Child Hit Their Head: When to Worry, a Paramedic's Guide
by Jeremy Manke on May 21, 2026
Hi there. If you're here, it's because you care, and that's a good thing. As a firefighter, paramedic, and instructor, I know that seeing your child bump their head is scary. Let me walk you through what to do, calmly.
When to Call 911 or Go to the ER
- Seizure or convulsions
- Repeated vomiting
- Worsening headache
- Confusion, trouble waking
- Weakness or loss of movement
- Slurred speech
- One pupil larger than the other
What is a Concussion?
A concussion is a mild brain injury caused by a bump, blow, or jolt to the head. It can happen even without loss of consciousness. According to the CDC and the American Academy of Pediatrics, quick recognition and gentle monitoring are critical for your child's recovery and safety.
Does Age Change What I Watch For?
The red flags above apply at every age. What changes is how easily you can spot them, and how quickly I'd have someone else take a look.
Babies and infants
This is the group where I'd be most cautious. A baby can't tell you their head hurts, can't describe feeling dizzy, and can't say they feel off. You're left reading behavior instead of words.
Watch for a baby who won't settle no matter what you try, who is unusually sleepy or hard to rouse for a feed, who vomits more than once, who is feeding poorly, or who just is not acting like themselves. A soft spot that looks bulging is another reason to be seen right away.
With infants, I'd lean toward calling your pediatrician even for a fall that seems minor. Better to make a call you didn't need than to sit at home wondering.
Toddlers
Toddlers fall constantly, and the vast majority of those bumps are nothing. A toddler who cries hard, then settles within a few minutes and goes back to playing normally, is usually fine.
What matters is the pattern over the next day or two. Watch for a toddler who keeps vomiting, who seems confused or unsteady on their feet, who won't stop crying, or who is noticeably more sleepy than usual. The red flags above still apply.
Falls onto the back of the head
Parents ask about this one a lot, usually after a fall backward off a couch, a chair, or a step. What matters more than the location is the height of the fall, the surface they landed on, and how your child is acting afterward.
A goose egg on the back of the head looks dramatic and is usually just swelling under the skin. Swelling alone is not the emergency. The symptoms in the red flag list are.
Home Monitoring: What to Watch For
- Behavior changes, acting "off" or "not themselves"
- Dizziness or loss of balance
- Persistent headache
- Nausea or mild vomiting
- Sleepiness or trouble awakening
Symptoms can develop over 24 to 48 hours. Even if your child didn't pass out, stay vigilant.
Comforting Care at Home
- Let your child rest in a quiet, familiar space.
- Offer gentle reassurance and a cool pack for swelling.
- Watch closely for new or worsening symptoms.
- No need to wake your child every hour unless a doctor advises it.
- Do not let them return to sports or strenuous play until cleared by a professional.
Prevention Tips
- Supervise playtime, especially near hard surfaces or playgrounds.
- Encourage helmet use for biking, skateboarding, and contact sports.
- Childproof your home. Secure furniture and block sharp corners.
Get the Concussion Observation Checklist
This printable sheet helps you remember what to watch for and when to call for help.
FAQs
Does my child need to pass out to have a concussion?
No. Many kids with concussions never lose consciousness. Trust your instincts and watch for symptoms like confusion, headache, or mood changes. If your child loses consciousness more than once, have them evaluated immediately.
Can my child go to sleep after a head injury?
If your child is alert and acting normally before nap or bedtime, it's usually safe to let them sleep. Check in periodically for normal breathing and responsiveness. If they will not wake up or are hard to wake up, get help.
My toddler hit their head. When should I worry?
Worry if you see any of the red flags above: repeated vomiting, a worsening headache, confusion, trouble waking, weakness, slurred speech, unequal pupils, or a seizure. A toddler who cries, calms down, and goes back to playing normally is usually fine, but keep watching them for the next 24 to 48 hours.
My baby hit their head and seems fine. Should I still call someone?
With infants, I lean toward yes. Babies can't tell you how they feel, so you're reading behavior instead. A call to your pediatrician costs you a few minutes and answers the question.
How soon can my child return to sports?
After at least 1 to 2 days of rest, children need to be symptom-free at rest and during light activity before going back to sports, and only with a healthcare provider's clearance, per CDC HEADS UP guidance.
How long should I watch my child at home?
Monitor closely for 24 to 48 hours after the injury. Seek advice or evaluation if in doubt or if new symptoms emerge.
Trusted Resources
You're Not Alone
Remember, you're not alone on this. If you want more tools, take a look at our children's first aid kits, designed for exactly these moments.
About the Author: Jeremy Manke is a PA-certified paramedic, firefighter, Pennsylvania-certified EMS instructor, Stop the Bleed instructor, and certified pediatric CPR and First Aid instructor. He is the founder of The Life Safety Pro, where he teaches parents and childcare providers how to respond to childhood emergencies with confidence.
