You know that baby-proofing is important. You keep the crib empty — no pillows, blankets or crib bumpers. You said “Thanks but, no thanks,” when your in-laws offered you that old crib with the drop-down sides. You put your baby to sleep in a sleep sack on their back. You got this whole safe-sleep thing figured out.
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But even with all your best intentions, it still happens. Babies can get hurt.
One common scenario: You put your baby down on your bed. You turn your back just for ONE SECOND. And … ugh … nightmare. The baby fell off the bed and hit their head. Or you put them on the changing table, reached for a diaper and they rolled off.
“It’s very common that babies fall from high surfaces, like beds, couches and changing tables,” says pediatrician Laura O’Connor, MD. “Even babies who don’t know how to purposefully roll yet can spontaneously, reflexively, roll over when you least expect it.”
In a gut-wrenching moment of panic, your first thought maybe to immediately scoop your baby off the floor and rush to the emergency room.
But, first. Take a deep breath. Babies are more resilient than you think, and they may just need a little time and observation before you make a harried rush to the pediatrician.
Sometimes babies need emergency medical attention after falling, and sometimes they’re just fine. Of course, you want to be sure your baby gets the medical attention they need, but you also don’t want to put them (and you!) through unnecessary stress — and an inevitable bill — from an ER visit if you don’t need to.
Dr. O’Connor helps explain what to look for after your baby hits their head so you can make a decision about what comes next.
What to look for when baby falls on the floor
Elevated surfaces and babies make for a bad combination. Babies fall off beds, changing tables and couches more often than you might think.
Falls are one of the leading causes of nonfatal injuries in kids, according to the Centers for Disease Control and Prevention (CDC).
Even very young babies can fall. No worse time to hit that “rolling over” milestone than when perched on a high bed.
Most of the time, babies aren’t severely injured after falling off a bed, but it can happen.
“The good news is that babies’ skulls are very resilient,” Dr. O’Connor says. “They have an open fontanel (soft spot) that allows for a lot of movement. It’s pretty rare to have any significant injury from a baby falling off a bed, but you don’t want to brush off signs of something serious.”
It can be hard to tell whether your baby has sustained an injury or is in pain when they can’t talk. But there are a few key signs to look for. Some are red flags to get emergency attention. Others warrant a call to the doctor but not necessarily in a rush. And sometimes, you can just move on with your life with a slightly more watchful eye.
Dr. O’Connor explains the difference.
Before picking up your baby after a fall, check for obvious signs of trauma. Dr. O’Connor says these signs warrant an immediate call to 9-1-1 for emergency help:
- Loss of consciousness.
- Discharge or blood coming out of the nose, ears or eyes.
- Uncontrolled bleeding.
- Swelling of the soft spot.
- Bruising or swelling along the head, or obvious skull fracture.
- Signs of any broken bones.
- Baby is inconsolable.
If your baby is showing signs of a major injury, as hard as it may be, you want to avoid the urge to them up to 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. O’Connor says.
If your baby is having a seizure after a fall, gently roll them to their side before calling 9-1-1.
A baby who is alert and crying after a tumble is a normal reaction. Falling is scary, even if they’re not injured. If you don’t see any signs of a traumatic injury, gently pick them up and console them.
“If they don’t improve with a few minutes of comfort from you, I would suggest getting quick medical attention,” Dr. O’Connor 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 an extra-close eye on your baby’s behavior over the next day. What you’re looking for is anything that’s out of the ordinary for your child. That might include things like:
- Abnormal eye movements.
- Increased sleepiness or fussiness.
You’ve probably already heard that if you suspect a concussion, you should keep your baby awake. But that’s not necessary. An overtired baby is going to act more sleepy, fussy and irritated than usual. Keeping your baby awake for a long time could cause them to seem as if something is wrong when really they’re just sleepy, Dr. O’Connor explains.
While they’re sleeping, though, you may try gently waking them after a few hours to make sure they’re rousable. If your baby isn’t responding to you when you try to wake them or if they seem lethargic or extra fussy or sleepy, it’s worth a call to your healthcare provider.
In general, Dr. O’Connor says that any behavior out of the ordinary should be checked out by a provider just to be safe. If you have reason to suspect that your baby is injured, trust your instincts. You know your baby and what’s normal for them better than anyone.
“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 a young age,” Dr. O’Connor says. “Even if it turns out to be fine, it can be good for parents’ peace of mind if nothing else.”
How to prevent baby falls
You can’t talk about falls without talking about preventing them in the first place. (Not trying to harp on you here. Accidents happen, and we know you’re doing your best!)
For good measure, though, Dr. O’Connor reminds us that babies should not be left on adult beds or on other elevated surfaces unattended — even if you think they aren’t rolling yet.
The CDC also recommends this advice to keep you child safe from falls:
- Keep your crib and other furniture away from windows to help prevent window falls.
- Always strap your child in to their high chairs, infant carriers, swings and strollers and supervise them.
- Place car seats or bouncy seats on the floor instead of a chair or kinds of elevated furniture.
- Use a stationary activity center instead of a walker than can tip or fall down stairs.
- Use the safety belt in the shopping card, and don’t leave your child alone in a shopping cart.
- Don’t let kids play unsupervised on high porches, decks, stairs or balconies.
- Secure TVs and furniture to the wall using mounts, brackets, braces, anchors or wall straps to prevent tip-overs.
Accidents happen. Even with all your best parental attention, they just do. Don’t be too hard on yourself. Keep an eye on your baby after taking a fall, and see a healthcare provider if you’re worried about an injury.