The consequences of a baby falling off the couch. Doctor Komarovsky on what to do if a child hits his head

What to do if a child falls and bumps his head.

In babies under 5 years old, the structure of the skull is somewhat different than in adults. In addition, the head is large enough to be heavy. To make the baby fall, just push it a little. He will easily lose coordination and fall over. In this article, we will tell you what to do if the baby fell and hit its head.

There are many reasons why a child often bumps his head:

Undeveloped nervous system
Large size and weight of the head
Lack of coordination of movements
Negligence

It so happens that the baby bangs its head against the wall on purpose and deliberately. There are a number of reasons for this:

A way to know yourself
Rage and anger
A way to get attention
Manipulation
Health problems

Note that if the toddler bangs his head on the bed before going to bed, this is an alarming signal. With this method, the baby is trying to relax. This indicates possible violations of the central nervous system.

This happens quite often. Most often this happens to children under one year old. From about 3-5 months, the child already knows how to roll over. That is why he should not be left alone on the couch or bed. If the crumb fell and hit its head, observe its condition. If he stood up and did not shout, then everything is fine. You need to be attentive to the baby during the day.

Alarming symptoms:

Lethargy, the baby is constantly sleeping
Anxiety and hysteria
Vomiting and nausea

If such symptoms appear, an urgent need to go to the doctor.

It is necessary to provide the child with first aid:

Assess the injury site and see if there is a bruise
If so, apply ice or a cold bottle to this place for 5 minutes
Treat the bruised area with an antiseptic

What to look for:

If the baby gets sleepy, don't let him fall asleep. This will help identify behavioral disturbances, if any.
Child behavior. He shouldn't be constantly nervous and hysterical.
Lack of appetite and poor coordination of movements
Nausea and vomiting. Urgently see a doctor

All these symptoms indicate a concussion, go to the doctor.

First aid:

Pick up the child and assess the site of the injury
If there is a bump, apply ice or something cold
If there is a dissection, then treat the wound with peroxide or brilliant green
If there are no visible bruises, observe the condition of the child.

How to proceed:

Do not let the baby run and play active games. You can go for a walk outside, but you should run and be active less. The walk should be calm
Don't let your child sleep right after the injury. Distract him, play some quiet games
If you experience alarming symptoms, consult a doctor

Alarming symptoms:

Vomit
Nausea
Constant tantrums
Drowsiness

This is quite dangerous, as it can cause the development of a brain hematoma. In order to prevent the deterioration of the condition, it is necessary to observe the child and, in case of deviations in behavior, urgently go to the doctor.

First aid:

Apply ice or cold
Treat the injury site with an antiseptic
Try to ensure peace, but not go to bed

Alarming symptoms:

Vomiting, nausea
Dizziness
Convulsions
Loss of consciousness
Tantrums

Vomiting is the first symptom of a concussion and possible head injury. It makes no sense to sit at home and continue to observe the state of the crumbs. Call an ambulance and go to the hospital. X-ray of the head is required. If violations are detected, the child is hospitalized and help to normalize the condition.

This is an alarming symptom, as sleepiness indicates injury.

Types of Head Impact Injuries:

Concussion. This is the mildest degree of trauma, since there are no particular disorders in the work of the brain. But some cells don't work well. After a few days, the condition returns to normal. There are no consequences.
Brain contusion. In this case, the internal tissues are damaged and require treatment. To restore brain function, the child needs the help of doctors.
Compression of the brain. This is the most dangerous injury, as there is high pressure inside the skull, which leads to periodic loss of consciousness. Requires the intervention of doctors.

What to do if the child does not wake up for a long time:

You must try to wake him up
Quite often, a child loses consciousness in a dream and may stop breathing altogether.
If you notice that the child is not breathing, call an ambulance and perform resuscitation procedures

Dr. Komarovsky believes that children hit their heads quite often. By the age of one year, 80% of all falls and blows to the head disappear without a trace, and do not require the intervention of doctors. If the child fell, cried a little and calmed down, then there is no reason to worry. You need to ensure calm play and observe the condition.

Alarming symptoms, according to Komarovsky:

Vomiting more than once
Impaired coordination of movements
Convulsions
Speech impairment
Loss of consciousness
Sensory impairment of one of the limbs
After hitting the head, bruises appear under the eyes
Discharge of blood or colorless fluid from the ears or nose

The child often hits his head: Komarovsky

Headbutting is a common occurrence for children. Your task is to monitor the child's condition and, if necessary, contact the emergency room.

