Baby Concussion

A concussion is an internal injury to the brain where no external injury occurred. Because a child’s body is so much smaller, the effects of a concussion are more severe.

A fall, hard bump to the head, tossing onto a mattress or rough shaking can injure the brain and change the way it works. Problems balancing, vision issues and remembering simple directions or loss of consciousness may occur following the event. In most cases, these effects are temporary lasting only a few minutes. You need to know what the symptoms for baby concussion are and how you should respond.

Symptoms of Baby Concussion

Infants, toddlers and young children have a limited ability to tell you how they feel. It’s important to recognize the following clues that indicate an invisible injury occurred:

• Loss of consciousness
• Unusual fuzziness where nothing you do solves the problem
• Disinterest in favorite toys or games
• Confusion – sometimes assumed to be stubborn rebellion, when it is unusual behavior it may be that the child is unable to figure out what you are saying or want him/her to do
• Dazed – looks at you and surroundings with a blank expression
• Tires much more easily than normal, wants to lie down at inappropriate times or places
• Dizziness – may appear as loss of balance when sitting, walking or standing
• Odd lack of coordination – unable to hold toys, tips cups over when reaching to grab them, inability to go forward or backward
• Changes in eating and sleeping – any unusual changes for no apparent reason that cannot be resolved normally
• Abnormally slow responses to games, directions, questions and sounds
• Changes in behavior of any kind that is unusual
• Repeated vomiting – when he is not sick

When Should I Call 911?

Immediately call 911 any time that your baby or toddler bumps his head, falls or is shaken even in play if he/she:

• Loses consciousness
• Begins twitching or jerking
• Appears not to recognize you or his toys
• Will not wake up after a nap
• Vomits more for no apparent reason
• Complains of a tingling or tickly feel in arms or legs
• Remains groggy, listless or confused for more than 15 - 20-minutes
• Sounds or acts like he is drunk, slurring speech, wobbly walk, tilts over in chair
• Spontaneous fluid appears from nose or ears

Notes and Warnings

• If immediate symptoms of concussion disappear only to reappear over the next several days, it is essential to have your pediatrician check out your child.
• If any of these symptoms continue after the first day of recovery, report it to your pediatrician immediately.

Concussions can have long-term effects on cognitive abilities. Take a concussion seriously at all times.

How to Diagnose Baby Concussion

When young children are involved, diagnosing a concussion involves gathering the facts from the parents and doing a physical exam. The doctor will test reflexes and responses, balance and coordination as well as eyes and breathing. The child’s range of motion in the head and neck as well as eye movement will be noted. Combining all the response tests, reflex actions and range of motion with the child’s history and the details of the immediate event will help the doctor determine if a concussion has occurred.

There is no test for concussion. CT scans and MRIs are unable to “see” a concussion but it does show if there is any bleeding in the brain. A physician may recommend a CT scan if the following symptoms are present:

• Loss of consciousness lasted more than 5 minutes
• Repeated vomiting following event
• Twitching or seizure type movements
• Fall occurred from a relatively high point - chair, couch or crib
• Hit by a fast moving object – a hard toy or ball
• Infants with any signs of injury to the head or skull area
• Neurological symptoms showing up during exam

How to Recover from Concussion

It can take 3 days to as much as 3 weeks for a toddler or infant to recover from a concussion according to the American Academy of Pediatrics. The length of time depends on the severity of the concussion.

According the report in the Journal of American Academy of Pediatrics [January 2014], recovery is hindered by unlimited physical and mental activity. For a small child, activities such as playing with toys, watching television, listening to music, coloring or reading/being read a book should be minimal to moderate. Engaging in any of these activities for 5 – 10 minutes is the maximum for any individual activity.

In the first 3 – 5 days, as much activity as possible should be avoided. For many parents, this means removing the child from the day care or any interaction with other children to avoid the possibility of additional injury. During this period, pay attention to any continuing or new symptoms that may develop. It is not unusual for additional symptoms to show up as much as two weeks after the event.

Always return for the follow-up visit. Just because there are no remaining symptoms of the concussion does not mean that the reflexes or responses are back to normal. Some symptoms are only detected by trained healthcare providers.

How to Prevent Baby Concussion

The following concussion prevention tips come from the Brain Injury Association of Arizona.

• Use the correct car safety seat for your child
• Make sure that outside play surfaces are covered by rubber or other cushioning materials
• Insist that your child wear a helmet when riding on anything with wheels and for all sports
• Reduce any chances that your infant/ toddler might fall