Toddler Head Injury: Warning Signs, Home Care & When to Call 911

Head injuries are common in toddlers learning to walk, climb, and explore. Most are minor, but young children cannot articulate symptoms, making vigilant observation critical.

🚨 CALL 911 / GO TO ER IMMEDIATELY IF:

• Loss of consciousness (even briefly) or inability to wake.
• Seizure or convulsions.
• Repeated vomiting (≥2 episodes).
• Clear or bloody fluid from nose/ears (CSF leak).
• Unequal pupil size.
• Weakness/numbness in limbs, unsteady gait.
• Severe/worsening headache (child holds head, cries inconsolably).
• Behavioral change: extreme irritability, lethargy, confusion, slurred speech.
• Large scalp hematoma (especially parietal/temporal) in child <2 years.
• Fall from >3 ft (or >5 stairs), car crash, high-impact mechanism.

⚠️ CONTACT PEDIATRICIAN TODAY IF:

• Single vomiting episode.
• Mild headache not improving with comfort measures.
• Increased sleepiness but arousable.
• Minor scalp swelling/bruise (apply cold pack).
• Any concern not listed above—trust your instinct.

🏠 HOME OBSERVATION (Minor Injury, No Red Flags)

• Wake checks: Every 2–3 hours for first 24 hrs (including overnight). Child should arouse normally, recognize you.
• Activity: Quiet play only. No roughhousing, sports, bike/scooter for 24–48 hrs.
• Pain: Acetaminophen (Tylenol) per weight. Avoid ibuprofen (Advil/Motrin) and aspirin for 24–48 hrs (theoretical bleeding risk).
• Hydration: Small, frequent sips of water/electrolyte solution.
• Cold pack: 15 min on/off for swelling (wrap in cloth).

📋 RETURN PRECAUTIONS (Next 48–72 hrs)

Return to ER if any red flag appears, or if child "just isn't right." Post-concussive symptoms (irritability, sleep disruption, appetite change, regression) can emerge days later.

Prevention

• Window guards, stair gates, furniture anchors.
• Helmets for wheels (trikes, scooters, balance bikes).
• Supervision on playgrounds, changing tables, beds.

When in doubt, have them checked. No one ever regretted a precautionary ER visit for a toddler's head.