VIDEO: Headbutts, Komarovsky

As soon as the baby begins to learn to roll over, rise and crawl, he needs an eye and an eye - a little researcher in an instant can roll out of bed or sofa and get hurt. It is good if he gets off with only fright, but, unfortunately, more dangerous situations happen. For example, if the baby falls out of bed, the consequences for the child may not be very happy if he hits his forehead or the back of his head. The consequences of such a fall are different - from hematoma and abrasion to traumatic brain injury. What should parents do in this case? When to call an ambulance and when not?

If a baby fell off the couch - what to do?

If the baby accidentally rolled off the sofa and hit the floor with the back of his head, then his first reaction is quite natural - he starts crying loudly and uncontrollably. The reason for this is fear and pain. What should parents do?

1. Calm yourself down.

2. Take the baby in your arms and try to calm him down (the best way is to give the breast, wiggle the baby).

3. When the baby calms down, examine the impact site.

4. If blood oozes, use hydrogen peroxide.

If you see redness on the back of the head or an abrasion, you can help the baby with a cooling compress. Just apply a handkerchief or bandage soaked in water to the back of your head. Further actions of the mother will depend on the behavior of the baby.

What symptoms should alert parents?

If a baby falls and bumps his head, look for the following symptoms. Their manifestation indicates the seriousness of the injury and the need to urgently consult a doctor or call an ambulance.

1. Crying does not stop for a long time.
2. The child shows apathy, does not play.
3. A wandering look, the eyes roll.
4. Pupils are different sizes or both are dilated.
5. The kid is too pale.
6. Vomiting has begun.
7. There is discharge from the ears or nose.
8. The child is annoyed by loud noises and touches.
9. Dark spots, hematomas appeared under the eyes.
10. Convulsions.

If a baby has fallen with the back of his head at the age of one year, other signs will help to navigate the severity of the injury:

1. The child walks uncertainly, he is carried to the sides, he himself is not able to change the position of the body, and until that moment everything was not so.

2. Slurred speech, inability to express a thought (if the baby already knows how to talk).

If you notice these alarming symptoms or at least one of them, you need to urgently call an ambulance or take your baby to the hospital for examination. It is important to understand that timely admission to the hospital will help prevent the dangerous consequences of a stroke. And what they are, you will find out about it right now.

The consequences of hitting the head in a child after a fall

A blow to the back of the head usually does not have serious consequences if the child is hit by falling from a small height (sofa, bed) onto a soft covering - a pile carpet or a blanket laid on the floor. Usually, in such cases, a small swelling (bump), abrasion or redness appears at the site of the injury. The crying of a child is rather a reaction to fear and minor pain sensations. Such an injury, soft tissue contusion, cannot threaten the health and life of the child.

However, you should still pay attention to the further behavior of the crumbs. If you have the slightest doubt about its adequacy, immediately arrange a visit to the doctor. "Popularly about health" insists - children under 6 months should be shown to a pediatrician after a fall in any case, even if you do not notice any deviations in his behavior. This requirement is due to the fact that in infants the bones of the head are too soft and mobile. Any fall and blow can have unpleasant consequences.

If you fall off the couch, the consequences can be more serious. Traumatic brain injury may occur. Any damage to the brain can be judged by the symptoms listed above, but the doctor will more accurately determine the degree of damage.

Traumatic brain injury is of two types - open and closed. In the first case, there is damage to the integrity of the skin and bones of the skull. In the second, we are talking only about damage to the brain inside, while the integrity of the skin and bones is not violated.

What are the most dangerous consequences of a blow to the back of the head?

After hitting a child with the back of the head, he could get the following types of brain injuries:

1. Concussion.

3. Compression of the brain.

A concussion in a child is a serious enough injury, but at the same time, at least the structure of the brain substance is not disturbed. A more serious condition is observed with brain contusion. It is characterized by the occurrence of one or more foci of brain damage and is manifested by prolonged loss of consciousness, impaired respiration and heart rhythm. If you do not provide assistance to the baby in a timely manner, serious health problems in the future or even death are possible.

Compression of the brain is an emergency condition due to which a child can die in a short time. In this case, a certain area of the brain is compressed by the damaged bones of the skull. In this state, fluid may leak from the ears, nose, hematomas under the eyes, there are clearly visible signs of impaired pulse, breathing, complete absence of reactions to stimuli.

If your baby has fallen, the consequences can be unfavorable, so you cannot take it lightly. At the slightest sign of brain injury, call an ambulance immediately to rescue your baby.

A baby who has never fallen out of bed or from a sofa during the first year of life is a rarity. And this is not because his parents are irresponsible, not at all. The thing is that a child at this age is especially observant and easily seizes the right moment to fall down from the couch, even when mom and dad are nearby.

