Help! My Baby Fell Down – (Bed, Couch, Etc ..)

When your baby falls off of anything – a bed, a couch, a high chair, or a changing table – it can be scary. You should always immediately check for injuries, especially if he landed on his head or back.

Of course, your baby will cry. What you need to be able to do is discern whether that cry means he got scared or if he’s hurt. You should be able to comfort your child while checking for injuries simultaneously, so he knows you care, and so that you know what action to take next.

You should also know how to prevent injuries from happening in the first place, so they are less likely to happen.

With the proper measures in place to avoid them – when they do occur, they happen to a lesser degree of seriousness.

Check For Injury

Check to make sure your child doesn’t have any serious injuries like broken bones, concussions, internal damage, or a head injury like a skull fracture.

While falls are dangerous, baby and toddler bones are softer than adult bones, so they don’t fracture as easily as adults, or even older children.

If your baby looks normal and seems to act fine after he calms down, the fall probably didn’t cause any severe trauma. Keep an eye on them throughout the rest of the day and the next twenty-two hours to make sure nothing abnormal develops.

Always err on the side of caution if you feel like the child got hurt. If you are uncomfortable with how far he fell or how he landed, take him to the doctor, especially if your child begins to act irritable or confused.

You shouldn’t need to keep your child awake after he falls, but with regular activity, it’s easier to tell how he’s acting and if it’s all normal.

If at any point you feel like your child is acting strangely, or you start to feel nervous about what happened, seek medical attention straight away – even if it’s just so you can feel a bit more reassured about it all.

Note from Dr. Leah Alexander, M.D., F.A.A.P.:”The following is a patient-friendly link from Cleveland Clinic Hospital that you may want to look at for more general information.

It includes quotes from the Center for Disease Control, and is a nice overview of what parents should look for and when to be concerned.

In clinical practice, I am asked by parents about what to do when their infant falls very frequently.

I typically advise them the first infant/toddler reaction should be to immediately
scream and/or cry. Contrary to what most parents think, crying is a GOOD sign.

Crying immediately means that the baby is intact neurologically, and the impact of the fall is minor. In addition to this initial reaction, the baby is also easily consoled after the fall.

On the contrary, if the infant is initially quiet, seems dazed, is sleepy, or is less interactive after the fall, this is very concerning, warranting immediate medical attention.

The University of Michigan Hospital has a good article on the difference in head injuries in infants and toddlers from those of older children.

I also inform parents that the height or distance of the fall makes a difference in whether or not there is a serious injury.

My usual guideline is that anything under five feet usually results in little or no injury, just a very upset baby.

Most common falls (from the bed, changing table, sofa, etc) are at lower heights than this and, in most cases, the baby is fine.

When to Go to the Emergency Room

If your baby shows signs of any of the following symptoms after he falls, you should seek medical care immediately. Call 911 or get to the nearest emergency room as soon as you can.

If your child seems to lose consciousness and isn’t breathing, administer CPR while someone else calls 911. Administer infant CPR if your child is younger than twelve months, or administer CPR if your child is twelve months old or older.

If no one else is with you, administer CPR for two minutes before calling 911 yourself – this can make all the difference sometimes in more severe cases.

If your child is bleeding excessively, you are unable to stop the bleeding with pressure, or your child has a seizure after falling, seek medical attention immediately to prevent further blood loss or brain damage.

If your child is unresponsive but is still breathing, call 911.

If your child is unconscious after the fall, or you are unable to wake him after sleeping, it’s important to seek medical attention right away. This could be a sign of a severe internal injury like a concussion.

Watch For Any Symptoms

There are symptoms to watch for if your baby experiences a fall. They are prone to several different injuries depending on how far they fell or how they landed.

If you notice any of these symptoms, you need to take him to the emergency room or call 911.

1) Any visible deformity, like an arm or leg, positioned awkwardly, or a joint that seems to be out of alignment could be a sign of a broken bone.

Note from Dr. Leah Alexander, M.D., F.A.A.P:”A note should be made here about limping or dragging the leg.

Most 9-12 month olds can crawl, cruise, or walk, and asymmetry of movement during these activities can indicate a sign of serious injury.”

2) Protrusions or unusual popping sounds also indicate that something could be broken, especially if your child seems to be favoring it or avoiding the use of it altogether.

3) If your child has a soft or swollen area on his head, especially on the side either above or behind his ear, this could be a sign of a skull fracture. Other symptoms include blood in the whites of his eyes or pink fluid and blood draining from the ears or nose.

