What to Do If Your Infant Falls Off the Bed or Changing Table

Look for these signs of an infant head injury
Baby on changing table

You cover all the sharp edges on your furniture. You plug all the electrical sockets, latch all the drawers and block off the staircase. You’ve baby-proofed your house to the best of your ability.

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But, inevitably, the day will come when your child gets hurt.

For some parents, that day comes when they turn their back to grab a diaper and baby rolls right off the changing table. Or they’re carrying baby along with a load of laundry down the stairs and trip and fall.

In this gut-wrenching moment of panic, you might be inclined to immediately pick your baby up off the floor and rush to the emergency room. But take a moment to breathe and observe first.

Sometimes babies need emergency medical attention after falling, and sometimes they’re just fine. You, of course, want to be sure your baby gets the medical attention they need, but you also don’t want to put them through unnecessary stress – and rack up medical bills — from an unneeded ER visit.

Pediatrician Ei Ye Mon, MD, provides some advice to assist in your decision-making.

Babies and falls

This scenario happens more often than you might think. Falls are the leading cause of nonfatal injuries in kids, according to the Centers for Disease Control and Prevention. In children under age 1, falls account for over 50% of nonfatal injuries.

And most of the time, children are not severely injured. But infants under 12 months of age have more fragile skulls, which makes falls more risky for them, Dr. Ye Mon says.

“The younger they are, the more dangerous it is for a serious head injury, no matter the mechanism of the fall or how high it is,” she says.

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Is it an emergency?

It can be hard to tell whether infants have sustained an injury or are in pain, but there are a few key signs to look for.

Before picking up a child after a fall, check for obvious signs of head trauma, which would warrant an immediate call to 9-1-1 for emergency help. Those signs include:

  • Loss of consciousness.
  • Vomiting.
  • Discharge or blood coming out of the nose or ears.
  • Swelling of the soft spot.
  • Bruising or swelling along the head, or obvious skull fracture.

If any of these signs are present, avoid the urge to pick up your child and comfort them. “With head traumas, it’s possible that they’ve also injured their neck or spine, and you don’t want to possibly worsen the injury by moving them,” Dr. Ye Mon says.

A deformity anywhere on the body that looks like it could be a broken bone should also be treated as an emergency.

If the baby is having a seizure after a fall, gently roll them to their side before calling 9-1-1, she adds.

If the child is alert and crying (that’s a normal reaction for a startled baby, even when there is no injury), and there are no obvious signs of injury, gently pick them up and console them.

“If they don’t improve after you console them, then I would be concerned,” Dr. Ye Mon says.

Keep a close watch for the next 24 hours

Symptoms of an injury might not be obvious right away, so even if you don’t think emergency medical care is needed, keep a close eye on your baby’s behavior over the next 24 hours.

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“Usually, once you’ve passed that 24-hour mark, it’s safe to say that anything scary is less likely,” Dr. Ye Mon says.

Babies are likely to want to go to sleep after a fall, whether they have a concussion or not. Dr. Ye Mon says it isn’t necessary to try to keep them awake to monitor them, but you should try waking them every few hours to make sure they’re rousable. If they’re not, seek immediate medical care.

If you notice any behavior that is out of the ordinary – if your baby is more fussy than usual or inconsolable – that’s something that should be checked out by a doctor, too.

And, if you have other reasons to suspect that your baby is injured, trust your parental instincts.

“If parents have any concerns at all, it’s never wrong to have them evaluated by a doctor to be on the safer side, especially at that age,” Dr. Ye Mon says.

Prevention is key

You can’t talk about falls without talking about preventing them in the first place.

Dr. Ye Mon recommends that babies do not sleep in adult beds or on other elevated surfaces unattended – even if you think they aren’t rolling yet. It’s even smart to place car seats or bouncy seats on the floor instead of a chair or kinds of elevated furniture that they could potentially fall off of.

And as hard as it is, try not to multitask. Use both hands to carry a baby and ensure that their neck is always supported.

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