Not all parents know what to do in such a situation, but it is extremely important not to get confused, not to panic.

Is it worth worrying

Although in the vast majority of cases, falls from a sofa, bed, and other high places are not dangerous, they should not be ignored. But don't panic.

First of all, the baby needs to be examined. Do not do this immediately after the child has fallen. His crying and even a high-pitched scream can be a reaction to fear, and in this case it will be very difficult to know if there is an injury.

There is no need to panic if the baby falls from a small height, fortunately, Mother Nature has provided a number of protective mechanisms for the baby in this case. However, parents should be vigilant and observe the state of their child. Any head injury can be potentially dangerous to the baby.

Parents should exercise maximum vigilance within 24 hours after falling, periodically wake up the baby if his sleep is longer than usual, and keep an eye on him.

What to do

The first thing parents should do if their nursing baby falls off the couch or bed is to pull themselves together and calm down, after which they need to pick up the baby and calm him down. You should not twist the baby, shake him, put him on his legs, etc., now he needs maximum peace.

If the child's behavior does not differ from his usual one - most likely, everything is normal with him, there is no trauma, and he was simply frightened.

But! If the child does not calm down after falling from the couch, bed or other tall object, it is better to play it safe. What do we have to do? If any of the following symptoms occur, call an ambulance or take the baby to the hospital. A head injury can be a serious danger to your baby.

Alarming symptoms

All parents, without exception, are obliged to know the potentially dangerous symptoms that can be observed in a child who has fallen head down on the back of the head, or face down.

After the child has fallen, any disturbances of consciousness are observed.
After falling out of bed or sofa (changing table, chest of drawers), the adequacy of the behavior does not correspond to the situation.
Any changes in speech.
The child has become overly drowsy.
The injury caused a headache that lasts more than two hours.
Convulsive manifestations.
Vomiting is repeated more than two times.
After the child has hit, there is a violation of coordination of movements, orientation in space, dizziness after more than one hour.

Weakness in the limbs, the child cannot move the leg or the arm.
After the child hits his head, pupil asymmetry is observed.
Even the slightest disturbance in the functioning of the senses can be a symptom that the injury is dangerous.
If the child hits his head and there is a discharge of any kind of fluid from the ears and nose, including bloody.
Nose bleed.
Bruises around the eyes and ears.

All of the above signs indicate that the injury is dangerous and you should immediately seek medical attention.

Take care of your head

Head injury from falls from high altitudes is the greatest danger to infants.

What should adults do? Be observant and seek emergency medical attention immediately if suspicious symptoms appear.

How to keep your baby safe from falls

Falls from a sofa or bed, as a rule, do not pose a serious danger to the crumb, since the height is not too high. However, such falls should be avoided whenever possible. A few simple safety rules will help.

Near the changing table (sofa, bed) it is worth spreading a soft blanket or pillows that will soften the blow if the baby falls.
You should not leave the baby alone on the bed. If you need to leave, take the baby with you or put it in a crib, where it will be safer.
Never allow the thought that the baby is not crawling yet and, therefore, will not fall off the couch. A moment and one coup is enough for a crumb to fall from a height.
Do not use high dressers and tables for changing.
You should not leave the baby alone in the stroller.
If the baby is already trying to sit, the bottom of the crib should be lowered.
A blanket, rug, or pillows can be placed on the floor near the crib.
When changing your baby on the changing table, it is worth supporting him with one hand, even if you are very close.

It is difficult to avoid falls at this age, but they can be made safer by removing sharp and hard objects from the floor that the child can hit, as well as spreading a carpet or blanket so that the baby's landing is softer.

In this article:

As soon as the baby learns to roll over and move, he will do it all the time. As a result, it may happen that the child, due to his active movements, will be injured, for example, when falling. If the baby fell out of bed, even if not from the highest one, this should not be ignored by the pediatrician.

It is good if everything ends in crying and fright without visible damage and consequences. This happens in most cases. The main thing is not to panic to parents and know what to do if the baby falls out of bed, what should be the first aid.

