Children after a car crash: what to watch for and what to do with the car seat

After a crash, adults can say “my neck hurts”. A small child cannot. They may cry more, refuse food or sleep differently, and nobody connects it to the accident. That is why, in the days that follow, what you observe counts as much as what your child tells you.

What a child cannot explain

The CDC warn that spotting a concussion is harder in young children, because they may not be able to express how they feel. Symptoms can also take hours or days to appear or be noticed.

In children up to age 4, watch for:

• More irritability or crying than usual.
• Seeking more comfort, such as wanting to be held all the time.
• Refusing to eat or nurse.
• Sleeping much more or much less than usual.
• Losing interest in play.

In children of any age, watch for changes in behavior, mood, sleep, eating, balance or walking. Nobody knows better than you what is normal for your child.

When to go to the emergency room

According to the CDC, call 911 or go to the emergency department right away if, after a bump or jolt to the head, your child has:

• Seizures.
• A headache that gets worse and does not go away.
• Repeated vomiting.
• Loss of consciousness, increasing drowsiness or cannot be woken up.
• Confusion, not recognizing people or places, restlessness or agitation.
• Slurred speech, weakness, numbness or poor coordination.
• One pupil larger than the other, or double vision.

In babies and toddlers, also if they will not stop crying and cannot be consoled, or will not nurse or eat.

It can affect them on the inside too

A crash can frighten a child even without a scratch. The National Center for PTSD at the U.S. Department of Veterans Affairs explains that reactions change with age:

• Under 6: they get upset when parents are not nearby, sleep badly or act out what happened in play.
• Ages 7 to 11: they replay it in games, drawings or stories, have nightmares, become more irritable or avoid school.
• Ages 12 to 18: it looks more like what adults feel, with anxiety, sadness or withdrawal.

If these reactions last or worry you, mention them to your child’s doctor.

The car seat after the crash

The American Academy of Pediatrics says not to reuse a seat that has been in a moderate or severe crash. A seat from a minor crash may still be safe, but under NHTSA’s criteria a crash only counts as minor if all of these are true:

• The vehicle could be driven away from the crash.
• The door closest to the seat was not damaged.
• No one in the vehicle was injured.
• The airbags did not go off.
• You cannot see any damage to the seat.

Check your seat’s manual too: some manufacturers ask you to replace it after any crash, even a minor one.

How we handle it at the clinic

We see patients of all ages. If your child was in the car, we can assess them, document what we find and follow up, and we review PIP coverage with you before starting. The visit happens in English or Spanish, whichever you prefer.

Sources

• Centers for Disease Control and Prevention (CDC), HEADS UP. Signs and Symptoms of Concussion.
• American Academy of Pediatrics (HealthyChildren.org). Car Seats: Information for Families.
• U.S. Department of Veterans Affairs, National Center for PTSD. PTSD Basics.

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This article is general information about our clinic and about children after an accident. It is not medical or legal advice and does not replace a consultation with a professional. If you have a medical emergency, call 911.