Head trauma is the most common cause of accidental death in infancy, David Graham of the Institute of Neurological Science in Glasgow, Scotland, reports in the July 2001 issue of "Brain." Accidental head trauma occurs frequently in infants. While most injuries are minor and cause no long-term effects except parental anxiety, serious disability and death can occur after accidental head trauma.
Causes
Automobile accidents most often cause head injury to infants, Yale-New Haven Children's Center reports. Placing rear-facing infant seats in the front seat of a vehicle can also result in death during a crash, not, as people suppose, from the baby's head hitting the seat back, but from the force of the airbag against the car seat, Kathleen Weber reports in the July 2000 issue of the University of Michigan Transportation Research Institution Review. Although over 20,000 falls from shopping carts were reported in 2006, with 74 percent incurring head trauma, fatalities are fortunately rare, but have occurred in past years. Falls from less than 1.5 meters, or around 5 feet, rarely result in serious trauma or fatalities, M. Oehmichen of Germany reported in the 2005 issue of "Neuropediatrics."
Physiology
An infant's head is larger than an adult's, and his brain has a 25 percent higher water content than an adults. This makes the brain soft, gelatinous and more fragile and prone to injury compared to an adult brain, pediatrician Roberta Hibbard, M.D., of Riley Children's Hospital explains.
Accidental vs. Non-Accidental Falls
In accidents not witnessed by an observer outside of the caregiver, the question of whether the injury was truly accidental or whether it was deliberately imposed may be raised. Infants can't speak for themselves and say how they got hurt. Over 80 percent of deaths from head injury in children less than 2 years old actually occur from non-accidental causes, according to Hibbard. Retinal hemorrhages in the eye, while seen in accidental injury, occur more commonly in non-accidental injuries, such as shaken baby syndrome, and are not seen after short falls, seizures, minor head trauma or CPR, Hibbard further states.
Timing
Children who die of accidental head injuries may have a period of consciousness before death, making it imperative that parents watch for signs of developing head injury after a fall or other potentially fatal head trauma. Children under age 24 months are most likely to have a lucid period following the injury, lead author Kristy Arbogast, Ph.D., reported in the July 1, 2005, issue of "Pediatrics."
Prevention
Most accidental deaths from head injury in infants are preventable. Not leaving an infant unattended and securing an infant properly in an approved car seat placed in the backseat can significantly reduce the risk of fatal head injury in infants. Infant seats should not be placed on top of shopping carts, and children should be restrained with belts while riding in the carts. Gates that block access to stairs help prevent potentially fatal falls.
References
- Riley Hospital for Children: Non-Accidental Head Injury in Infants; Roberta Hibbard, M.D.
- UMTRI Research Review: Crush Protection for Child Passengers; Kathleen Weber; 2000
- Yale-New Haven Children's Hospital: Infant and Child Car Seats
- "Brain": Paediatric Head Injury; David Graham; July 2001
- American Academy of Pediatrics: Shopping Cart-Related Injuries to Children
