Head bruises and bumps come with the toddler territory. Thanks to tots' developing motor skills and ever-increasing curiosity, they can be especially prone to trips, stumbles, falls and a whole host of other little accidents that could lead to a bump on the head.

Usually, a bump to the noggin’ isn’t a big deal, and a kiss from a parent, along with some soothing words and a Band-Aid, are the only "treatment" necessary.

But occasionally, a toddler’s head injury may be more serious and could lead to a concussion or, in rare cases, bleeding or swelling of the brain. Here’s what to do if your little one hits her head, plus what you need to know about getting toddler head injuries diagnosed and treated.

Types of head injuries in children

A head injury in children (and everyone else) is any impact or trauma to the outer surface of the head or face (like the forehead), the blood vessels, the scalp, the skull or even, rarely, the brain.[1]

Many head injuries in toddlers are mild, like a bruise or bump on the head, or an open wound in the form of a scrape or cut. More serious and less common toddler head injuries might include a concussion, a fractured skull bone, swelling or even internal bleeding.

There are several different types of head injuries, including:[2]

  • Contusion. A contusion, which is a bruise, happens when small blood vessels are damaged by the impact of the injury, but it doesn’t puncture the skin. These tiny vessels fracture and leak a bit of blood, which stays trapped under the skin. The result? A classic purple, red or blue bruise mark that can be swollen and painful to the touch until it heals. These bruises on the head aren't usually anything to worry about and often happen on the forehead or scalp.[3] A very serious head injury, however, can cause deeper bruising to the brain, or a brain contusion.
  • Scalp wound. This is a cut or break in the skin on the scalp. Depending on the injury, the wound may be superficial, deep or gaping.[4]
  • Concussion. A concussion is a type of traumatic brain injury (TBI) that occurs when a hit to the head (or an excessively forceful hit to the body) causes the brain to move rapidly back and forth. The sudden movement of the brain can in serious cases cause chemical changes and can damage some of the brain cells.[5]
  • Skull fracture. A skull fracture happens after a severe impact or blow that causes a bone in the skull to break. There are several types of skull fractures and a break can occur in different parts of the skull. A skull fracture may be accompanied by a concussion, bleeding or other injury to the brain.[6]
  • Bleeding. Bleeding can occur on or under the scalp, in the brain tissue, or in the layers that surround the brain.

What causes toddler head injuries?

Head injuries in toddlers may be caused by:

  • Minor falls and accidents that happen while your toddler is playing or running around — if she gets hit with a ball or runs into the edge of a table, for example.
  • Car accidents. These are another fairly common cause of head injuries in little ones this age, which is why driving safely and proper car seat use are all the more important.
  • Physical abuse. This, sadly, is another cause of some toddler head injuries. While it's less comnmon than the others, it should be taken very seriously because it can be a chronic problem that can lead to repeated trauma to the head.

What are the signs of a head injury in children?

Many times, you’ll either see what occurred to cause your toddler’s head injury or she’ll cry a lot and touch the sore spot to let you know something happened and it hurts.

Symptoms of a head injury can occur right away or may develop slowly over several hours or days. Depending on the type of injury, its severity and where it occurred on or inside the head, toddler head injury signs and symptoms can include:[7]

  • A bump, cut or bruise on the head
  • A visible dent where the blow occurred
  • Child won’t stop crying
  • Headache (which can be difficult to discern in a young toddler because she may just cry, whimper and possibly hold or rub her head)
  • Black-and-blue discoloration under the eyes or behind the ears
  • Aggressive or irrational behavior
  • Refusing to eat
  • Slurred speech
  • Memory loss
  • Dizziness
  • Confusion
  • Drowsiness
  • Nausea and vomiting
  • Problems with balance
  • Numbness or weakness on part of the body
  • Child is unresponsive
  • Seizures
  • Bleeding or fluid leakage from the ears or nose
  • Loss of consciousness

What should I do if my toddler hits her head?

It can be tricky to know what you should do after your child has hit her head. You may wonder if you should take your child to the hospital or take a watch-and-wait approach (and if so, what to watch for after a child hits her head).

Here are some tips about when to take your child to the ER and what to look for at home.

