Managing Baby's Head Hematoma After a Fall: What Parents Should Know

Q: Managing Baby's Head Hematoma After a Fall: What Parents Should Know

Hello, Miss： You mentioned, "I would like to ask the doctor how long it takes for a hematoma to resolve and if there are any quick methods to reduce swelling? If it doesn't go away, do I need to return for a follow-up, and could there be any more serious conditions?" <br>To accel

Baby fell off the bed?

The baby is seven months old and fell from the bed onto a tiled floor, with the bed height being approximately 70 cm.
The baby was taken to the hospital within 20 minutes and underwent an X-ray, which initially indicated that there were no bone issues.
The doctor prescribed a topical ointment and provided educational materials for us to observe at home.
It has now been five days, and the baby’s eating, sleeping, and activity levels are all normal, with no symptoms listed in the educational materials.
However, there is a hematoma on the head, about the size of a half goose egg, located on the upper side.
We are wondering if the swelling is so pronounced due to improper icing during the first 48 hours, as the swelling was not noticeable initially and there were no bruises.
After 48 hours, we switched to warm compresses.

We would like to ask the doctor how long it typically takes for a hematoma to resolve and if there are any methods to expedite the reduction of swelling.
If the swelling does not subside, should we return for a follow-up appointment, and could there be any more serious conditions to be concerned about?

Nìmíng, 30~39 year old female. Ask Date: 2024/05/06

Dr. Jiang Junyi reply Neurology

Hello, Miss: You mentioned, "I would like to ask the doctor how long it takes for a hematoma to resolve and if there are any quick methods to reduce swelling? If it doesn't go away, do I need to return for a follow-up, and could there be any more serious conditions?"
To accelerate the absorption of a hematoma, clinically, Hirudoid is used.
When using Hirudoid, please apply it evenly 2-3 times a day based on the size of the affected area (gently apply, avoiding "pressing or rubbing"), and continue until the condition improves.
Generally, treatment for blunt trauma should last more than 10 days, while superficial thrombophlebitis should be treated for 1-2 weeks.
When using Hirudoid, avoid applying it on open wounds and injured skin to prevent affecting wound healing, and avoid contact with the eyes and mucous membranes.
Since the hematoma in children can be more severe, if you are concerned, you can follow up at a pediatric neurology clinic.
Because the fontanelle has not yet closed, some patients can be monitored for intracranial bleeding using ultrasound.
Thank you for your question.
If you have related issues, feel free to discuss further.
Wishing you good health and peace.

Dr.
Jiang Junyi, Taoyuan Medical Center / Hualien Medical Center, cares about you.

Reply Date: 2024/05/06

More Info

When a baby experiences a head injury, such as a fall from a height like a bed, it is crucial for parents to be vigilant and informed about the potential implications and management of head hematomas. In your case, your seven-month-old baby fell from a height of about 70 cm onto a hard surface, which can indeed lead to a head hematoma. Here’s a comprehensive overview of what you should know regarding the management of your baby’s head hematoma after the fall.

Understanding Head Hematomas
A head hematoma occurs when blood collects outside of blood vessels, often due to trauma. In infants, this can manifest as a soft, swollen area on the head, commonly referred to as a "goose egg." The swelling is typically due to blood pooling in the tissues, and while it can be alarming, many hematomas resolve on their own without significant complications.

Duration and Management of Hematomas
1. Duration of Resolution: Generally, head hematomas in infants can take anywhere from a few days to several weeks to resolve completely. The duration largely depends on the size of the hematoma and the individual healing process of the child. Smaller hematomas may resolve within a week, while larger ones can take longer.

2. Ice and Heat Application: Initially, applying ice to the area can help reduce swelling. However, it’s important to apply ice wrapped in a cloth to avoid direct contact with the skin, which can cause frostbite. After the first 48 hours, heat can be applied to promote blood flow and healing. If you suspect that the ice was not applied correctly, it’s understandable that the swelling may have been exacerbated.

3. Observation: Since your baby is showing normal eating, sleeping, and activity levels without any concerning symptoms (such as vomiting, lethargy, or unusual irritability), this is a positive sign. Continue to monitor for any changes in behavior or new symptoms, as these could indicate complications.

When to Seek Further Medical Attention
1. Persistent Swelling: If the hematoma does not begin to decrease in size after a week or if it appears to be increasing, it would be prudent to return to your pediatrician for further evaluation. While most hematomas resolve without intervention, persistent swelling could warrant further investigation to rule out complications such as a more significant underlying injury.

2. Signs of Complications: Be alert for any signs of complications, including:
- Increased irritability or inconsolable crying
- Changes in feeding patterns
- Vomiting or signs of lethargy
- Seizures or unusual movements
- Any new swelling or bruising in other areas

Conclusion
In summary, while the presence of a head hematoma can be concerning for parents, many cases resolve without significant issues. Continue to monitor your baby’s condition closely, and do not hesitate to seek medical advice if you notice any concerning changes or if the hematoma does not improve. Regular follow-ups with your pediatrician can provide peace of mind and ensure that your baby is healing appropriately. Always trust your instincts as a parent; if something feels off, it’s better to err on the side of caution and consult a healthcare professional.

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