The first actions of parents after the fall of the child

What parents should do if a nursing baby falls out of bed:

If the baby accidentally flew off the couch or bed, cried for about 10 minutes and calmed down on his own, while his health does not cause fear, he is still cheerful and active, nothing serious happened. Most likely, in the place where the blow fell during the fall, redness, swelling, and then bruising will appear. It is advisable to put a cold lotion or compress on this place to eliminate the swelling. In the coming days, it is recommended to visit a pediatrician and make sure that everything is normal with the baby.
If the baby fell out of bed and did not cry in the first seconds or cry for a long time, this is an alarming signal. If, after a fall, the baby refuses to eat, does not want to move, becomes lethargic and capricious - most likely, he has a head injury. This is a dangerous pathological condition that requires immediate medical attention. It is imperative to call an ambulance or take the child to a hospital on your own. It is important that the baby does not fall asleep before being examined by a specialist.
If, as a result of the fall, the baby cried for a short time and calmed down himself, but after a while a noticeable soft bump appeared in the area of the fall - an urgent need to go to the hospital, most likely it is a brain contusion. Symptoms of this condition can be loss of consciousness after a fall, a malfunction of the heart, and impaired breathing. Of course, all these signs are the reason for immediate medical attention.
If the child has fallen from the height of the changing table or bed and after that he cannot lean on his legs and arms normally, most likely he has a dislocation or other damage to his limbs. Urgent help from a traumatologist is required.

After falling, the baby may cry at the same second - this means that he was just scared. If tears and screams did not appear immediately, most likely he is crying from the pain. In any case, the fact of falling from a height, even insignificant in the understanding of an adult, requires more careful observation of the baby over the next few days. The fact is that the first signs of trouble may appear with a little delay, and the consequences of the fall will make themselves felt a little later.

How do you know if your child needs immediate medical attention?

If this did happen, and the baby fell out of bed, then what should be done, how to understand that he needs urgent medical attention? First of all, you cannot panic and throw a tantrum, frightening and traumatizing the psyche of the baby even more, who already had to experience stress and pain from a fall. Pull yourself together and do the following manipulations.

Pick up your baby carefully and place them on a flat surface for a close examination. Most often, babies hit their head when falling, examine it for bruises, abrasions and other injuries.

What if the baby fell out of bed and lost consciousness? First of all, you need to take a small mirror in your hands and bring it to the lips of the child, checking the breathing. Then try to feel for a pulse. At the same time, it is necessary to call emergency help. If a child, for example, at the age of 5 months fell out of bed and does not regain consciousness for a long time, you need to go to a medical facility immediately.

If the child does not have the consequences of a fall, such as loss of consciousness, convulsions, injuries and bruises, after the examination, you need to immediately reassure the baby by picking him up, sing a song or offer your favorite toys. When injuries are detected, the child needs maximum rest, no unnecessary movements until an emergency arrives.

Damage in the form of abrasions and small cuts can be treated on your own. In most cases, such wounds heal quickly, within a few days, since the skin of children is quicker to regenerate. A slight swelling usually indicates a soft tissue injury, most often there is nothing serious about this.

If the place of the fall begins to swell quickly, then the injury is more dangerous, urgent medical attention is needed. In any case, it is advisable to put a cold compress on the site of the injury before the arrival of the doctors.

How to provide first aid to a child before an ambulance team arrives:

If a child falls out of bed at 6 months old and starts having convulsions or cramps, it is necessary to pick him up and hold him in a strictly horizontal position until the doctors arrive.
If a child at the age of 7 months fell out of bed, and one of his limbs is in an unnatural position, you need to try to fix the limb as carefully as possible and not touch the child until the doctors arrive.
If the toddler can already speak, ask if he remembers how the fall happened. If a baby falls out of bed at the age of 9 months, ask him to stand on his feet (at this age, most babies learn to walk and do this request without difficulty). If you have any problems with this request, you should seek medical help.

Apathy or, on the contrary, increased excitability of the nervous system, the appearance of cold sweat, blood in the urine and feces, vomiting - all this can indicate internal injuries that have arisen. I urgently need to go to the hospital.

Possible consequences

When a baby falls out of bed, the consequences can be very different.

The signs of trouble that should alert you are as follows:

violation of consciousness, inadequate reaction to what is happening;
problems with speech skills (relevant for children who can speak);
drowsiness and lack of interest in the surrounding reality;
severe pain in the head, lasting at least two hours;
repeated vomiting;
problems with limb control, persistent imbalance;
discharge of any nature from the nasal cavity, throat or ears, including mixed with blood;
circles and blue spots under the eyes;
sharp pallor of the skin.

Any of these symptoms are urgently needed. If the baby falls out of bed, the consequences can be felt even after a few days. According to statistics, 90% of all falls from a low height end for children with bumps and abrasions, less often with a slight concussion of the brain. And only 10% of falls require urgent medical attention.

The most severe consequences are concussion, brain contusion and head injury.

Lethargy and drowsiness, severe headaches accompanied by prolonged crying, convulsions, bruises under the eyes and in the area of the auricles may indicate a concussion. Older children may complain of hallucinations of a visual and olfactory nature, speech disorder.

