Signs of a Concussion in Baby or Toddler
The short answer
A concussion is a mild traumatic brain injury caused by a bump, blow, or jolt to the head. Babies and toddlers cannot tell you they have a headache or feel confused, so parents need to watch for behavioral signs. Concussion symptoms in young children include: excessive crying, change in eating or sleeping patterns, loss of interest in toys or activities, unsteadiness, vomiting, irritability, and loss of newly acquired skills. Most concussions resolve within 1-2 weeks. However, any head injury with loss of consciousness, repeated vomiting, or worsening symptoms needs immediate emergency evaluation.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
0-12 months
Signs of a concussion in a baby include: excessive or inconsolable crying after a head bump, vomiting (especially more than once), unusual sleepiness or difficulty waking for feeds, a bulging soft spot (fontanelle), change in feeding patterns, and appearing dazed or less responsive than usual. Babies cannot tell you their symptoms, so observe behavior changes carefully. After any head injury, watch your baby for 24-48 hours. If your baby seems normal, is feeding well, and is alert, close observation at home is usually sufficient. When in doubt, call your pediatrician.
1-3 years
Toddlers with a concussion may show: excessive crying after the injury, vomiting, crankiness or irritability beyond what is normal, loss of balance or unsteady walking, change in sleep patterns (sleeping more or having trouble sleeping), loss of interest in favorite toys or activities, and regression of recently learned skills. Older toddlers may say their head hurts or hold their head. After a head injury, monitor for 24-48 hours. Limit stimulating activities and screen time for a few days. Full recovery typically occurs within 1-2 weeks. If symptoms worsen or do not improve, see your pediatrician.
What Should You Do?
When to take action
- Crying after a head bump that settles within 15-20 minutes
- A bump or bruise on the forehead after a fall
- Your child returning to normal activity shortly after a minor head bump
- Your child vomited once after a head injury but seems otherwise fine
- Your child seems mildly different in behavior after a head bump (slightly more irritable or sleepy)
- You want guidance on how to monitor your child after a head injury
- Symptoms are mild but not fully resolved after a week
- Loss of consciousness (even briefly) after a head injury
- Vomiting more than once after a head injury
- Difficulty waking your child or excessive sleepiness
- Seizure after a head injury
- Clear fluid leaking from the nose or ears
- One pupil larger than the other
- Worsening headache, confusion, or irritability over the hours following the injury
- Any head injury in a baby under 3 months
- A fall from a significant height (more than 3-4 feet)
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Medical Concerns
Baby Fell Off the Bed or Couch
Falls from beds, couches, and changing tables are one of the most common accidents in infancy. Most falls from furniture height (2-3 feet) do not cause serious injury, but every fall involving the head deserves careful monitoring. If your baby cried immediately after the fall and is now acting normally - alert, feeding, and moving all limbs - serious injury is unlikely. However, certain warning signs require immediate medical evaluation.
Baby or Toddler Fell Down the Stairs
Falls down stairs are a common injury in babies and toddlers. Most stair falls, especially from just a few steps, do not result in serious injury. However, any fall down stairs warrants careful observation. After a fall, check your child from head to toe for signs of injury. If your child cried immediately, is consolable, is moving all limbs normally, and has no visible signs of serious injury, observe them closely for 24-48 hours. Any fall from a significant height, loss of consciousness, persistent vomiting, excessive sleepiness, or signs of a broken bone require immediate medical evaluation.
Signs of a Broken Bone or Fracture in Baby
Children's bones are more flexible than adults' and often bend or partially break (greenstick fracture) rather than snapping completely. Signs of a possible fracture include: swelling, deformity (the limb looks bent or crooked), inability or refusal to use the limb, severe pain when the area is touched, and a snapping or popping sound at the time of injury. If you suspect a broken bone, immobilize the area (do not try to straighten it), apply ice wrapped in a cloth, and take your child to the emergency room or urgent care for an X-ray.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.