Falls

 

My baby fell off the couch. What should I do?

Whenever your baby takes a serious tumble — from a couch, bed, highchair, crib, or countertop, for example — you'll need to do a thorough check for injuries, especially if he falls on his head or back.

You'll want to make sure that your baby doesn't have any serious wounds, that he hasn't broken any bones, and that he hasn't suffered a concussion or other internal damage. Falls can be serious, but because your baby's bones are soft, they don't fracture as easily as those of an older child.

If your baby looks okay to you and seems to be acting normally, chances are the fall didn't cause serious injury. Be thankful, but keep an eye on him. Continue to carefully observe your baby for the next 24 hours, especially if he bumped or fell on his head.

And err on the side of caution: If you're uncomfortable with the severity of your baby's fall — you think he had to have gotten hurt — or if your baby is acting irritable or confused, take him to the doctor to get checked out.

Call 911 if your baby experiences any of the following after a fall:

• A loss of consciousness. If your baby isn't breathing, have someone call 911 while you administer infant cardiopulmonary resuscitation (CPR) until help arrives. If you're alone, give your baby CPR for two minutes, then call 911 yourself.
• Bleeding that you're unable to stop with pressure.
• If your baby is breathing but not responsive — he's unconscious after the fall or you're unable to wake him up after he goes to sleep, for example.
• Take your baby to the emergency room or talk to his doctor immediately if you notice any of the following:
• Signs of a broken bone, including an obvious deformity, like a wrist that is bent awkwardly, or an arm or a leg that seems out of alignment.
• Signs of a possible skull fracture: A large, soft area on the scalp, especially on the side of the head (above or behind the ear); blood showing in the whites of his eyes; or pinkish fluid or blood draining from his nose or ears.
• Signs of a concussion, such as unusual eye movements or pupils that are unequal in size; persistent vomiting; or excessive sleepiness. Depending on your baby's age, look for a change in how he crawls or walks; weakness or confusion; or problems with speech, vision, or motor skills.
• Prolonged crying or screaming, which could indicate a possible internal injury.

What should I do if my baby develops a bump on his head?

"Goose eggs" on the head are common, especially in babies who are just learning to get around by themselves. Although a bump on the head can look scary, it doesn't necessarily mean that your baby is seriously hurt. When swelling occurs on the head, much of it protrudes outward because your baby's skull is just under the skin.

To help the bump go down, wrap an ice pack (or a bag of frozen peas, in a pinch) in a thin towel or diaper and hold it on the bump for 15 to 20 minutes. Nursing or feeding your baby during this time can help distract him from the chill and discomfort.

If you think that your baby is bothered by the bump, ask his doctor about giving him the appropriate dose of acetaminophen or ibuprofen. Never give your child aspirin, which can lead to a rare but serious condition called Reye's syndrome.

My baby has just started walking and falls a lot. How can I reduce his risk of serious injury?

When babies start to walk, they seem to take more stumbles than steps. Minor bumps and bruises are an unavoidable part of developing motor skills and independence. As long as your baby is under constant adult supervision and his play area is free of ungated stairs, sharp edges, and other hazards, most falls will not cause serious injury.

When your baby does take a tumble, try not to overreact. Rushing to your baby's side every time he stumbles will wear you out and make him overly cautious. If he's upset, calmly comfort him and encourage him to get back on his feet.

Still, falls are the number-one cause of accidental injury in children, and one in three of these accidents is preventable. So do what you can to keep your baby safe, including:

• Cushion sharp corners on furniture. Because they're low, coffee tables are common culprits in childhood bumps and bruises. You may want to pad the corners of your coffee table, or you may find it worthwhile to pack the table away until your child is a more confident walker.
• Put skidproof pads under all rugs. Or remove throw rugs until your baby is more sure-footed. And use a nonslip mat to keep your baby from sliding once you're bathing him in the big tub.
• Keep your baby away from elevated porches and decks, and place gates at the top and bottom of each staircase. (Choose a mesh gate rather than the accordion style, which can trap and pinch little fingers.)
• Be extra vigilant about holding your baby on the changing table. Some tables have straps that can help you keep your grip on a real wiggler, but they may not be enough to prevent a fall, so don't ever leave your baby on the table unattended.
• Keep the stairs in your home free of objects that you might trip over when you're carrying your baby.
• Lower your baby's mattress as soon as he starts standing up in his crib.
• When you're at the grocery store, buckle your baby into the shopping cart. And don't walk away from the cart, even for an instant. Also strap your baby into his stroller and his highchair.
• Keep a sharp eye on your baby at all times if he's started climbing on the furniture. You'll want to act quickly to keep him from falling.
• Use window guards on windows. Don't rely on screens, which aren't designed to keep a child from falling out.

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