at a play ground and hit a metal pole a few days ago and at first it was a big knot and with in an hour the knot went down should I be concerned because it went down so quickly …

  15. My brother hit his head and has a huge bump on his head and wants to go to the hospital. It looks bad but not like super bad. I am scared and so is he.

  16. My 4yr old fell off his bike hit his head no bump but like red little dots in a circle, not sure if he was out or not ,said was OK cried, now 6hours later in bed was sick once should I take him to hospital

  17. My son hit is head a few minutes ago. He cried and what not and screamed. He is 7mo ths old. There is a goose egg on the side of his head right were there is an indentation where his skull bones aren’t fused together. He ate a bottle and dosed for five minutes. I got nervous and woke him . He is now playing in his walker but I am a first time mom and I worry about it being so close the sent.

  18. He is fine. The dent in his skull was where the bones haven’t fused. Did she cry when it happened?

  19. My 2yr old son was playing with the dog this morning outside my dad left the bed box spring on the wall and the baby was walking by and fell on him and hit him in the head he has a big soft lump in the injury and looks like it’s spreading.

  20. Hi! My son bumped his forehead in the a table’s edge about 6 months ago.what worries me is that the bruise is still visible (slightly purple).should i be worried?thanks!

  21. Some people may find it informative or helpful so if it wasn’t for u ok and move on don’t put it down and insult it. At least it’s was trying to help parents and be informative to ease some’ worries and or possibly prevent an unnecessary visits wasting your time and worry !

  22. My 3 month old son while balancing himself in a positioning setting up strengthening set wabbled back and hit the back of his head on it, and immediately let out a loud cry I pulled him out And soothed him to ok . But since then been worried. He’s only three months old and hit the back of his head on it ? Haven’t noticed anything out of ordinary ,other than he’s slept on and off a lot since this. He didn’t sleep much during day before other than small naps either so not sure if it’s anything to be alarmed over or if I should take him to be checked or not ?

  23. Hi Tony,
    My son, 1 yr fell down too. Incidentally slipped by his own pee. His head now soft too. Same with your son experience. How long will the soft head turn to normal again? Did your son go for CT Scan? I am terrible worry now. He seems normal just like before.

  24. I believed you should get him check out since there a change in behavior it’s best to be safe since he so small.

  25. My 2yr old fell and hit his head too, but he is taking playing and all but he got a goose egg on the back of his head , he fellow again on that same spot and now I’m worried even though I wasn’t before,it is big and soft, I’m using ice but he is screening whenever I use it..is there any other solutions for it??

  26. You’re an idiot, if you don’t want to read it then don’t, some of us do.

  27. My 4 year old did a back flip and hit his head on the side of the pool and a has a big goose egg. This was very helpful thank you

  28. Bloggers and the like often weave what they think is entertaining quips into their writing. As a former EMT, I’m with you. Just the facts, ma’am.

  29. Hahaha. Just Google ‘adult head injuries’ and you’ll have a zillion sources to read. Methinks you’re a bit of a troll, Booblah Bob.

  30. Wow really? When it comes to my child being sick and not knowing what to do ill read the entire encyclopedia! Front to back as many times as possible to understand whats happened… some people ill tell yah!!! Yes should i stay or should i go… very helpful because im wondering do i take my child to the hospital or is she ok am i over reacting or not….

  31. My child just turned 4 she fell at soccer fell head first into the goal post 3 weeks ago now. I took her to the hospital immediately she got 3 stitches. A week later got the stitches out. Right away the next day she was clumsy said she had a headache. I gave her tyelonal made her rest. When she got the stitches out the doctors office said oh shes fine without really checking her.. its just 3weeks now since it happened she was clumsy today she seems irritated she said tonight her head hurts. She hasent said anything about not feeling well until today shes been playing like normal. Tonight her ears are sensitive to noise. I dont know if i should take her baxk to the hospital and have her examined i really want to but im wondering could she be over tired will making her rest/sleep help.?So this post was helpful . When she wakes up in the morning ill decide if i take her to the hospital if she still has the headache. It was really scary this happened and im so so woŕried about a head injury. I thought she was good playing like normal not saying anything about it hurting becauae i put cream on the scar everyday. But ive read it may take a few weeks for the concussion to set in… im a single mom 27 years old. Played soccer my entire life i never seen this happen to anyone so im really sad it happened to my baby girl i wont ever let her play soccer again. And the worst part is it was a make up game we didnt even need to be there that day infact my little girl didnt wanna play i was like lets go home then she decide to play and boom it happened. Im really sad about it especially if she has a head injury shes so little she still cant communicate exactly how she feels. I really hope shes just been playing to hard to much ipad not enough sleep cuz i know the doctors gonna tell me to make her sleep. Its better to be safe then sorry so i might just take her back to the hosptial anyways this friday will be 3 weeks exactly since it happened.

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