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We baby-proof our houses. We make sure the floor is never wet, harmful things are out of reach of the little one, and the place is so clean that the baby gets nothing to put in his mouth. In short, we develop an invisible shell of protection around our babies. In spite of our best efforts, babies get hurt, they fall from their bed, they slip on the floor while crawling or they simply put their fingers in the door corners.
We cannot foresee all the situations, and some accidents are so unfathomable that you will be shocked even to imagine that such things happen at home. Injuries do happen, but if they are minor then it is just a momentary pain for the little one, but if they are major then it could spell a problem. A concussion is one such injury that could lead to developmental and growth problems in babies.
What Is A Concussion?Sponsored
Concussion is a head injury caused by a sudden jolt or blow to the head. The human brain is protected by the tough, bony skull from the outside and the cerebrospinal fluid from the inside. The skull provides protection from hard objects while the cerebrospinal fluid cushions the brain. However, when the head suffers a severe jolt or impact, it hurtles the brain with the inner side of the skull. The point of impact damages the neurons and blood vessels. This injury is called a concussion (1).
Concussion is a closed head injury, which means the skull does not show any marks, but the brain will get affected (2). A concussion disrupts the normal brain activity and can make the baby unconscious in severe cases. The Harvard Medical School grades concussion on three scales of severity, as below (3):
- Grade 1: The least severe form of concussion when the individual’s brain functions return to normal after 15 minutes
- Grade 2: When the brain malfunctions and the person is in a confused state for more than 15 minutes
- Grade 3: When the impact is so severe that the person becomes totally unconscious
As a concussion may be severe, you need to be alert and look out for the signs of concussion in a baby.
[ Read: Head Injuries In Babies ]
Signs Of Concussion In Babies
The signs are subtle and difficult to understand if the baby has had a concussion. Symptoms may not show immediately after the injury (4). However, you could look out for:
- Loss of consciousness: The baby could become unconscious or slip into semi-consciousness. This is due to the injury to the neurons that affects normal brain function.
- Dizziness or body balance issues: Baby loses balance when he walks. He could be unsteady while crawling and shows poor coordination in body movements.
- Dazed, confused, and slurred speech: The baby is unable to understand instructions and seems unresponsive. Older infants, who can talk will have trouble forming sentences and will not speak clearly.
- Abrupt loss of interest: The baby does not enjoy the toys, games, and activities. He is mostly calm and silent.
- Crying excessively: A concussion could be like a dull pain, making the baby cry and be irritable and cranky.
- Vomiting and nausea: The baby is unable to digest anything and throws up whatever he eats. If the infant is older, he may complain about feeling sick in the stomach.
- Sudden change in daily routine: There is a sudden change in eating, sleeping, and diaper soiling patterns as they happen at new or irregular times.
- Bleeding or fluid oozing from nose or ears: Blood from nose or ears indicates damaged blood vessels. If the baby does not have cold but has a clear fluid dripping from the nose, then it could be the cerebrospinal fluid, which is leaking through the skill and out through the nose.
- Seizures: It includes fits, convulsions, and episodes of loud crying with violent body movement.
- Stiffness or droopiness: The baby’s body seems stiff or droopy. His limbs could appear to be fixed or moving around involuntarily.
The above signs are referred to as post-concussion syndrome, which are the after-effects of a concussion. You must also keep an eye out for other probable signs such as a wound or bump on the head. An infant may also touch a part of his head repeatedly, especially while crying, indicating pain in that part.
[ Read: Baby Brain Development ]
What Causes A Concussion In Babies?
A variety of reasons causes concussions in infants as they have rudimentary reflexes and cannot protect themselves.
- Having a fall: A baby falling from the bed, having tripped on an object, or falling while hoping or running, could hurt himself and cry loudly. If the child is older, he will call out a parent. Check for bruises or lacerations as they could cause concussions. Babies can also fall from other high platforms like a windowsill or from a small chair or sofa.
A study by UNICEF found that falling from ground level accounted for 8% of fatal falls (5). The risk can increase substantially when an older infant makes an attempt to run, hop, or jump over an obstacle.
- When an object falls on the head: A baby could playfully yank the wire of a table lamp, or an older infant could shake a big object, making them fall on their head.
- Baby hits his head to an object: Babies can hit their head to an object while crawling or walking. For example, older infants who crawl at a faster pace may not notice objects in front of them or walk head-first into something.
- Vehicle accident: Babies are at a greater risk of head injuries in car crashes because their heads are larger in proportion to their bodies (6). Infants can also sustain a concussion due to a fall from a two-wheeler or when riding a tricycle or bicycle.
As you may have noticed, simple, everyday activities can be a cause for concussion in babies. The American Academy of Paediatrics recommends you take your baby to a doctor if there is any injury to the head.
[ Read: Common Newborn Baby Problems ]
How Is Concussion In Babies Diagnosed?
