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The sound was something Brendan O'Neill's parents, teammates and coaches will never forget.

A stinging line drive to the 12-year-old's forehead during a Petaluma National Little League game on Tuesday night made an almost indescribable smacking sound.

O'Neill, a pitcher, fell immediately to the ground, writhing in pain, his skull fractured and his nose broken and bloodied. The game — an extra-innings nail biter — became an afterthought as Brendan's father, coaches and an umpire who is a paramedic rushed to the mound.

On Friday, Brendan remained hospitalized in Oakland with serious facial injuries, his parents Dennis and Leslie at his side. He answered the phone in the ICU on Friday before passing it to his parents. He is on pain medication and too much activity wears him out, they said.

The ball struck Brendan "square between the eyes," said League President Anthony Lackey.

Brendan suffered a broken nose and multiple fractures to his forehead, but did not lose consciousness. His eye sockets are intact and there is no swelling of his brain. Four days later, his eyes remained too swollen to open.

"I think it's going to be OK," his mother said Friday from the hospital. "They're managing his pain right now. They are just making sure that everything is good before they go in to repair the fractures."

At first, both parents thought Brendan caught the ball.

"Brendan is fast," said his mother. "He turned in that split second and I thought it just skimmed his face. But there definitely was a noise, a sound. And that was probably one of the scariest things."

"It was very scary," said Jesse Moore, the coach of Brendan's EMG team of 11- and 12-year-olds.

"The way the ball came off the bat, it was probably one of the hardest hits we've seen at the field. It just went directly into his forehead. The sound it made, it was terrible, pretty sickening."

Majors pitchers throw from a mound 46 feet from the batter.

The injury reignited the discussion about youth baseball safety, particularly about the safety of aluminum bats used by Little League teams compared with wood bats.

In 2010, Marin Catholic High School pitcher Gunnar Sandberg was struck in the temple in a similar play. He spent three weeks on a ventilator in a medically induced coma. A portion of his skull was removed to alleviate pressure and reattached 10 weeks later.

Sandberg played the following year. His league voted to switch to wooden bats, as have others around the country.

But injury and bat-performance studies comparing wood bats to aluminum bats are contradictory and the governing body for Little League International stands behind the safety of metal bats.

"There is no data to indicate that the few catastrophic injuries to baseball pitchers from metal bats would not have happened if the batter was using a wood bat," it says in a statement on its website.

"Before any sport makes rule changes, equipment changes, or other changes related to the safety of the participants, it is imperative that these changes are based on reliable injury data and not anecdotal information."

Petaluma National Little League president Lackey said the board of directors meets Thursday and will discuss Brendan's injury and possible changes to improve the safety of the young players. Those could include switching to wood bats, using a larger field for older players and requiring the use of protective headgear for pitchers.

Sandberg has promoted a lightweight pitcher's helmet made by Easton-Bell that slides over a baseball cap and protects a player's forehead and temples.

After his injury, state legislators considered instituting a moratorium on metal and composite bats in California high schools.

But the high school sports governing body agreed preemptively to require so-called BBCOR bats, which are designed to perform more like wood bats and limit the speed of batted balls.

Protective headgear for softball and baseball pitchers, infielders and base coaches also has been considered. Some softball pitchers use them in Sonoma County high schools.

Brendan and his family said they accept the risks inherent in sport. Brendan, the third of four kids, is "a tree climber," his mother said.

"I come from a large family and we've all played sports," she said. "Accidents happen and this truly was just a very freak accident."

Brendan specifically wanted to let the batter, a friend of his, know that he doesn't blame him.

Dennis O'Neill, a firefighter, also wasn't endorsing the "ban metal bats" movement.

"Brendan would want everyone to know that no one is at fault," he said. "It's all part of competing and we know that in our family. He's ready to compete again. He's an athlete."

The boy has received an invitation from Oakland A's outfielder Jonny Gomes, a Petaluma native, to join him on the field before a game. And Brendan's favorite ballplayer, Pablo Sandoval of the San Francisco Giants, has offered his best wishes and tickets to a Giants game.

Moore, Brendan's coach, said more than just the injury will remain in his memory after visiting his player in the hospital.

"He goes, 'So how did we do?' " Moore said, because Brendan didn't remember the end of the game. "He couldn't even open his eyes. That comment is going to stick with me forever. It showed his spirit."