<s>[INST] I sat my 4 month old baby up on his changing table to put lotion on his back, he slipped out of my hands and fell back hitting his head on the sharp edge of the changing table rail. He cried with high pitched screams for several minutes. I nursed him to calm him down, he spit up a little but that is not unusual after he nurses. He acted normally, no dialated pupils for about half an hour after and just feel asleep at usual bedtime. Is there a possitthat he has a serious brain bleed or injury? Do I need to take him to the ER? Should I not let him sleep? [/INST] Hi... Thank you for consulting in Chat Doctor. I understand your concern. First be reassured that your kid is normal. I will suggest you danger signs of head injury -1. Vomiting continuously2. Seizures3. Watery of bloody discharge from ears and nose4. Unconsciousness5. Altered sensorial or behavior. If none of them are present, I don't think you should worry about his trivial head injury. For pain, you can give oral Paracetamol in the dose of 15 mg/kg/dose(max ceiling dose 500 mg) every 4-6th hourly.  Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on Chat Doctor are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. </s>