Only a medical practitioner can make a conclusive diagnosis and tell if the baby has a concussion. Here is how the condition is diagnosed:
1. Check for the physical signs:
- The doctor will check for external signs of brain trauma such as a bruise, wound, or swelling on the head. He will also look for any swelling in the fontanelles, the soft membranous tissue that connects the skull bones of an infant.
- Injured blood vessels rupture internally and bleed, which is seen on the skin as a blue-black patch.
- In severe concussions, the baby may develop blue or black skin discolorations around the eye.
- An unbalanced dilation of the pupils may occur, where one eye is permanently dilated while the other is normal. Both eyes may stay dilated with wide-open pupils that do not respond to light. The doctor checks the dilations and abnormalities.
2. Basic medical tests:
- Concussion can cause a malfunction in motor skills, and a doctor tests these skills to determine the damage.
- The doctor will conduct basic tests to discern if the baby’s vision and hearing are affected. She would check if the baby turns his head towards a sound or spots a moving object in peripheral vision.
- In case of older infants, the doctor will ask the infant to touch his nose, throw a ball, walk in a straight line, or something similar.
3. Imaging tests:
- If the test results are inconclusive or the symptoms of concussion are severe, then the doctor would conduct imaging tests to assess the skull.
- An x-ray is quite likely to be the first choice since it is quick and damage can be assessed easily.
- Scans such as CT and MRI can be conducted in extremely severe cases as they provide a three-dimensional image of the baby’s skull.
Once the doctor confirms the concussion, the treatment begins immediately.
[ Read: Neurofibromatosis In Babies ]
How Is Concussion In Babies Treated?
The treatment of concussion will depend on the extent of the injury. The treatment could include:
- Rest: Rest is the most important treatment since it is non-invasive, baby-safe, and also ideal for a non-open wounds condition such as concussion (7). The doctor will advise you to keep the baby away from vigorous physical activities involving his cognitive skills as the brain needs rest.
- Topical ointment: If the baby has a bruise or small wound at the point of impact, then the doctor will prescribe a topical ointment primarily to prevent infection and alleviate the pain.
Infants do not require any other treatment than rest and probably some medicinal creams to cure their concussion. Some home remedies for pain such as an ice pack can help the infant feel better, but do not force it on the baby if he dislikes the cold sensation.
What Are The Long Term Effects Of Concussion In Infants?
Concussions heal over time and do not necessarily cause any serious health problems. However, it is ideal to get a concussion checked by a medical professional to know the extent of damage. If left untreated, the concussion could lead to:
- Loss of developmental milestones: A baby may lose out his achieved milestones as the injury alters the brain’s motor skill ability. An infant may reach a milestone, only to forget it in a few days. You could observe a complete regression in his skills and abilities.
- Permanent problems while feeding or sleeping: The baby is unable to sleep or eat properly and has a changed regime. In severe cases of trauma, the infant may develop insomnia, which is an inability to fall asleep (8).
- Vertigo: Vertigo is the dizzy feeling that occurs in bouts or is triggered by a random stimulus. The condition can persist forever, returning in intervals of days or weeks. Vertigo caused by a concussion is referred to as post-traumatic vertigo (9).
- Pause in head circumference growth: Some cases of severe concussion pause the growth in the baby’s head circumference for a few weeks (10). The head growth resumes weeks later, but head growth could lag in comparison to the rest of the body.
- Poor concentration and cognitive disability: Older infants may have trouble picking up new words. They lose concentration even with activities they like. If the problem persists, then it may cause severe cognitive impairment and intellectual disabilities.
You can avoid both short and long-term problems by preventing concussions
[ Read: Epilepsy In Babies ]
How To Prevent Concussions In Babies?
You can mitigate the risk of concussions by keeping your baby safe at home. Here are a few precautions you can take:
- Baby-proof your house: Tie wires high above and remove elevated objects that can cause injury when they fall over the head. Cover all the sharp edges of furniture and remove items, such as a carpet or doormat that could trip the baby.
- Never leave an infant unattended: Babies tend to be fidgety and love to hold and move things and, therefore, must be under adult supervision. Older infants should also play under adult supervision, especially while playing with things such as a football or swing and slides.
- Get a crib for the baby: Babies must sleep in cribs that are specifically designed for their age. Do let your baby sleep alone on regular beds, as babies tend to roll off the edges.
- Get baby car seat: Buy an infant safety harness for your baby when traveling in a car, even for short distances. Choose safety harnesses certified by reputable agencies or organizations. Choose a five-point harness over a three-point one. A five-point harness straps the infant to the seat at five points viz. two shoulder points, two hip points, and one between the legs. The three point harness leaves out the two hip points. Babies should be latched facing the rear of the car as it prevents a sharp shock to the neck and head in case of forward collision.
Remember, never hesitate or delay taking your baby to a doctor in case you suspect a concussion. It is a good thing to get the baby medically checked if he just suffered a head impact. Some simple precautions are all you need to prevent infant concussion and keep the baby safe.
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