Send Him Home?

[SilverSabre25]

17 month DCB is asleep in the middle of my kitchen floor right now. It's an hour until naptime and he's been acting tired for half an hour or so. He only naps 45 minutes (usually...he did sleep 2.5 hours yesterday...) and so I was trying to get him through lunch before putting him down.

He doesn't seem to have a fever. He has a stuffy nose, but not enough to keep him out of daycare even by my own sick policies (DD has had a cold, too, but again, not enough to keep her out either), and has seemed perfectly fine today. He did fall down the stairs a few hours ago (half a flight, wood) and he usually does fine on stairs, so that was really weird. I watched him carefully after the fall and he was just fine, not even a bump or bruise so I don't think the fall is the cause of this...

I'm wondering if I should call his mom to pick him up early today. He goes home between 4 and 4:30 anyway, so only four hours. I hate to call her because she's a single mom working at a minimum wage job. I'm also wondering if I should call her just to let her know what's going on and suggest making him a doctor's appointment. What do you think?

[Carole's Daycare]

You should call mom right away, so she has time to get him in to on-call Dr today. He may have an ear infection- they go hand in hand with congestion sometimes- and it may be affecting his equilibrium, hence the fall-. If he fell at all, whether you see bruises or not and is acting extra sleepy you should be waking him up and so on in case of concussion- and once again- call mom.

[kendallina]

Was he acting tired before he fell? If he was, then I probably wouldn't worry (especially since he was so tired yesterday too), but if he wasn't tired this morning or if you didn't notice, I would call mom right away and have her call the doctor and see what they say. I'm sure it's probably nothing serious, but anytime they fall and then are really tired that's a HUGE warning sign that something could be wrong. Good luck, hopefully everything's okay.

[My Daycare]

Check his eyes too. See if they change with light/dark (Dialate).

[SilverSabre25]

There's no concussion; I'm first aid trained and know what to look for and checked him out quite thoroughly after the fall. Concussions show up pretty quickly if there are problems and he was just fine, eyes normal, no puking, etc. He gets here at 9:30 and wakes up for the day at about 9, so he was not tired. He got tired at about 11:30 (more than an hour after he fell) and fell asleep at noon. I did move him to the pack n play and checked on him frequently throughout the nap. He woke up at 3 and is just fine! The nose is mostly unstuffed now too, interestingly. I tried to call his mom to give her a heads up but the numbers I have for her didn't work--and it's not such an emergency that I feel comfortable calling the dad (who is apparently quite the jerk and barely in the boy's life, doesn't even pay child support).

Will definitely be mentioning it to her at pick up and will be getting new numbers. He doesn't come again until Monday and does have a tendency for ear infections.

[nannyde]

There's no concussion; I'm first aid trained and know what to look for and checked him out quite thoroughly after the fall. Concussions show up pretty quickly if there are problems and he was just fine, eyes normal, no puking, etc. He gets here at 9:30 and wakes up for the day at about 9, so he was not tired. He got tired at about 11:30 (more than an hour after he fell) and fell asleep at noon. I did move him to the pack n play and checked on him frequently throughout the nap. He woke up at 3 and is just fine! The nose is mostly unstuffed now too, interestingly. I tried to call his mom to give her a heads up but the numbers I have for her didn't work--and it's not such an emergency that I feel comfortable calling the dad (who is apparently quite the jerk and barely in the boy's life, doesn't even pay child support).

Will definitely be mentioning it to her at pick up and will be getting new numbers. He doesn't come again until Monday and does have a tendency for ear infections.

I think your training on concussions may be incomplete. Falling down a half a flight of stairs (which if these are a full flight of 11/12 stairs) is a significant fall especially if the surface he landed on was wooden. The force that a child would hit the floor would easily be enough to cause a concussion.

Here is a good link from the Mayo clinic:

http://www.mayoclinic.com/health/concussion/DS00320/DSECTION=symptoms

The signs and symptoms of a concussion can be subtle and may not be immediately apparent. Symptoms can last for days, weeks or even longer.

Any time a child has this kind of a fall ... and espeically when they land on a hard surface like a wooden floor... the parent should be notified immediately so they can decide whether or not to have the child examined. Catching the injury before swelling internally becomes severe (which can happen slowly over days) can mean the difference between life and death.

Falling asleep in an unusual place at a time when he is normally up would have also been an indicator that he should be looked at.