4) Signs of a concussion include persistent vomiting and excessive sleepiness. If your child is old enough to crawl or walk, look for changes in his crawling or walking patterns to determine if something is wrong. If your child can speak, pay attention when he communicates that he is dizzy, has a headache, looks weak or confused, or has problems with vision, speech, and motor skills.

5) Look out for a potential brain injury if you notice changes in pupil size or unusual eye movements. Prolonged crying and screaming could help you identify an internal injury like bleeding or organ damage.

You know your baby better than anyone, so you’ll be able to tell if something isn’t right, and whether the cry means he’s in pain or simply scared.

Listen to your instincts and do what you feel is right for you and your baby – as we always say, better safe than sorry!

How to Treat Minor Injuries at Home

These types of falls happen in the blink of an eye, especially when a parent is exhausted or distracted.

It’s common after a fall to notice minor injuries that you can treat at home.

Goose eggs happen to babies who fall and kids who are learning to crawl, walk, skip, jump, or ride a bike.

Note from Dr. Leah Alexander, M.D., F.A.A.P:” These are typically seen on the forehead, and occur because of the proximity of scalp veins to the skin surface, causing a collection of blood called a hematoma.

They self-resolve over the course of a week.

Any such bump associated with mental status changes requires medical evaluation.”

These kinds of injuries might look scary or freak you out, but it doesn’t necessarily mean they hurt much after the initial incident.

Swelling of the head tends to protrude outward because the skull is just under the skin, so there’s nowhere for the swelling to go.

Wrap ice or a frozen bag of vegetables in a thin towel and put it on the bump as soon as you notice it. Leave it there for five minutes at a time, rotating it on and off for an hour.

Distracting your baby by nursing, feeding, or reading a book helps to keep their mind off of the pain and the ice that they may find annoying or uncomfortable.

If your baby acts like the bump is painful, check with your doctor first and administer the correct dose of pain medication like infant’s or children’s ibuprofen or acetaminophen.

Weight determines medication dosage, so you can generally calculate how much to give your child based on the chart on the back of the bottle – but if you feel better checking with a doctor first for reassurance, that’s obviously always the better option.

There are also medications you cannot give before a certain age, so be sure the medicine is safe for your child. It could cause further injury if you give the wrong medication or give it in the wrong amount.

Preventing Serious Injury Before or After a Bump on the Head

Getting hurt is a part of growing and learning. Bumps and bruises are normal, and, to an extent, you shouldn’t try to avoid the natural learning that comes from making mistakes.

As long as you supervise activities and make sure his play area is clear of stairs, sharp corners, and other dangerous items, his falls won’t cause any serious injury.

However, if he does fall, try to remain calm.

Rushing to comfort him immediately every time something happens wears you out, makes him overly cautious to experiment with new things, and teaches him that you can catch him or fix all of his problems.

He needs to learn to do things on his own and problem solve for the right solutions.

It is essential, though, to make sure that while you remain calm and don’t overreact, you still treat any injury appropriately and don’t end up neglecting it if it’s serious enough.

Falls are the most common cause of accidental injury in children, and a lot of these incidents are preventable.

1) Furniture Protection

While these things happen, you should still do what you can to prevent it.

Put corner guards on sharp furniture like coffee tables and other pieces that are low enough to the ground that your child can reach them easily.

Note from Dr. Leah Alexander, M.D., F.A.A.P:” A few examples of dangerous furniture are glass coffee tables and unsecured shelves or televisions.

Injuries from heavy furniture toppling onto an infant have been reported and often resulted in lawsuits.

Here is a Consumer Reports article that discusses this and the products that can cause injuries to infants.

You can also put dangerous furniture away until your child is old enough to walk steadily by himself.

Always watch your child vigilantly once he can climb on furniture or stairs.

Keep stairs gated, as mentioned, and make sure you’re there to act quickly if he pulls up on furniture and promptly falls.

2) Rug Pads

Make sure rugs have pads underneath to make them skid-proof. That way your child won’t slip while walking on it.

You can also put rugs away until your child is old enough to know how to walk on them.

Always use a non-slip mat in the bathtub to keep your child from sliding when he’s big enough to take baths.

3) Blocking Elevated Surfaces

Try to keep your baby in flat areas away from porches, decks, or stairs where they could fall.