When to go to the emergency room for a toddler head injury

Prompt medical treatment is important when it comes to toddler head injuries, especially if they're more serious and may involve a concussion.[8]

If your child has hit her head on a hard surface because she fell from a high spot like her high chair or the changing table (the threshold is 3 feet or higher for children under 2 years old and 5 feet or higher for kids 2 and older), if she was hit in the head by a fast-moving object like a ball, or if you spot any of the following symptoms, call 911 or head to the emergency room with your toddler:[9]

  • She’s lost consciousness (even for a moment) or appears totally dazed.
  • She can’t stop crying.
  • She vomits, especially if it happens more than once after she hits her head.
  • She seems clumsier than usual afterward or isn’t speaking or walking normally.
  • You can’t wake her up easily after she’s dozed off.
  • Her pupils (the dark central part of the eye) are different sizes.
  • There is severe head or face bleeding, including bleeding from the nose or ears.
  • There’s an object sticking out of the wound.
  • She has memory loss or confusion.
  • She has a persistent or severe headache that gets worse, or she has significant neck pain.
  • She’s more aggressive or irritable than usual.
  • She has a visible dent on her head or discoloration/bruising under the eyes or behind the ears.
  • She has a seizure.
  • She has been forcefully shaken.

While you’re waiting for the ambulance

  • Don’t move your child if she’s unconscious. Wait for medical help in case there’s a neck or spine injury.
  • If your child isn’t breathing or doesn’t have a pulse, begin CPR.
  • If your child was wearing a helmet when the injury happened, don’t remove it.
  • Don’t remove an object that’s sticking out of the wound.
  • Don’t wash a head wound if it’s deep or bleeding a lot.
  • If your child has a seizure or is vomiting, try to keep her head and neck straight while turning her onto her side. This prevents her from choking and also protects her neck and spine.

What to watch for at home

For anything more than a light bump on the head, the American Academy of Pediatrics (AAP) recommends that you call your child's doctor for guidance.[10] The pediatrician may tell you to bring your child to the office, go to the ER or keep an eye on your child at home.

If the doctor says it’s fine for your child to stay home for the time being, he or she will go over what to expect, how to treat any symptoms, whether or not your child should avoid any activities, and signs and symptoms you should look out for.

As long as the doctor gives you the okay and your child is alert and behaving like her normal self after the fall or blow, here’s what you can do at home:[11]

  • Watch your toddler carefully for a few days because some head injuries can cause delayed symptoms. If you notice any of the symptoms that warrant a visit to the ER, your child’s condition seems to get worse, or you’re just worried, contact the pediatrician or go to the ER.
  • Use an ice pack or bag of frozen veggies wrapped in a washcloth to help bring down the swelling and soothe a toddler’s head injury.
  • If your child is in pain, give her acetaminophen (avoid ibuprofen, which can increase any bleeding). 
  • Unless your doctor tells you otherwise, let your child sleep. It’s common for toddlers to doze off after a head injury, so don’t be alarmed if your sweetie wants to snooze — she’s probably just exhausted. 

Check on your child a few times while she’s sleeping, especially if the injury happened around bedtime or naptime and your child falls asleep shortly after. As long as her skin color and breathing are normal, and you don’t sense any issues, it’s okay to let her get her beauty rest.

However, if you feel like something is off, try to wake your child up. She should do some fussing and try to get back to sleep. If your child seems unresponsive or you can’t wake her up, call 911 or take her to the emergency room right away.

How are head injuries in children diagnosed?

Your pediatrician will examine your child and ask you how her head injury happened, as well as inquire about any medical issues your toddler has or any meds she takes.

Based on the checkup, your little one may need to go to the ER to have a CT scan (a three-dimensional X-ray image taken by a computer) of her brain to look for signs of swelling, bleeding or fracture. The CT scan may only take about 10 minutes, but don’t be surprised if you have to wait a couple of hours for the results (there are plenty of ways to keep your toddler entertained in the ER waiting room if she's up to it).[12]

If the test comes back normal and the doctor sees that your toddler seems stable (she’s eating snacks and looking at the books you stashed in your bag), you’ll both be sent home.

Even with a normal CT scan, your doctor may tell you that your little one had a concussion (these microscopic brain injuries won’t show up on the scan), which means her brain was shaken around in her skull — one reason why she may seem confused or is having trouble paying attention. 

If the CT scan comes back with abnormalities (like torn blood vessels or a skull fracture), your child may need hospitalization and/or surgery. 

How is a toddler head injury treated?

The good news: Most kids eventually recover. If the injury is minor, no treatment may be necessary. Just a little extra TLC should make things better.

Treatment for other toddler head injuries depends on the location of the injury, the severity, your child’s symptoms and her age.