With a brain injury, the child may cry immediately after falling, but quickly calm down and forget about the trouble, continuing to behave as before. However, after a few hours or even days, a soft, mobile swelling may form in the scalp area, under which fluid has accumulated. In this case, the child develops headaches, it is quite possible that hearing and vision impairment.

If a baby falls out of bed at the age of 8 months and has a head injury, it is impossible to calm him down for a long time. In this case, the baby will not take a breast or a bottle, and his movements will become poorly coordinated. At the same time, vomiting, swelling and pulsation in the fontanel area, rapid pulse, cold sweat may occur. In severe cases, clear fluid mixed with blood may ooze from the auricles - this means that the child has a skull base fracture.

How to prevent falling?

If a nursing child falls out of bed, the consequences can be dire.

In order to prevent falling and to protect your baby as much as possible, it is important to adhere to the following recommendations:

In the process of swaddling the baby, you need to constantly hold him with one hand - this should become a habit, in this case, the fall will not occur, even if the mother has to be distracted for a second.
If you urgently need to leave for a minute, you need to take the child with you or put him in a crib or playpen with high sides, for a second you should not leave the baby unattended on an unprotected surface, even if it seems that he is sleeping.
If there is no crib with bumpers or you do not want to disturb the baby's sleep on the couch or parental bed, you can put pillows over it as a safety net and leave for a very short time.
Always secure your baby in the stroller or highchair with the straps.
From the moment when the baby learns to stand on its own legs, or at the age of 6 months, lower the bottom of the crib to the lowest position. Kids at this age are very active, and even if it seems that they cannot bend over the side and fall out, it is better not to tempt fate.
Always try, while the baby is not in your arms, to keep him in a crib with bumpers, in an arena or on the floor, in extreme cases, twist the blanket to protect the child from falling off the couch.
It is better to swaddle a baby on the couch or bed of the parents, and not on a special table or regular table. In the event of an oversight, even if the baby falls out of bed, the consequences of this fall will be less painful than from the height of the table.
A clean floor and carpet are an excellent safety net for the time when you need to leave the room - the child will simply have nowhere to fall from the floor.

The best way to keep your child safe and eliminate the likelihood of falling, as well as other unpleasant situations, is simply not to take your eyes off him. Unfortunately, as practice shows, this is not always possible. After all, parents are also people who need to do their own thing. Therefore, you need to think in advance for the child a comfortable place to stay awake, where he will be in relative safety.

If the baby has not yet learned to crawl, then it may be the floor (just not cold and not dirty). It is enough to equip the place away from the sharp corners of furniture and drafts and provide the child with toys. You can purchase a playpen that will reliably limit the child's physical activity if you need to go to the next room for a minute.

It is very difficult to find a child who has never fallen from a small height in the first year of life. This happens to some children more than once. Fortunately, in most cases, such falls do not harm the child in any way; the nervous system of young parents suffers most in such cases. There is no need to engage in self-flagellation if the child does fall. It is enough to take note of this incident, as a definite lesson, and in the future try to prevent this from happening again.

Useful video on what to do when a child falls

Unfortunately, it is not uncommon for the baby to be on the floor. What are the actions of the parents in this case?

Dangerous height or where a child might fall

A small child is surrounded by care and attention from birth. His relatives do everything possible so that nothing threatens the health of the baby. But even the most attentive mother can make a mistake. Sometimes it is enough just to turn away for a second - and the baby is already on the floor.

The fact is that not everyone correctly understands the possibilities of a crumb. Even a newborn child, making chaotic movements with his arms and legs, may well move to the edge and fall, although the likelihood of this is small.

Particularly dangerous places from which a fall is possible for babies under 6 months are the changing table, sofa, and also the parents' bed. After six months, the baby begins to actively master new movements, learns to sit, crawl, stand on his feet at the support, and then walk.

At this age, he can fall out of his crib, from a highchair, from a stroller, etc.?

Most often, when falling, babies hit their head: up to 1 year old, the head is the most vulnerable place due to its rather large size and mass in relation to the body. But damage to other parts of the body is also possible. Most often these are bruises, in rare cases - a bone fracture or traumatic brain injury (TBI).

If the child hits his head ...

Headbutts in babies under 1 year old are quite frequent, and they do not have to fall at all, because the baby can accidentally hit the surrounding objects or furniture, making active movements. In this case, basically everything goes without consequences: there is not a head injury, but only a bruise. However, when falling from a height, the likelihood of a traumatic brain injury (HMG) increases many times.

What is TBI?

Traumatic brain injury is a mechanical damage to the bones of the skull and soft tissues of the head (brain, its vessels, cranial nerves, meninges).

