Concerns After Baby Falls from Bed: Signs of Injury and Next Steps

The baby fell off the bed, which is approximately 60-70 cm high?

Hello, doctor.
My one-year-old child fell off the bed this morning at 8 AM while I was preparing his milk.
I turned my back for a moment, and he fell.
The floor only has a 2 cm thick mat.
I didn’t see how he fell, but when I looked, his head was on the mat.
I’m not sure if his head hit first or if his hands and body did.
I’m very worried.
I immediately picked him up.
I would like to ask:
1.
He didn’t cry, just made a sound of surprise.
Does this mean he isn’t in pain, or is he just stunned? At 70 cm tall, is this fall considered serious? Most mothers say their children cry immediately after a fall, so what does it mean that he didn’t cry? Could he have a concussion?
2.
I checked for external injuries right away; there were no bruises or swelling, but some areas of his skin seemed a bit red to the touch.
If there is a brain hemorrhage, would it be visible without external injuries, or could it take a few days to show?
3.
He is drinking, eating, and playing as usual, but with slightly less intensity and is not as lively as usual.
4.
He woke up crying from hunger at 2 PM and had some milk.
I gave him some porridge for a snack around 4 or 5 PM, and about half an hour later, he vomited a small amount.
Is this related to the fall today or because he ate too much? He usually eats more, so I’m worried that the vomiting might be due to the head injury.
How should I monitor him moving forward? For how many days should I observe him? Does this situation require a visit for a head scan? I really don’t want to go for one.
Thank you for your response, and I wish you peace and happiness.

kelly, 30~39 year old female. Ask Date: 2017/03/08

Dr. Xiao Kaiwen reply Pediatrics

The indicators for seeking medical attention after a head injury in infants include: 1.
Is there a significant wound with bleeding that requires hospital treatment? 2.
Did the baby lose consciousness temporarily at the moment of impact? 3.
After the head injury, is there persistent vomiting, unsteady walking, or altered consciousness? Is there a noticeable decrease in activity level? (This should be observed for three days.) 4.
Did the baby fall from a height exceeding 100 centimeters (usually falls from below 100 centimeters are considered safe)? Therefore, I believe your child's condition is safe.

Reply Date: 2017/03/08

More Info

I'm sorry to hear about your child's fall. It's understandable to be concerned after such an incident, especially with a young child. Here’s a comprehensive response to your questions and concerns regarding your baby's situation after the fall.

1. Initial Reaction and Crying: When a child falls, their immediate reaction can vary significantly. Some children cry immediately, while others may not show much reaction at all. The fact that your child only made a sound and did not cry could mean a few things: they might not have experienced significant pain, or they could be in shock. It’s important to note that a lack of crying does not necessarily indicate a lack of injury. Children can sometimes be stunned or momentarily dazed after a fall.
2. Signs of Injury: You mentioned that there were no visible bruises or swelling, but there was some redness on the skin. This is a good sign, as it suggests that there may not be significant external trauma. However, internal injuries, such as a concussion or brain bleed, can occur even without visible external signs. Symptoms of a concussion can sometimes take hours or even days to manifest. Common signs to watch for include persistent vomiting, unusual drowsiness, irritability, or changes in behavior. If your child exhibits any of these symptoms, it is crucial to seek medical attention immediately.

3. Behavioral Changes: You noted that your child is less active than usual. This could be a normal response to the fall, as children may feel a bit off or tired after such an incident. However, if the lethargy persists or worsens, it could be a sign of a more serious issue. It’s important to monitor their behavior closely over the next few days.
4. Vomiting: The vomiting you described could be related to the fall, especially if it occurs shortly after eating. However, it could also be due to overfeeding or a mild stomach upset. If your child continues to vomit, especially if it’s accompanied by other concerning symptoms (like those mentioned earlier), you should consult a healthcare professional.
5. Observation Period: It’s generally recommended to observe your child for at least 24 to 48 hours after a head injury. During this time, keep an eye out for any changes in behavior, appetite, or physical symptoms. If your child seems to be improving and does not exhibit any concerning symptoms, you may not need to seek immediate medical attention. However, if you have any doubts or if symptoms arise, it’s always better to err on the side of caution and consult a pediatrician.

6. When to Seek Medical Attention: If your child experiences any of the following, you should seek medical care:
- Persistent vomiting
- Severe headache
- Confusion or difficulty waking up
- Unusual irritability or lethargy
- Seizures
- Any signs of a serious injury (e.g., bleeding, difficulty walking)
In conclusion, while many children recover well from minor falls, it’s essential to monitor your child closely for any signs of complications. If you have any lingering concerns or if your child’s condition changes, do not hesitate to reach out to a healthcare professional for guidance. Your child's safety and well-being are the top priority, and it’s always better to be cautious when it comes to potential head injuries.

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