Bumped heads are a common scenario for infants and children, and they rarely need medical attention and often seem worse than they really are. But you also need to be aware of when to be seen by a doctor.

Ice the lump: The first thing to know is don’t panic. These are mostly harmless. Spend about 20 minutes applying a cold compress to the bumped area (if the bump was hard enough to cause a swollen lump). Ice water in a baggy works well with a cloth or thin towel, or an ice pack covered in a thin towel – you don’t want it too ice cold. Most toddlers won’t let you hold anything cold to the lump, but try your best. After you’ve done this, then it’s time to assess. And of course, if it’s bleeding, holding the cold compress/cloth to the area should stop the bleeding. If there’s little to no lump, that’s fine – don’t worry about that. There’s a myth that “no bump” is a bad thing but it’s not. It could still help to hold a cool compress to the bumped area to prevent or minimize a later bruise.

Check the pupils: Once your child has calmed down, look at his eyes and pupils. If they are equal, that’s good. If you shade each eye with your hand, then pull it away and you see the pupils constrict (get smaller), that’s a good sign. You can also shine a moderately dim light near the eyes to check for pupil constriction too. If you aren’t able to assess constriction, simply noting that the pupils are both the same general size is enough to reassure that there’s likely no internal head injury.

Relieve the pain/swelling: Arnica is a great homeopathic to reduce swelling. By mouth or topical or both. Ibuprofen can also be given if your child is in significant pain (see dosing in Fever section).

Let you child nap: If naptime is coming up, it’s OK to allow a nap, but check your child every 20 minutes to make sure he is napping peacefully and breathing comfortably.

Check your child periodically that night: Wake your child up every 2 hours that night to make sure he responds as you would expect. If you don’t with to do this, at least wake yourself up and check on your child to make sure he is breathing comfortably and seems to be sleeping peacefully. You can also elect to sleep near your child that night too.

What to watch for: Here are circumstances in which you should be seen in an ER right away:

  • Pupils aren’t equal
  • Your child vomits more than twice in an hour during the several hours after injury. Vomiting a day later, especially with diarrhea, is more likely an unrelated intestinal illness
  • Mental changes – your child has difficulty speaking or forming coherent sentences or is unable to stay away (and he’s too old for naps)
  • Neurologic symptoms – unable to walk, too dizzy to stand, facial or eye muscles won’t work well
  • Loss of consciousness – if your child was unconscious for 10 or more seconds at the time of injury

Should you be seen by your doctor just in case: In general, no. We don’t recommend you be seen just to be checked if you child has none of the above signs and is acting normal after the injury. But we welcome you to get checked if you wish, of course.

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