A fall is a concerning event for any parent, especially when a baby is involved. Even though falls are a common cause of injury in infants, the moment it happens can trigger intense alarm. This guide offers clear, systematic steps to manage the crisis, providing actionable information to assess the situation and determine the appropriate follow-up care.
Immediate Response and Initial Assessment
Your immediate reaction should be to stay calm and assess the scene before moving the baby. If the baby is unresponsive, not breathing, or bleeding profusely, immediately call for emergency medical help. Do not move the baby unless they are in immediate danger of further injury. If the baby is non-responsive or seizing, gently roll them onto their side, maintaining neck alignment, while waiting for help.
If the baby is crying and appears conscious, pick them up and provide comfort. While holding your baby, perform a rapid visual and physical inspection for obvious signs of trauma. Look for cuts, excessive swelling, or any visible deformity in the limbs or head.
Pay particular attention to the head, checking for soft, boggy areas, which can indicate swelling, or indentation, which might suggest a skull fracture. Observe their breathing pattern to ensure it is regular and not labored. A brief cry followed by a return to normal behavior is a reassuring sign, often indicating fright rather than serious injury.
If you feel comfortable that no severe head, neck, or spinal injury has occurred, console your baby. Once they are calm, check their responsiveness by attempting to make eye contact or engaging them with a familiar toy. Even if the baby appears fine, contact your pediatrician to describe the fall and receive tailored advice.
Signs Requiring Immediate Medical Attention
Certain signs suggest a serious injury, particularly head trauma, and warrant an immediate trip to the emergency room or calling emergency services. Serious injury is more likely if the fall was from a height greater than three feet or onto a very hard surface.
One concerning sign is any loss of consciousness, even if momentary, or difficulty waking the baby. Excessive sleepiness, where the baby is unusually lethargic or cannot be roused to feed, indicates a problem. Multiple episodes of vomiting, especially if projectile, are a red flag for increased pressure within the skull.
Neurological signs are important to watch for due to the potential for concussion or intracranial injury. These include unequal pupil sizes or any abnormal eye movements. A bulging fontanelle when the baby is not crying suggests elevated intracranial pressure.
Any discharge of blood or clear fluid from the nose or ears must be treated as a medical emergency. Seizures or convulsions, such as rhythmic jerking or stiffening of the body, also require immediate care. Persistent, high-pitched, inconsolable crying is another indicator of distress needing urgent evaluation.
Monitoring and Follow-Up Care
Continued observation is necessary for a full 24 hours after the fall, even if the baby seems fine after the initial assessment. This helps detect delayed signs of brain injury, such as a slow bleed. Monitor for any changes in mood, behavior, or feeding patterns that deviate from the baby’s norm.
During this 24-hour window, you do not need to keep the baby awake, but you must be able to wake them easily. Gently rouse them every two to four hours to ensure they awaken easily and respond appropriately. Difficulty waking the baby or unusual confusion signals a need for immediate medical consultation.
Keep track of the baby’s feeding and diaper output. A refusal to feed or a significant change in wet or soiled diapers can be a subtle sign of distress. If any symptoms progress or worsen, contact your pediatrician immediately.
Preventing Future Falls
Preventing future falls involves environmental safety modifications and constant, active supervision. The most frequent falls occur from elevated surfaces like beds and changing tables, often because parents underestimate how quickly a baby can roll. Never leave a baby unattended on any surface that is not the floor, a crib with the rails up, or a safety-approved playpen.
A simple measure is to change diapers and dress the baby on a mat placed directly on the floor whenever possible. When using baby equipment like high chairs or changing tables, always use the safety straps and harnesses. Even with straps, maintain a hand on the baby at all times when they are on an elevated surface.
As babies become mobile, adjust the crib mattress to the lowest setting before they can stand. If you co-sleep, ensure the baby cannot roll into a gap or off the mattress edge. Securing furniture like dressers and bookshelves to the wall also prevents severe injury from climbing.