It sounds like this little one is fine .. and many are after a fall of this nature but IME as a RN and a child care provider for 31 years, I always feel it is better to be on the cautious side.

[Crystal]

I think I would have called Dad, it could have been very serious, and even if he's a deadbeat, he still could take him to be checked......and I'd be livid with the Mom for not making sure to update her contact info when it changed

[Unregistered]

I hope the little one was ok - and since this post is a day old and you haven't posted to the contrary, I'm assuming he is.

I'm no medical expert but I have to agree with nannyde. I'm a dcp and I have also raised 3 boys who've all had their share of head bumps and bruises. I distinctly remember one incident w/one a son who got a HUGE bump in the middle of his forehead after he hit an end table. He ended up perfectly fine, but during that visit, I remember my dr telling me that a babies head can swell enormously after a bang and most likely they will be fine (but you should always have it checked). It's when they take a good hit to the noggin and don't show a bump or bruise that should put you on guard. The fact that this child was sleeping in the middle of the kitchen floor (which was something that you said never happened), would have made me act immediately to contact mom or dad. I would also had done my best to keep that baby awake until mommy came to get him.

But I'm guessing your little dck ended up ok. Which is good news.

[SilverSabre25]

He's fine. Mom agreed it was probably an ear infection brewing, as he's very prone to them.

He really more rolled down the stairs rather than fell. I watched it happen, was right there, and he didn't really hit his head. There were no bumps or bruises, he acted perfectly normal, and it was well over an hour, closer to an hour and a half before he was getting tired. Everything I've ever seen says that concussion signs show up within half an hour. He wasn't throwing up, eyes were fine, movement was fine.

He was sick beforehand--runny nose, fussier than he usually is, not as "get-up-and-go". After talking to mom at pick-up, she said that he had a really bad night the night before, which explains the early naptime. I checked on him frequently while he slept and he was just fine every time.

So...as parents...do you really rush your kid to the doctor every single time they bonk their heads?

[QualiTcare]

silversabre,

i think you did the right thing. i'm sure if you felt there was any chance of an injury you would've acted. i'm embarrassed when i tell people this, but i had a baby (1 year old) who climbed out of his high chair while we were outside. i had him sitting in it out there eating snack, and he fell off the highchair (stood on the part where they eat) and hit his head on the concrete. it was AWFUL! i really felt my heart stop - i was running toward him and watching it happen. i've never known a child to be able to climb out of a highchair like that. of course he cried and he hadn't had a nap yet - so he started falling asleep as soon as he calmed down - the crying wore him out. i put a bag of peas on the back of his head and let him lay down to sleep. i just sat with him with my hand on his back the whole time he slept. i told his mom about it at the end of the day incase a knot came up later and she actually laughed and was like, "omg i bet you were freaking out. i should've told you he can get out of his highchair." she's a nurse and she didn't seem worried at all. she also mentioned when i was talking to her about not being sure if i should call that you should always check their ears bc if it's serious then their ears usually leak fluid.

i didn't feel the need to call the doctor because i had a total of 3 head "injuries" between my 2 kids. the first was my daughter who learned to roll for the first time ever while i turned around to grab my purse to leave - she was lying on the sofa and fell onto the hard floor. she seemed fine, but the daycare called and insisted i take her to the doctor. she WAS fine. second time my son busted his head on the corner of a coffee table and had a huuuge knot. the doctor acted like it was no big deal and i asked him when SHOULD you take them to the doctor? they hit their heads all the time...i don't want to over or under react. he told ME to watch them (even if they have a huge knot) that it's not likely they are injured unless they start wobbling/losing balance - their eyes are rolling back in their head - or if they vomit. he fell out of a tree about a year later and i called ask a nurse because didn't want to go to the doctor for no reason. she told me the same thing - and he was asleep and she told me it was fine for him to sleep. i asked bc i always heard not to let them.

anyhow, i think you did fine. my dck's mom wouldn't have wanted me to call her and have her leave work (even though it sounded really scary) if she knew i didn't think he was really injured. it's a tough call, but usually your instincts are right.

[Unregistered]

You did the right thing you would of known if he had a concussion. My middle Son climbed up on a friends little table they had by the door outside and he fell and hit his head on the croncreate step I noticed right away he couldnt stand up straight it was like he was drunk his eyes moved rapidly back and forth he had a minor concussion they said with a major concussion you are out cold so like I said you would of known if he did.