A concussion is a mild traumatic brain injury resulting from a bump, blow, or jolt to the head, or a hit to the body that causes the head to move rapidly. This sudden movement forces the brain to shift inside the skull, temporarily disrupting normal brain function through chemical changes. Recognizing this injury in infants is challenging because they cannot communicate symptoms like headache or dizziness. Caregivers must rely entirely on careful observation of physical signs and subtle changes in behavior. Early detection of certain signs is paramount to the infant’s safety.
Immediate Signs Requiring Emergency Care
Acute symptoms following a head injury indicate a medical emergency and require an immediate call to 911 or transport to an emergency room. Any loss of consciousness, even if brief, is a serious sign requiring immediate medical evaluation. Seizures, which may appear as rhythmic twitching, jerking movements, or sudden stiffening, demand urgent attention.
Persistent or forceful vomiting, especially if repeated after the injury, can signal increased pressure within the skull. Caregivers should also look for signs of a skull fracture, such as bleeding or clear, watery fluid draining from the nose or ears. An infant who cannot be woken up from sleep, or who appears significantly drowsy, requires emergency intervention.
A difference in pupil size, where one pupil is larger than the other, is a concerning sign of intracranial injury. In infants, a bulging or tense soft spot (fontanel) after a head injury indicates swelling or pressure. An infant who is inconsolable with crying that will not stop, or who exhibits increased confusion, restlessness, or agitation, must be seen immediately by medical professionals.
Monitoring for Subtle Behavioral Changes
Since infants cannot verbalize discomfort, a concussion often manifests as deviations from their normal routine and temperament. Changes in feeding habits are a common indicator, such as refusing to nurse or take a bottle, or showing a loss of appetite. This refusal to eat or drink can signal nausea or a generalized feeling of being unwell.
A shift in sleeping patterns also warrants concern, including sleeping much more than usual, difficulty waking up, or having trouble falling asleep. An unusual increase in drowsiness or difficulty rousing them from sleep should be closely monitored. Behaviorally, an infant may become unusually irritable or fussy, crying excessively and unable to be consoled by typical soothing methods.
The infant might display increased clinginess, seeking more comfort than usual from a caregiver. They may also show a lack of interest in favorite toys or people, suggesting a change in cognitive or emotional engagement. Caregivers should look for a “blank stare” or if the infant appears dazed or confused, indicating impaired neurological function.
Initial Care and Observation Protocols
Following a head injury, the first step is to assess the injury site and maintain a calm presence to keep the infant from becoming distressed. If a lump or bruise is visible, applying a cold compress wrapped in a cloth for up to 20 minutes can help reduce swelling and manage pain. Caregivers should avoid applying pressure directly to the injury site, especially if a skull fracture is suspected.
It is helpful to immediately document the incident details, including the time the injury occurred, the mechanism (how it happened), and the infant’s initial reaction. This information is invaluable for medical providers during the assessment process. For the first 24 to 48 hours, close monitoring is essential as concussion symptoms can be delayed.
Monitoring the infant’s sleep is important; allowing them to sleep when tired aids healing but should not disrupt the normal routine. If a medical professional advises a specific sleep-monitoring protocol, such as waking the infant periodically, this guidance must be followed. Over-the-counter pain relievers like acetaminophen may be used for discomfort, but ibuprofen and aspirin should be avoided immediately post-injury due to the risk of affecting blood clotting.
Medical Evaluation and Recovery Expectations
A medical professional diagnoses a concussion primarily through a detailed history of the injury and a thorough physical and neurological exam. They assess the infant’s level of alertness, coordination, reflexes, and responses to stimuli. The caregiver’s report on the infant’s behavior before and after the injury is often the most important tool for diagnosis.
Imaging tests, such as a Computerized Tomography (CT) scan or X-ray, are typically avoided unless severe symptoms or high-risk factors suggest a structural injury or intracranial bleeding. The goal is to minimize unnecessary radiation exposure while identifying clinically significant injuries. A concussion is a functional injury, meaning the brain is working abnormally, and may not show up on imaging even if symptoms are present.
The primary treatment for a concussion is physical and cognitive rest for the first one to two days to allow the brain to heal. For most infants, recovery is quick, with symptoms often resolving within a few weeks. However, since the infant’s brain is still developing, recovery may take longer, sometimes requiring several weeks. Continued monitoring at home and follow-up appointments are necessary to ensure a complete return to baseline function.