THANKS FOR YOUR QUERY. You do not mention your child s age & her exact behaviour after falling down. Most likely it is an external injury. But vomiting is an ominous sign and you should rush your child to the emergency room of a hospital immediately and get a CT Scan of brain done. The goose bump or swelling that may appear after a head blow is the result of the scalp s veins leaking fluid or blood into (and under) the scalp. It may take days or even a week to disappear. Call the doctor if your child is an infant; has lost consciousness, even momentarily; or if a child of any age has any of these symptoms: won t stop crying complains of head and neck pain vomits repeatedly difficult to awaken isn t walking normally If your child is not an infant, has not lost consciousness: Apply an ice pack or instant cold pack to the injured area for 20 minutes every 3 to 4 hours. Observe your child carefully for the next 24 hours. If you notice any of the signs of internal injury(unconscious for few minutes), call your doctor immediately. If breathing is normal, and you observe or sense no other abnormalities, let your child sleep (unless the doctor has advised otherwise). There s no need to keep a child awake after a head injury. If you aren t comfortable with your child s appearance, rouse your child partially by sitting her up. Your child should fuss a bit and attempt to resettle. If she doesn t protest, try to awaken your child fully. If your child can t be awakened or shows any signs of internal injury, call the doctor. HOPE THAT HELPS.