Falls, Cuts and Bruises

by Audrey Paul, MD, PhD, FACEP , Karen Goodman, MD, and Catherine Verow, MS, CCLS

Generally, cuts that are small with easily controlled bleeding can be managed by your pediatrician. Falls with head injuries and bruising should be seen by your pediatrician and, in a newborn, will require a visit to the ER.

Falls from any height can be more serious for younger babies whose bones and skulls are not as well formed. Any falls with head injuries and/or bruising should be seen by your pediatrician and, in a newborn, require a visit to the ER. After a fall you should immediately call your pediatrician who will likely refer you to the emergency room for further testing. This may include x-rays and other computer-assisted imaging (such as CT scans).

If your baby has a cut and is bleeding, the first thing you should do is apply direct pressure to stop the bleeding and then clean the cut with water. After applying direct pressure to the wound, you should call your pediatrician to determine whether stitches may be needed.

Nosebleeds or bleeding that does not stop easily can be a sign of a bleeding disorder or infection.

Because newborns are not mobile, bruising is fairly unusual. Some babies have birthmarks; these should not be confused with bruises. If you do see bruising on a baby (and are uncertain whether this is a birthmark) the baby should be examined to rule out other causes, including possible issues involving blood clotting.

Conclusion: If your baby exhibits any changes or symptoms that appear severe or life threatening, go to the closest ER immediately. If your newborn does not appear to be in immediate distress, but something still does not feel right to you, trust your instincts! Call your pediatrician. An ER visit may or may not be necessary, or your pediatrician may recommend that you go to a pediatric ER. When speaking to your pediatrician, ask if your ER is staffed with pediatric emergency medicine physicians 24/7, since pediatric emergency physicians are often more comfortable managing pediatric emergencies especially in newborns.

Ultimately, you are your baby’s best advocate, and you know your baby best. If you have any questions trust your instincts and always call your pediatrician. In an emergency, if you do go directly to the ER, you should contact your pediatrician. Your pediatrician can be helpful not only medically (by providing information to the hospital staff) but also emotionally. Your doctor knows you and your baby and can help you deal with a stressful situation. Remember, newborns show symptoms and signs of illness differently than older children, so staying attuned of and being aware of the best expertise and being prepared for the places to go for any potential newborn emergency can be life saving!

The preceding information is intended to empower and inform your decisions. Its development was funded in part of a generous grant from R Baby Foundation.

The R Baby Foundation seeks to save the lives of newborn babies by educating parents, supporting research, and providing emergency room equipment and training to medical professionals.