Toddler falls: When should you worry?
November 10, 1999
Web posted at: 11:37 AM EST (1637 GMT)
By Daphne Miller, M.D.
As the very word "toddler" suggests, toddling over and falling down is a fact of life for new walkers. Sometimes these falls happen headfirst, which can be scary for both child and parent. Fortunately, most head bangs are minor and require nothing more than a kiss and maybe a cold compress to reduce the size of a lump.
There are times, however, when a head injury may be more serious, causing bleeding, swelling in the brain or a skull fracture. It's important for parents to be able to differentiate minor head injuries from more serious ones so they'll know when to consult a doctor.
To be on the safe side, if a toddler has experienced a real bang to the head, parents should observe her closely for 24 hours and briefly wake the child every two to three hours throughout the night. Parents should contact their health provider immediately if their child exhibits any of the following symptoms:
Loss of consciousness, or appearing not to respond to speech or touch. This is hard to evaluate when a child is asleep. However, a little shake and a loud voice should arouse even a deep sleeper.
Bleeding or emitting clear fluid from the ears or nose.
Nonstop bleeding from the scalp. Even small head cuts can be quite bloody, because blood vessels in the scalp are close to the surface. However, steady pressure with a piece of gauze should stop small cuts from bleeding within 5 to 10 minutes.
Confusion. Check to see whether the child appears disoriented or is unable to recognize you.
Severe headache. This is difficult to evaluate unless the child is capable of communicating verbally.
Convulsions or seizures.
Muscle weakness, difficulty walking, or one-sided weakness in an arm or leg. If the child appears to have injured her spine or neck, try if at all possible not to move her until medical help arrives.
Pupils of different sizes.
Preventing head injuries
According to the Brain Injury Association, over a million brain injuries to children occur each year. While many head bangs in toddlers are unavoidable, the following measures can help prevent serious injuries:
Babyproof your home. The Consumer Product Safety Commission (CPSC) offers an online brochure on childproofing the home at http://www.cpsc.gov/cpscpub/pubs/grand/12steps/12steps.html.
Put safety gates above and below stairs.
Make all high places (including tables, stools and counters) inaccessible.
Use corner and edge bumpers, and lock windows.
Never leave your toddler unsupervised. Make sure there is always an able-bodied adult present.
If your child isn't yet crawling, have him or her play on a padded or carpeted floor instead of in a baby walker. According to the CPSC, baby walkers on wheels are associated with 23,000 emergency room visits every year for children 15 months and younger -- with nearly a thousand of those injuries requiring hospitalization. (While more recent baby walkers are safer because of their wider trays, they also keep babies from being able to grasp objects or see their feet while they walk. A study published in the October 1999 Journal of Developmental and Behavioral Pediatrics also suggests that walkers are associated with a slight delay in mental and physical development.)
Make sure your toddler is in a car seat and properly buckled up every time you go for a car ride. Visit the National Safe Kids Campaign web site for information on buying and installing the right car seat: http://www.safekids.org/buckleup/childseat.cfm.
Daphne Miller, M.D., is a family doctor in a community-based clinical practice in San Francisco. She is affiliated with the Department of Family and Community Medicine at the University of California, San Francisco, and graduated from Harvard Medical School. She lives in San Francisco with her husband and two children.
Copyright 1999 webmed, Inc. All rights reserved.
RELATEDS AT :
Raising healthy children With Nancy Anderson
U.S. Consumer Product Safety Commission
National Safe Kids Campaign
Note: Pages will open in a new browser window
External sites are not endorsed by CNN Interactive.
LATEST HEALTH STORIES:
China SARS numbers pass 5,000
Report: Form of HIV in humans by 1940
Fewer infections for back-sleeping babies
Pneumonia vaccine may help heart, too