  • If your child has a very minor cut on the face or scalp, gently clean it with mild soap and warm water and put a bandage on it (ask the doctor if you should apply an antiseptic first).
  • A long or deep cut may require stitches. Most minor contusions will fade away and disappear within a couple of weeks.
  • If your toddler has had a concussion, she will have to take it easy for the first few days. Make sure she gets plenty of rest, and limit her physical activities and other activities that require a lot of thinking and concentration.

Also, avoid activities that could put your child at risk of injuring her head again. As time goes on and your child starts to feel better and have fewer symptoms, you can gradually increase her activity as she can tolerate it. If your toddler starts to have symptoms again after resuming more vigorous activity, stop and try again another day.

After a concussion, most kids feel better in a few weeks, though it can vary by type and severity of the injury and some may have symptoms for months. If your child’s symptoms linger, discuss it with the doctor.

Other treatment for toddler head injuries (again, depending on the location, severity and your child’s symptoms) may include medication, referral to a specialist, hospitalization or surgery.

Can there be complications with head injuries in children?

Although the majority of toddler head bumps aren’t a big deal, in some cases, a head injury can cause complications.

A severe blow to the head could cause what’s known as an intracranial hematoma, which is bleeding in or around the brain. This is a serious condition that puts pressure on the brain. If not treated immediately, it can cause damage to the brain and be life-threatening.[13]

Some severe traumatic brain injuries (TBI) can cause long-term complications. Nerve damage from the injury can lead to a loss of function in vision, smell, hearing and taste and/or changes or loss of function in speech, mobility and cognition. A child with a mild or moderate TBI may have problems with learning, memory and concentration. She may also experience difficulties in emotional, sensory, communication and social areas.[14]

After a TBI, a child may have short- or long-term changes in behavior or personality. Toddlers with severe brain injury usually require rehabilitation, which may include physical, occupational or speech therapy.

How can head injuries in toddlers be prevented?

All toddlers experience an occasional bump on the head. However, there are some things you can do to prevent toddler head injuries:

  • Childproof. Put safety gates at the tops and bottoms of stairs, secure heavy, climbable furniture and TVs to the wall, and install window guards.[15]
  • Supervision. Don’t leave your toddler alone on a high surface such as a changing table, bed, sofa or high chair. Use any restraining straps your baby gear comes with, but don't have a false sense of security. Little ones wriggle and roll a lot.
  • Buckle up. Always use the harness and safety straps when your toddler is in her stroller, in the high chair or on the changing table.
  • Avoid baby walkers. They’re not safe and cause thousands of injuries each year.[16] Your child may fall out of a walker, use it to pull down heavy objects, or fall down the stairs while using it.
  • Provide a safe sleeping space. Keep the side rails on your child’s crib or toddler bed up. Lower the mattress to the lowest setting and avoid using crib bumpers even though your child isn't a baby anymore because they can be used to climb out of the crib. And never put the crib or bed next to a window or within reach of a heavy piece of furniture.
  • Protect her head. Make sure your child always wears a helmet while riding a tricycle, scooter or bike (yes, even with the training wheels), or when in a child seat on the back of an adult's bike.
  • Car seats are a must. Always use a child’s car seat and make sure your toddler is properly strapped in while she’s traveling in a vehicle. The car seat should be rear-facing as long as possible, until your little one reaches the highest weight or height limit according to the manufacturer.
  • Safe playground play. Supervise your little one when you take a trip to the playground. Make sure the equipment is age-appropriate for your child and check to be sure it looks well-maintained. Also look to see that there are guardrails to help prevent falls. The surfaces under play equipment should be soft and made of shock-absorbing material like rubber mulch or wood chips. Teach your toddler to go down the slide feet first and avoid running behind or in front of the swings while other kids are on them.[17]
  • Lock up. Consider avoiding having any guns in the house. If you do have firearms at home, keep them well out of reach, locked and unloaded. Store all firearms in a locked cabinet and bullets in a separate locked cabinet, with the keys safely hidden from and inaccessible to little ones.
  • Never shake or deliberately hurt your child. Violent shaking, even if brief, can cause serious injury. Leave your child in a safe place and step away to collect yourself if you feel frustrated. Seek and accept help from loved ones. Choose patient, trustworthy caregivers to watch your child in your absence. Avoid leaving your toddler with people who drink heavily or may be under the influence of other drugs. And make sure all caregivers know about the dangers of shaking and of hitting a child's head.
Remember, most toddler head injuries tend to be minor and don’t cause lasting damage. After a little (or a lot) of wailing, your tot may forget all about it. If it’s a serious head injury, try to stay calm. Knowing what to do can help aid your toddler’s recovery.