Head injury in the pre-mobile infant is less
readily sustained than when the child begins
to stand upright at approximately 12 months.
Head injury in the pre-mobile infant should
therefore prompt an exclusion of abusive
injury. The head is the most common site
for bruising secondary to abuse, and bruising
and other minor injury is more common after
the child has begun to mobilise (National
Society for the Prevention of Cruelty to
Children 2009).
The reflex that enables an individual to
put out an outstretched hand instinctively
when falling develops at approximately
eight to nine months. Despite this, infants
when first mobilising may sustain head and
facial injuries as the head of the infant is
proportionately much larger than that of
the adult. In addition, the skull of the infant
has patent fontanelles (unfused apertures in
the bony skull). The posterior fontanelle is
patent until approximately five months and
the anterior fontanelle is patent until around
18 months of age. During intracerebral
bleeding the fontanelles may become full or