Traumatic brain injuries include:
concussion (mild TBI - there are no obvious changes in the structure of the brain, but functional activity may be impaired);
brain contusion of varying severity (accompanied by the destruction of the medulla in a certain area, causes severe functional disorders);
compression of the brain (severe pathology that occurs against the background of a brain injury or rupture of a large blood vessel, which leads to the formation of an intracranial hematoma).

In babies with typical falls, compression of the brain is extremely rare. To receive such an injury, the child must fall from a height of at least 2 m or hit a very hard or sharp object.

We assess the situation. Symptoms of a traumatic brain injury in a child are not the same as in an adult, which is due to the structural features of the skull and internal structures of the infant's brain. In some cases, a prolonged asymptomatic course of TBI is possible, or, conversely, a violent manifestation of symptoms with minimal trauma. This is due to the flexibility of the bones of the skull, their mobility relative to each other in the area of the seams, as well as the age-related anatomical and physiological characteristics of the brain. The cells of the brain in infants are not yet fully differentiated, i.e. there is no strict division according to the zones of brain functions, therefore, the symptoms are often blurred.

When he hits his head, the baby feels pain, redness appears at the site of the blow. In the future, a slight swelling may develop. If nothing else has alerted you, you should not worry: this is not a head injury, but a contusion of the tissues of the head. In this case, you need to give the child a cold compress and soothe him. Cold constricts blood vessels, stopping subcutaneous bleeding, has anti-inflammatory and some analgesic effect.

A hot water bottle with ice, a small plastic bottle of cold water, or any cold, non-traumatic object is suitable for the compress. It should be wrapped in a diaper or towel, applied to the site of the injury and held for 10-15 minutes. It is important that the effect of cold is directed strictly at the bruised area - the surrounding tissues should not be touched. If the child does not allow the compress to be held - is capricious, dodges, - you can moisten a gauze napkin, bandage or a piece of cloth in cold water and tie it to the damaged area. The dressing should be changed as it warms up for half an hour.

One of the symptoms of a brain injury can be loss of consciousness. But for babies, this phenomenon is quite rare, and often it does not accompany even severe damage. This is due to the underdevelopment in infants of the cerebellum and the vestibular apparatus in general, which are responsible for coordinating movements. You also cannot find out if the baby is experiencing a headache. Thus, the most characteristic signs of traumatic brain injury in infants are:

loud screaming as a reaction to pain;
increased physical activity, general anxiety, or, conversely, lethargy and increased drowsiness;
vomiting, refusal to eat;
pallor of the skin.

These signs are characteristic of a concussion. For a brain injury of varying severity (damage to the medulla itself), in addition to the above (or without), the following symptoms are characteristic:

rolling eyes, temporary strabismus or difference in pupil diameter;
loss of consciousness (it can be assumed if, after falling, the baby did not scream immediately, but after one or several minutes).

You can assess the consciousness of a child after a fall by three signs:

Opening the eyes (whether the baby opens his eyes himself, or to a loud sound, or to a painful stimulus, or does not open at all).
Motor reaction (here it is important to evaluate the baby's movements: is there any physical activity at all, does he move the limbs in the same way, is the tone of individual muscles increased).
Verbal contact (whether the child is walking, smiling, crying, moaning, or no voice).

Such an assessment can be made a few minutes after the fall, when the baby has already come to his senses. Normally, he should move normally, walk (or pronounce syllables) and open his eyes in the same way as he always did.

A dangerous symptom is a temporary external improvement when, after sleep, the child's external signs of trauma, which were previously present, disappear. But after that, the baby's condition may deteriorate sharply.

There are also open craniocerebral injuries, when the integrity of the bones of the skull, and possibly the dura mater, is compromised. In this case, there is a risk of infection of the brain tissue.

Thus, there are many signs of brain injury. Therefore, parents should be alerted to any deviation from the usual behavior of the baby. You need to see a doctor in any case if the child has fallen and hit his head. If everything is limited to a bruise of the soft tissues of the head without other pathological signs, you need to show the baby to a pediatrician and a neurologist in a polyclinic. In case of symptoms of brain contusion (especially loss of consciousness and lack of reactions to external stimuli - light, sounds), as well as in case of open traumatic brain injury, an ambulance should be called immediately.

If the blow to the head was not accompanied by the appearance of dangerous symptoms (for example, loss of consciousness), the child should be shown to the pediatrician on the same day or, in extreme cases, the next day after the injury (you can call the doctor at home or bring the baby to the clinic). If necessary, the pediatrician will send the baby for consultation to other doctors (neurologist, traumatologist).

Late seeking medical attention is fraught with the deterioration of the child's condition.

