CALL 911

This is a life-threatening emergency. Call 911 immediately, then follow these steps while waiting for help.

Head Injury from a Fall

Content reviewed against published AAP, PECARN, CDC guidelines

Editorial policy

Last reviewed:

Babies and toddlers fall frequently — off beds, changing tables, stairs, and furniture. Most falls result in minor bumps, but head injuries can be serious. Babies under 1 are especially vulnerable because their skulls are thinner and their heads are proportionally larger. Knowing which symptoms require emergency care versus observation at home is critical.

Immediate actions

  • Call 911 immediately
  • Pick up baby and assess — check for responsiveness, breathing, and visible injuries
  • DO NOT: Do NOT pick baby up roughly or shake them after a fall

Step-by-Step Response

1

Stay calm and assess

Pick baby up gently. Check for responsiveness (are they alert? crying?). Look for obvious injuries: bleeding, swelling, deformity. A baby who cries immediately after a fall is usually a good sign.

2

Check for emergency signs

Call 911 immediately if: baby is unresponsive, having a seizure, bleeding heavily from ears/nose, has clear fluid from ears/nose, has unequal pupils, or is not moving a limb.

3

Control bleeding

Scalp wounds bleed a lot due to rich blood supply — this does not necessarily mean the injury is severe. Apply firm pressure with a clean cloth for 10 minutes. If bleeding does not stop, go to ER.

4

Apply cold compress

For bumps and swelling ("goose eggs"), apply a cold compress wrapped in a cloth for 20 minutes on, 20 minutes off. A large bump does not necessarily mean a serious injury.

5

Monitor closely

Watch baby for 24-48 hours after a head injury. Check on sleeping baby every 2-3 hours for the first night (wake briefly to ensure responsiveness). Observe for: vomiting, unusual sleepiness, irritability, unsteady movement.

6

Assess height of fall

Falls from less than 3 feet (like a couch) onto carpet rarely cause serious injury. Falls from 3+ feet, onto hard surfaces, or involving stairs are higher risk. Falls from significant height always warrant medical evaluation.

7

Watch for delayed symptoms

Some brain injuries show symptoms hours later. Watch for: increasing sleepiness, repeated vomiting (more than once), worsening headache (inconsolable crying), confusion, walking unevenly, one pupil larger than the other.

8

Document the fall

Note: time of fall, height, surface landed on, which part of head hit, baby's immediate reaction, and any symptoms observed. This information helps doctors make decisions.

What NOT to Do

  • ✕Do NOT pick baby up roughly or shake them after a fall
  • ✕Do NOT apply ice directly to skin — always wrap in a cloth
  • ✕Do NOT give baby aspirin or ibuprofen for a head injury — use acetaminophen only if needed
  • ✕Do NOT assume baby is fine just because they cried immediately (crying is actually a good sign)
  • ✕Do NOT let baby go to sleep right away — monitor alertness for 1-2 hours
  • ✕Do NOT ignore vomiting after a head injury — one episode may be normal, but repeated vomiting is concerning

When to Seek Help

Call 911 if:

  • Baby is unresponsive or very difficult to rouse
  • Baby is having a seizure after the fall
  • Clear or bloody fluid coming from ears or nose
  • Baby is not moving an arm or leg after the fall
  • Heavy bleeding that does not stop with 10 minutes of pressure
  • Baby fell from a significant height (over 5 feet) or onto a hard surface like concrete
  • Baby has a visible skull deformity or depression
  • Pupils are different sizes

Go to ER if:

  • Loss of consciousness, even briefly
  • Vomiting more than once after the fall
  • Baby is excessively sleepy or difficult to wake
  • Baby under 6 months with any significant head bump
  • Fall from over 3 feet onto a hard surface
  • Visible swelling that is getting rapidly larger
  • Baby is inconsolable for more than 30 minutes
  • Any change in behavior that worries you — trust your instincts
  • Baby is not using an arm/leg normally after the fall
  • Bruising behind the ears or around the eyes (late signs of skull fracture)

Call your doctor if:

  • Baby fell and hit their head but seems normal — for guidance on monitoring
  • Single episode of vomiting after a fall (common, usually benign)
  • Baby has a large bump (goose egg) but is otherwise acting normally
  • You are unsure whether the fall warrants an ER visit
  • Baby is more fussy than usual after a fall but otherwise eating and alert
  • The fall was from a height of 3+ feet

Age-Specific Guidance

0-6 months

Falls from changing tables and beds are most common at this age. Babies at this age have soft skulls and open fontanelles, which provide some protection but also mean injuries can be harder to detect. Any significant head impact in this age group should be evaluated by a doctor.

6-12 months

As babies become mobile (rolling, crawling, pulling up), falls increase. Common falls: rolling off beds, pulling up and falling backward, toppling while learning to stand. The skull is still relatively soft and the head is proportionally large.

1-3 years

Toddlers fall constantly while learning to walk and climb. Most falls from standing height are minor. Concern increases with falls from furniture, stairs (more than 3 steps), or heights over 3 feet. Head injuries from running into objects are also common.

Prevention

  • Never leave baby unattended on elevated surfaces (changing table, bed, couch)
  • Always use safety straps on changing tables, high chairs, and strollers
  • Install baby gates at the top AND bottom of stairs
  • Use window guards on windows above the first floor
  • Keep crib mattress at lowest setting once baby can pull to stand
  • Remove bumbo seats and similar devices from elevated surfaces
  • Pad sharp furniture corners in play areas
  • Ensure baby walkers are not used — AAP recommends against them due to fall risk
  • Supervise climbing toddlers constantly — they climb before they can safely descend

Frequently asked questions

Should I call 911 for head injury from a fall?
Yes. Baby is unresponsive or very difficult to rouse
What should I do first?
Pick up baby and assess — check for responsiveness, breathing, and visible injuries. Call 911 if baby is unresponsive, having a seizure, or bleeding heavily from the head. Apply gentle pressure with a clean cloth to any bleeding scalp wound. Apply a cold compress (ice wrapped in cloth) to any bump for 20 minutes. Watch baby closely for the next 24-48 hours for concerning symptoms. Do NOT let baby go to sleep immediately — observe for at least 1-2 hours first
What should I NOT do?
Do NOT pick baby up roughly or shake them after a fall. Do NOT apply ice directly to skin — always wrap in a cloth. Do NOT give baby aspirin or ibuprofen for a head injury — use acetaminophen only if needed. Do NOT assume baby is fine just because they cried immediately (crying is actually a good sign). Do NOT let baby go to sleep right away — monitor alertness for 1-2 hours. Do NOT ignore vomiting after a head injury — one episode may be normal, but repeated vomiting is concerning
How can I prevent this?
Never leave baby unattended on elevated surfaces (changing table, bed, couch). Always use safety straps on changing tables, high chairs, and strollers. Install baby gates at the top AND bottom of stairs

Sources

AAPPECARNCDC

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Emergency Guides

seizure responsecpr infantcut laceration

Bottom line

This is a serious emergency. Always call 911 first, then follow the steps above while help is on the way.

You are doing the right thing by learning what to do in an emergency. Being prepared is one of the best things you can do for your child.