Toddler head bumps and injuries: What to do

Kids fall all the time ― know when a head injury is serious enough to rush him to the doc.

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From the time your baby flips over for the first time, you worry that’ll she roll off the bed. When junior takes her first step, you worry about potential dangers like the corners of your coffee tables, your bookcase tipping over, even trailing window and electrical cords. As she grows older, you worry that she’ll take a tumble down the stairs.

Indeed, a quick look around your home and it’ll seem like a head injury hazard is lurking around every corner. And chances are, your peewee will get a knock in her head some time or other, if she hasn’t already.

According to KKH Women’s and Children’s Hospital, about half of the children who seek treatment in the Children’s Emergency come in for injuries sustained from head trauma. About 20 per cent of these children require treatment by specialists at the Paediatric Neurosurgery Department.

Mum of two Louisa Yap got the fright of her life when her 3-year-old son Adam missed a step while walking down a flight of stairs and tumbled down four to five steps. “He landed on his bum, but hit the back of his head several times ― that was what worried me,” she says.

Adam cried uncontrollably for an hour, and then fell asleep, probably from exhaustion, she said. Yap later took her son to her GP just to make sure that he was fine. “He seemed to have gone back to his usual self in a couple of hours, but I was worried about any internal head injuries he might have sustained,” she explains. Thankfully, Adam was unscathed by the fall.

About half of the children who seek treatment in the Children’s Emergency come in for injuries sustained from head trauma.

Dr Dawn Lim, a paediatrician at Kinder Clinic @ Paragon, says that it’s very common for toddlers to fall and hit their heads as toddlers are still very unsteady on their feet. “But for them to have actual serious injuries is not that common.”

This is because the little ones don’t usually fall from a great height as they have a much lower centre of gravity as compared to adults. “So, when it does happen, parents don’t always rush them to the clinic,” Dr Lim adds.

But just how serious can ahead injuries get? And how do you assess your child’s injury?

Possible head injuries include:

* Bruises and cuts External injuries, these can include a blue-and-black mark or an open wound that requires stitching.

* Concussion A brain injury arising from a blow to the noggin. Symptoms can range from mild to severe.

* Skull fracture When the bones in your child’s head crack.

Parents usually bring their children in to the A & E clinic if there is an open wound, or if the “knock is deemed to be very heavy,” Dr Lim notes. “The injury could be internal, or external, or you could have both.”

Parents should be alert to signs of internal injuries. Learn what these are.
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Red flags

Take note of what happened to your child during the fall and in the 48 hours after. “Did she black out? Did she have a fit? Is she drowsy? Did she vomit or feel nauseous? “Also, look out for any neurological deficit, like being weak in one arm or one side of her body,” adds Dr Lim. “Vomiting, in particular, could mean some sort of swelling in the brain.”

If you notice any of the following signs in your toddler, bring her to the doctor at once.

* Vomiting.
* Blurred vision.
* Prolonged headaches.
* Sluggishness.
* Confusion.
* Problems focusing or concentrating.
* Lethargy.
* Trouble balancing.
* Ringing in the ears.
* Sensitivity to light or noise.

Vomiting is a sign of a possible brain injury, so the doctor will likely send the child for a CT scan, and possibly, get a neurosurgeon to take a look. “We are concerned that there is a bleed in the brain because that may require surgical intervention,” says Dr Lim.

If not treated early enough, the injury can be very serious ― “Permanent damage to the brain, and possibly, even death, though this is rare,” Dr Lim adds.

“Vomiting, in particular, could mean some sort of swelling in the brain.”

If the doctor suspects that your child has a skull fracture, a skull X-ray may be carried out, though it’s rarely needed as your child’s abnormal signs are a more reliable indicator of serious injuries.

If your child’s injury seems to be mild and you are monitoring her for any other symptoms, you can follow these guidelines:

* When in doubt, go to the doctor. You are never wrong to seek help if you think the head injury may be more serious than it looks.

* Let her get enough rest and reduce the stimulation. The brain recovers with rest.

* Avoid high-energy activities for a while, so as to prevent another injury or blow to the head.

* It is fine to let her sleep ― rest helps her to heal.

* Keep other caregivers informed of the injury. Ask them to contact you should your child show atypical symptoms or any changes of behaviour.

Prevention

More than 80 per cent of head injuries in young children occur at home. In order to reduce the likelihood of your child getting a head injury, you shouldd make the effort to ensure that your home is child-safe. Here are several pointers:

* Ensure that any spills are wiped up quickly to prevent slipping.

* Place cushioned corner guards on the sharp corners of furniture to soften the impact of any bumps.

* Keep the floors clear of toys to prevent tripping.

* Make sure that loose furniture is secured to walls.

* Never leave your tot unsupervised on a raised surface.

* Use baby gates at the top and bottom of stairs to prevent unsupervised climbing.

* Check your baby equipment. Some, like walkers and sarong cradles, can actually cause falls and injuries.

* Have a first-aid kit handy so that you can treat external injuries quickly.

Photos: iStock

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