Before the arrival of the doctor

All that a mother can do before the doctor arrives is to calm the baby, put a cold compress on the site of the injury and provide the baby with peace. If a child has an open craniocerebral injury, cover the damaged area with a sterile gauze bandage and urgently call an ambulance. With an open traumatic brain injury, cold should not be applied.

When the doctor arrives, he will examine the child and, if necessary, take you and the baby to the hospital for additional examinations and treatment.

Diagnosis of TBI

The first link in the diagnosis is a doctor's examination. The doctor assesses the general condition of the child, his consciousness, the state of reflexes, physical activity, the integrity of the bones of the skull. The purpose of further research depends on the preliminary diagnosis after examining the crumbs and on the capabilities of a particular medical institution. Sometimes only one study is enough to make a diagnosis, and sometimes, if doctors have doubts, they have to do several of them at once.

If the large fontanelle on the crown of the baby has not yet grown, it is possible to conduct neurosonography in a hospital or clinic - an ultrasound examination of the brain through the large fontanelle. X-ray computed tomography (CT) is widely used in the diagnosis of brain pathologies. Currently, CT is the most reliable method for examining the brain.

Magnetic resonance imaging (MRI) is not related to X-rays, but is based on the absorbing capacity of magnetic fields. MRI allows you to get a more contrasting image of brain tissue than CT. However, CT and MRI are rarely prescribed for infants, since one of the conditions for their implementation is complete immobility of the patient, which is almost impossible to provide with a small child. These studies for babies are possible only under anesthesia if absolutely necessary.

To assess the integrity of the bones of the skull, craniography (X-ray of the skull) is performed. Ophthalmoscopy - fundus examination - is an additional research method. It allows you to identify signs of increased intracranial pressure, which is important for the diagnosis of intracranial hemorrhage or cerebral edema.

Lumbar puncture is a more reliable diagnostic method for suspected intracranial hemorrhage. CSF is collected with a needle inserted between the spinous processes of the 3rd and 4th lumbar vertebrae. But during the puncture, the child should be immobile, since there is a risk of damage to the brain tissue.

How is TBI treated

Treatment is prescribed based on examination data and clinical studies. For concussion and bruises of the brain, treatment is usually medication. With a concussion, the baby is usually treated at home, and with brain bruises - in a hospital. As a rule, the child is prescribed drugs with anticonvulsant, antispasmodic, hypnotic effects. Also, the baby will be advised to rest for 4-5 days. The word "peace" for a baby should be understood as the absence of new impressions, limiting the number of people around to mom and dad, maintaining silence in the room where the baby is.

Consequences of TBI

After a concussion, the brain usually recovers within 1–3 months without any long-term consequences. In more serious injuries - brain contusions - the consequences depend on the severity of the injury. They can be different - from dizziness and impaired coordination of movements to increased intracranial pressure and epileptic seizures (seizures with loss of consciousness).

Severe trauma can result in psycho-emotional disorders (up to dementia) or movement disorders (for example, inability to perform any movements). With open traumatic brain injuries, there is a risk of infection of the brain tissue (encephalitis) and the development of meningitis - inflammation of the lining of the brain.

If the kid did not hit his head ...

The first step is to quickly assess the condition of the child and examine the site of the injury. If you saw the very moment of the fall, then it will not be difficult to find the place of possible damage. If you were not around, you should, if possible, calm down and carefully examine the crumbs.

We assess the situation. The site of the injury can be seen by the characteristic redness that appears in the first seconds after the fall. Over the next few minutes, reddening of the skin may increase, as well as the development of swelling, followed by the formation of a hematoma. A hematoma occurs when a large number of subcutaneous blood vessels rupture from a blow, resulting in an accumulation of liquid blood in the tissues, which has a red-burgundy color. A small hemorrhage cannot be called a hematoma - it's just a bruise (a bruise when a small number of subcutaneous blood vessels are damaged).

When the site of injury is found, you need to immediately apply a cold compress to the baby, as described above - in the section on TBI.

In a normal course, the hematoma decreases every day, and its color changes. Fresh hematoma is dark red, gradually it turns blue, and then yellow. To speed up the resorption of the hematoma, you can use heparin-containing ointments that prevent blood clotting and, therefore, have a resorbing effect, or make an iodine mesh, which has a similar effect.

Parents should be alerted to the sudden appearance during the healing period (in the first 2-3 days after injury) reddening of the skin over the hematoma, general malaise of the baby, rise in body temperature, increasing pain at the site of the injury (in this case, the child will begin to show anxiety, and to touch the place hematoma will react with a sharp loud cry). All this may indicate suppuration. In this case, the baby needs to be urgently taken to the surgeon. He will open the hematoma so that the purulent contents can flow out, and apply a bandage.