Use baby gates at the top and bottom of stairs to keep them from trying to climb up or down.

Mesh baby gates work the best because they can’t accidentally pinch their fingers and you can fit it to any size opening. You can move it around the house as needed, depending on where you’re playing.

4) Strapping In

If you use a diaper changing table, make sure you use the straps to ensure your baby doesn’t roll or wiggle off of the table.

If you have an extraordinarily active baby, this can also help you change him more efficiently, because he won’t roll while you’re trying to clean him, apply diaper rash cream, or put the new diaper on.

Don’t leave your child unattended on the table, even if it’s only for a few seconds to throw the diaper away.

Note from Dr. Leah Alexander, M.D., F.A.A.P:” There is a product that allows the parent to keep a hand on the baby while applying diaper rash cream.

I’m not trying to promote a product and I have no monetary interest in it, but the Swipensnap applicator allows one to extract and apply the cream with one hand.

5) De-Cluttering Floors

Keep yourself safe as well, by making sure the floors and stairs are unobstructed by items that could cause you to trip while holding your baby.

If it’s helpful, create a safe space in every room and at the bottom of the stairs for toys and other baby items, so it’s easy to de-clutter every time your baby is done playing with.

Note from Dr. Leah Alexander, M.D., F.A.A.P:” Remove small objects that an older infant or toddler can “move into position” for climbing onto furniture or other

For example, small stools can become unexpected “ladders” that result in the infant making his/her way to a shelf and falling off.”

6) Crib Mattresses

Lower the mattress in your child’s crib as soon as he’s able to pull up or stand.

This will keep him from climbing out, or make it harder for him to hurt himself while trying to climb out.

7) Shopping Carts

At the grocery store, make sure you buckle your child into the seat of the shopping cart and don’t walk away from the cart, even if it’s only for a few moments to grab an item off of the opposite shelf.

Keep your child strapped into his stroller on walks and to his high chair while eating.

8) Protecting Windows

Pull furniture away from windows so your child can’t climb up and get access to an open window.

Make sure you use window guards so your child can’t open the window and fall out, and don’t rely on screens because they’re not designed to keep children from falling through.

Never, under any circumstances, put your baby on top of a bed, couch, chair, or the changing table alone, even for a second.

Even if your baby is not yet rolling, kicking feet and waving arms could cause your baby to scoot.

There’s also a first time for everything, and it often happens when you least expect it. The first time they roll could be the first time you leave them alone on an elevated surface.

Wrapping It Up

When in doubt, be cautious.

Take your baby to the doctor or emergency room for a thorough examination if you’re nervous or uncomfortable.

Stay calm, and most importantly, don’t blame yourself. Babies fall, and chances are, he’ll be just fine.

Reacting, but not overreacting, quickly could save his life.

Watching your baby and doing what you can to reduce his risk of falling can help you prevent further injury.

It’s always better to childproof sooner rather than later, but if you begin noticing some new milestones like crawling or walking, prepare for those immediately.

If your baby falls, keep watching for at least twenty-four hours to ensure he’s recovering correctly and that he’s not displaying any delayed symptoms or effects.

Engage in fall prevention, and you will likely never have to worry about it.

Educate yourself on what to do in the event of a fall, and even if it happens, everyone will be safe and happy.

Note from Dr. Leah Alexander, M.D., F.A.A.P:”Although much of this article is in regards to head injuries, it is also important to discuss falls/injuries due to the use of an infant walker.

Despite years of recommendations against infant walker use, many parents or grandparents continue to use them today.

Unfortunately, I have seen a few cases of 2nd and 3rd degree burns from the infant getting away from the parent too quickly while in a walker, knocking off a hot iron or stove pot.

Also, falling down stairs while in a walker results in a femur fracture almost 100% of the time.

Here is what the AAP recommends about the use of walkers (it doesn’t).

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Medically Reviewed By: Leah Alexander, M.D., F.A.A.P.

Medically Reviewed By: Leah Alexander, M.D., F.A.A.P.

Leah Alexander, M.D. FAAP began practicing pediatrics at Elizabeth Pediatric Group of New Jersey in 2000. She has been an independently contracted pediatrician with Medical Doctors Associates at Pediatricare Associates of New Jersey since 2005. After graduating from Kalamazoo College and Michigan State University College of Human Medicine, she completed her pediatric residency at Overlook and Morristown Memorial Hospitals. She is board certified in General Pediatrics.

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