When a child experiences a head injury, parents often seek clear guidance. Understanding what truly matters after a child hits their head is paramount for providing proper care and recognizing when professional medical attention is necessary. This article aims to clarify the appropriate steps parents should take.
Understanding the “Stay Awake” Myth
A common belief suggests that a child must be kept awake after a head injury to monitor for serious complications. This notion stems from an outdated concern that a child might slip into a coma or that unconsciousness could mask worsening symptoms.
However, current medical understanding indicates that undisturbed rest is beneficial for brain recovery. It is not necessary to prevent a child from sleeping after a head injury, provided they do not exhibit any urgent symptoms. Instead of focusing on keeping them awake, the primary goal should be to observe them for specific indicators of a more serious issue. Sleep allows the brain to heal and is an important part of the recovery process.
Urgent Signs After a Head Injury
Certain symptoms after a child’s head injury warrant immediate emergency medical attention. These include:
Any loss of consciousness, particularly if it lasts longer than 30 seconds.
Persistent or worsening headache that does not go away.
Repeated vomiting (more than once or twice within an hour).
Changes in mental function, such as confusion, disorientation, slurred speech, or difficulty recognizing familiar people or places.
Seizures or convulsions.
Changes in physical coordination like stumbling, clumsiness, or weakness/numbness in limbs.
Fluid or blood draining from the nose or ears.
Unequal pupil sizes.
Significant bruising around the eyes or behind the ears (sometimes called “raccoon eyes” or “Battle’s sign”).
If a child is hard to wake up or keep awake.
Unusual paleness lasting more than an hour.
Non-Urgent Concerns and When to Call Your Doctor
While some symptoms demand immediate emergency care, others indicate a need to contact your pediatrician or family doctor. These include:
A mild headache that is not worsening, or mild dizziness.
Irritability, excessive crying, or changes in behavior that are not severe.
Changes in sleep patterns, such as being more sleepy than usual but easily roused, or difficulty sleeping.
Minor bumps or bruises on the head without other worrying symptoms.
If a child refuses to eat or nurse, or shows a lack of interest in favorite toys.
Monitoring and Recovery After a Head Injury
After an initial assessment, ongoing monitoring is important for a child recovering from a head injury. Parents should observe the child closely for at least 24 to 48 hours for any new or worsening symptoms. This includes watching for changes in their mood, behavior, sleep patterns, and appetite.
Encourage quiet activities and avoid strenuous physical play, sports, or activities that risk another head impact during the recovery period. While some symptoms may not appear immediately, they can develop over several hours or days following the injury. If any new concerning symptoms emerge or existing ones worsen, contact your doctor immediately for further guidance.