If, after a fall, the hematoma continues to increase in size, you should also urgently consult a surgeon, as this may indicate ongoing bleeding. If the baby remains restless with a visible bruise, it is better to consult a doctor, since the crumbs may have a crack in the bone. This phenomenon is more common in young children than fractures. A crack can be suspected when a swelling appears at the site of the impact, as well as if the baby begins to cry when you try to move his injured limb.

When examining the impact site, it is important to determine if there is a fracture. Its signs:
severe pain at the fracture site; if a limb is broken, it will be very painful for the baby to move it;
severe swelling and bruising at the fracture site;
change in the shape or length of a broken limb (shortening or lengthening);
limitation of limb mobility or, conversely, its excessive mobility;
crunch when moving the injured limb.

If one or more of these signs appear, you should call an ambulance. In this case, the injured area should be immobilized if possible, for example, with the help of a stick or plank, tied with any piece of cloth to a broken limb. If the child cannot calm down due to pain, you can give him an anesthetic based on PARACETAMOL or IBUPROFEN in accordance with the age of the baby and the dosage indicated in the drug's instructions.
If there is an abrasion at the site of the injury (this is possible when falling on an uneven floor), you need to do the following:

wash the wound with soap under running cool water;
treat damage with hydrogen peroxide;
treat the edges of the wound with an antiseptic solution (iodine or brilliant green);
dry the wound with a gauze cloth;
apply a sterile bandage: cover the damaged area with a sterile napkin (it can be purchased at the pharmacy - the napkin is sold in a sealed package with the inscription “sterile”) and fix it with a bandage or adhesive plaster. If sterile dressings are not available, a germicidal patch can be used.

Fracture treatment

In the hospital, after examination, the doctor may prescribe an x-ray, and then, depending on the severity of the damage, measures will be taken:
The imposition of a splint - a one-sided plaster cast in the form of a long strip - consisting of several layers of plaster bandage, which is shaped into a damaged limb and fixed with a bandage (for simple fractures without displacement of bone fragments).

An operation lasting several minutes under general anesthesia, followed by the imposition of a plaster cast (for fractures with displacement and comminuted fractures). During the operation, bone fragments are compared, which is necessary for the full restoration of function and the absence of complications after a fracture.

When applying a splint, you and your baby will need to visit a traumatologist for examination
once a week - provided that redness does not appear under the bandage and there is no loss of sensitivity of the injured limb. (Parents should be alerted to the paleness, as well as the cold snap of the injured limb relative to other parts of the body).

If an operation is required, you and your baby will have to stay in the hospital for 3-5 days to make sure that everything went well. Then the baby will be discharged home with plaster cast, and the traumatologist will observe him on an outpatient basis.

The plaster cast, as well as the splint, are removed when the bone is completely fused, which can be controlled by taking an X-ray. Depending on the site of the fracture, the duration of this period can be from 2 weeks (for example, with a fracture of the phalanx of the fingers) to 3 months (with damage to the bones of the lower limb and pelvis).

Prevent injury

As already mentioned, babies fall most often due to the fact that parents underestimate their capabilities. Very young, just-born children also fall - most often due to the fact that mothers leave them on the changing table unattended to run for cream or answer a phone call. Making chaotic movements, the baby is able to move around quite well, therefore, in no case should even a newborn baby be left alone where he can fall. In order not to be absent when changing a diaper, changing clothes, etc., prepare everything you need in advance. And if you need to go to the phone or open the door, it is better to take the baby with you or put it in a crib. Do not leave your baby unattended on an adult bed or sofa. Although their height is less than, for example, a changing table, for a small child this may be enough to cause serious injury.

It is also necessary to raise the side of the bed in a timely manner when the baby learns to roll over. And when the child starts to get up, it is necessary to lower the bottom of the crib - preferably to the lowest level so that the baby cannot fall out, bending over the sides.

To be able to leave the baby alone and not be afraid for his safety, you can purchase a playpen or make the floor in the room as safe as possible (remove the wires, put plugs on the sockets, remove all small and traumatic objects, put blockers on boxes that the baby can reach, secure the sharp corners of the furniture).

Statistics show that very often babies fall out of highchairs or strollers. Therefore, when putting a baby on a highchair, you should definitely fasten it with five-point seat belts. A baby stroller should also be equipped with such belts, and you should definitely use them, even if the baby is constantly in your field of vision. After all, even if the mother is distracted for only a second, there is a risk that the child will fall. And the consequences of a fall, as we have already seen, can be very severe.