Baby or Toddler Fell Down the Stairs
The short answer
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.
By Age
What to expect by age
Babies who fall down stairs are at higher risk for serious injury because they cannot protect themselves during a fall. Their heads are proportionally larger, making head injuries more likely. After any stair fall in a baby under 1: check for responsiveness, movement of all limbs, and visible injuries. If your baby cried immediately and seems normal, still watch closely for 24 hours for vomiting, excessive sleepiness, change in feeding, or unusual behavior. Babies under 3 months who fall should be evaluated by a doctor regardless of how they appear, as signs of head injury can be subtle.
Toddlers fall down stairs frequently as they learn to navigate them independently. Most falls from a few stairs result in bumps and bruises. After a fall: comfort your child, check for bumps, bruising, swelling, and ability to move all limbs. Apply ice to bumps. Watch for these red flags over the next 24-48 hours: vomiting more than once, excessive sleepiness or difficulty waking, unsteady walking (beyond what is normal for their age), crossing eyes or unequal pupils, clear fluid from nose or ears, and personality changes. If any of these occur, seek medical care immediately.
What Should You Do?
When to take action
- Your child cried immediately after the fall and was consolable within a few minutes
- A small bump or bruise on the forehead (the forehead is designed to take impacts)
- Your child returned to normal activity shortly after the fall
- The fall was from a small number of stairs (2-3 steps)
- Your child fell from more than 3-4 stairs
- There is significant swelling or a large bump
- You want reassurance after any stair fall
- Your child is limping or not using an arm or leg normally after the fall
- Loss of consciousness, even briefly
- Vomiting more than once after the fall
- Excessive sleepiness or difficulty waking your child
- Seizure after the fall
- Clear fluid leaking from the nose or ears
- Unequal pupil sizes or crossed eyes
- Not moving an arm or leg, or crying when a body part is touched (possible fracture)
- A baby under 3 months who has fallen from any height
- A fall from a full flight of stairs
Sources
Related Resources
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.
Signs of a Concussion in Baby or Toddler
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.
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.
I'm Worried About Lazy Eye (Amblyopia)
Amblyopia (lazy eye) is the most common cause of vision loss in children, affecting about 2-3% of kids. It occurs when one eye develops weaker vision because the brain favors the other eye. The tricky part is that amblyopia often has no obvious outward signs - the eye usually looks normal. Early detection through routine vision screening is critical because treatment is most effective in the first few years of life.
Anaphylaxis Signs in Baby
Anaphylaxis is a severe, potentially life-threatening allergic reaction that affects multiple body systems. In babies, it can be caused by food (most commonly), insect stings, or medications. Signs include widespread hives, facial or throat swelling, difficulty breathing, persistent vomiting, and becoming limp or unresponsive. Anaphylaxis is a medical emergency. If you suspect anaphylaxis, use an epinephrine auto-injector if available and call 911 immediately. Early recognition and rapid treatment lead to excellent outcomes in the vast majority of cases.