Babies can suffer concussions, a form of mild traumatic brain injury (TBI). Diagnosing a concussion in an infant is uniquely challenging because they cannot describe symptoms like a headache or dizziness. Caregivers must rely entirely on observing subtle changes in behavior and physical function. This reliance on non-verbal cues makes it important for parents and guardians to know what signs to look for after any head trauma. A concussion occurs when a bump, blow, or jolt causes the brain to move rapidly inside the skull, temporarily disrupting its normal function.
Why Infant Concussions Present Differently
An infant’s anatomy and developmental stage create a unique vulnerability to head injury compared to older children or adults. A baby’s head is disproportionately large, making up a greater percentage of their total body weight. This top-heavy ratio means that during a fall or sudden stop, the head experiences a much greater acceleration and deceleration force.
The neck muscles supporting this large head are underdeveloped and weak, providing less stability and control. This reduced muscle support allows for a more violent whipping motion during impact, increasing the strain on the brain tissue. Furthermore, the rapidly developing brain has a higher water content, which may make it more susceptible to injury.
A baby’s skull is not yet a solid, fused structure, featuring “soft spots” known as fontanelles. These gaps allow the brain to grow rapidly, but they also offer less rigid protection than an adult’s fully ossified cranium. The anterior fontanelle, the largest one located on the top front of the head, typically remains open until a child is between 10 and 24 months old.
Recognizing the Signs of Head Trauma
Because infants cannot vocalize their discomfort, caregivers must recognize symptoms through changes in the baby’s established routines and demeanor. These changes often manifest in four main categories: behavior, physical movements, digestion, and visual responses.
Behavioral Changes
A noticeable shift in temperament is often the most telling sign of a potential concussion in an infant. Caregivers should watch for excessive irritability or a persistent, inconsolable crying that differs from the baby’s usual fussiness. Conversely, an unusual quietness, lethargy, or loss of interest in favorite toys and activities can also indicate altered brain function.
Changes in the infant’s sleep patterns are also common following a head injury. This can present as sleeping significantly more than usual, unusual drowsiness, difficulty waking, or the opposite: trouble falling asleep or waking more frequently. Any deviation from the normal sleep-wake cycle warrants close observation.
Physical and Motor Changes
Physical signs related to motor function include difficulty with coordination or balance, which can be seen even in non-mobile infants. If an infant is crying when the head is moved or turned, this could indicate neck pain or sensitivity. For older infants beginning to walk, an increase in stumbling or a noticeable unsteadiness is a sign of a potential problem.
Gastrointestinal symptoms frequently appear after a head injury due to the brain’s involvement in regulating nausea and vomiting. While one instance of spitting up is common, repeated or persistent vomiting, particularly if it is forceful or projectile, is a serious warning sign. A sudden change in feeding habits, such as refusing to nurse, take a bottle, or a noticeable decrease in appetite, should also be noted.
Visual and pupil changes can indicate increased pressure within the skull. A noticeable difference in the size of the pupils, where one appears larger than the other, is a red flag that requires immediate medical attention. An inability to focus the eyes or a sensitivity to light, causing the baby to squint or turn away, can be a sign of neurological distress.
Immediate Steps and Medical Triage
Following any head injury, the first step is to comfort the infant and assess the situation calmly, applying a cold compress to the site of impact to reduce external swelling. For a minor bump where the baby cries briefly but quickly returns to normal behavior, close monitoring for the next 24 to 48 hours is often sufficient. Monitoring should include checking on the baby every few hours, even during sleep, to ensure they wake up easily.
It is important to contact a pediatrician immediately if the baby exhibits any symptoms, even if they seem mild. These symptoms include persistent crying, a refusal to feed, or any changes in their usual behavior or sleep that last longer than a brief period. A medical professional can assess the circumstances of the injury and the baby’s risk level.
Certain “Red Flags” signal a severe injury that requires an immediate emergency room visit or calling emergency services. These critical signs include:
- Losing consciousness.
- Experiencing seizure-like activity.
- Being difficult to wake up.
- Clear fluid or blood draining from the ears or nose.
- The anterior fontanelle appearing unusually sunken or bulging.
- Persistent vomiting (multiple episodes).