Burns
Burns are never fun. Most injuries aren't a total barrel of laughs, but there can be a weird sort of pride in doing something really dumb and ending up with a great story with a matching scar. My nephew, who broke his arm clean in two (I'd never seen a floppy forearm before) falling over a bench playing tag in the dark in a field loves showing off the scars from the metal pins they put in, and it's a story fit for a best man's speech.
Burns are not like that.
Most burn stories sound more like horror stories than funny anecdotes, the scars are often much bigger and more invasive, and the healing period for serious injuries is longer, more painful, and much less glamourous than fun-coloured casts all your friends can sign.
70% of burns in children occur to those under the age of 5 years old, with almost half of all child burns occurring in under 2-year-olds. And because children's skin is thinner and more delicate than adult skin (there's a reason I pay so much money every month for specialist anti-ageing skincare), they're not only at greater risk in terms of the likelihood of getting burnt but also in how bad that burn could be.
Most children get burnt at home, with around half of these happening in the kitchen. That makes sense, that's where we do a lot of 'making things hot'. Young children are grabby little monsters, and ESPECIALLY if you tell them not to grab the thing, they're going to try and grab the thing.
Young children also have very small brains (don't worry, it doesn't last forever), so the 'let go of the thing that is hurting you' reflex hasn't formed yet. My niece (aged two ish) stood with her foot under the steam vent of my parents' fancy new cabin shower steam room pod screaming while the adults in the room (there were three of us, myself, a surgeon, and a nurse) figured out what the problem was. It didn't cross her two year old little brain to move out of the way, and as the steam was nearly invisible and the vent was so low to the ground, we couldn't see the danger amidst the chaos.
It's okay though, her father (a surgeon) and mother (a nurse turned midwife) knew what to do to minimise the damage, and they even took her to the hospital as well, just to be sure.
So here are some of the tips we've picked up (based on real world experience) to keep your child's skin sizzle free:
Fireworks. We love them. They're pretty, and they're magical and they're literally rockets that explode. So do your research. Fireworks come in four different categories - F1, F2, F3, and F4 - getting more dangerous the further along the list you travel.
Do not let your children play with fireworks. Do not let your teenagers play with fireworks. Do not let your irresponsible uncle play with fireworks. Do not play with fireworks if you have been drinking or have taken any drugs. Do not let your dog play with fireworks. My preference would be that fireworks be left to the professionals, but if you're really set on setting up your own private display, make sure you have enough space to correctly set them off, and make sure you have buckets of water ready in case you need to put one out rapidly.
And I feel like I shouldn't have to say this, but to some people it's not completely obvious. DO NOT POINT FIREWORKS AT ANYONE WHEN YOU'RE SETTING THEM OFF. Seriously guys, it's 2024, we have the internet, we should know better by now.
Sparklers are fun, and relatively safe, too. They shouldn't be given to children under the age of five, and all children should be supervised while holding them. Sparklers can burn at up to 1600°C, so don't let your kids run around with them because if they trip and fall, it'll take an eye out. The good news is there'll be little to no blood because at those temperatures any wounds will be cauterised on contact. Good-o.
Children should wear gloves when holding sparklers to minimise the risk of stray sparks, and when they are done they should be collected in a bucket of water to make sure they're fully extinguished.
Barbecues get hot. Barbecues stay hot for a while. It's easy for parents to sit back and relax during a family barbecue and let the kids run around by themselves. Do you see where this is going? .
Keep your kids away from barbecues, even once the cooking is done. Disposable barbecues should be dunked or drenched in cold water to cool them quicker, and not left in the long grass or half buried in the sand where people walk barefoot and can't see them.
Does it feel like I'm saying things that everyone already knows?
They don't.
As a general rule, fire is hot. Always assume that the fire is hot. Fireguards can (and should) be used around indoor fires (and heaters), but outside you may not have something of the kind. Stand a safe distance away from the fire. How far is that, you ask - the answer depends on the size of the fire, but generally speaking, if your skin is prickling, that means you're cooking.
If you're outdoors and wearing plastic, meltable clothes like waterproof jackets or wellies, go back far enough that your skin stops prickling and then take a couple of very big steps further away.
Keep a bucket of water or a hosepipe nearby in case you need to extinguish your bonfire in a hurry, and never leave the bonfire unattended.
Don't throw things into the fire at all, but especially don't throw anything like a pressurised can into a fire. A deodorant can in a fire is a missile, and you've got no way of aiming or controlling it.
Do you know what's a great way to ruin a Sunday morning?
Stepping on a hot curling iron.
Hair straighteners and curling tongs can reach 235°C and they take a while to cool down. Keep them out of reach (including any cables that could be pulled deliberately or accidentally) on a high shelf, and seriously consider getting a heat-proof bag to keep them in. It's not just better for protecting children, but also for protecting carpets and floorboards. Scorch marks on the floor are difficult to hide and can ruin the whole decorative scheme of a room.
Speaking of things that stay hot for a while, irons. Personally, I haven't cracked out the iron since before COVID. I got a steamer for formal attire (best decision I ever made), and let's face it, most of the time I wear clothes that don't need ironing.
What can I say? It works for me.
But if you are one of those people who likes a nice, crisp shirt, you're going to want to follow the same steps as hair straighteners. Keep the iron out of reach until it's fully cooled, and make sure the wire is tucked up and out of reach.
Hot water bottles should never be put directly against the skin. They might not burn as quickly as a hot iron, but prolonged contact can cause some serious damage. There's a reason they come with cute covers. There's more information about hot water bottle safety in the 'Scalds' section below.
Radiators, by design, get hot. Keep cots and highchairs pulled away from radiators because chubby little arms and legs can get wedged against them, and that's no fun for anybody.
Scalds
Scalds are wet burns. Cups of tea, pans of boiling water, baths that are too hot. You get the idea.
A scald is just as bad as a burn, and sometimes even worse - if an item of clothing gets drenched in boiling water, the wet fabric will stick to the skin and increase the scald area, as well as the amount of time the burning temperature is applied.
60% of children who come into the emergency room with burns have been scalded by hot drinks. Anecdotally, the hot drinks most likely to send a child to the hospital is a cup of tea. But I don't think that's a reflection of tea drinkers drinking dangerously, more a possibility that there are just quite a lot of tea drinkers in the UK. Who would have guessed?
At any temperature above 44°C, human skin begins to take damage. Most adults start to feel pain at 43°C. The higher the heat, the quicker the damage occurs.
By 70°C, adult skin burns in seconds.
Do you remember that story of the woman who sued a fast food chain because of the hot coffee? That coffee was served between 80-90°C and left her with 3rd-degree burns (the worst kind) on 6% of her body, and lesser burns over 16%.
For children, it's even worse. 52°C is enough to cause full-thickness burns on a child's skin. Now keep in mind that it can take twenty minutes for a cup of boiling tea to cool to below 52°C, so that twenty minutes is a pretty big window for your little one to get burned every time you sit down for a cup of tea. Especially if (like me), you tend to make a cup of tea and then forget about it until it's stone cold.
So here are some things you can do to minimise the risks of scalds in your home.
1
Grabby Hands
Babies and toddlers have grabby hands, but fortunately they've only got stumpy little arms. Keeping your hot drinks far enough back on the table that the wriggly child on your lap can't reach it in one quick movement is the best way to stop them from tipping a fresh pot down themselves. Other solutions include duct taping their hands to their laps, or dressing them only in water proof fire repellent suits, but neither of those are actually very practical, and we wouldn't really recommend them.
Other things that can be pulled down by grabby hands include saucepans, small appliances like kettles and coffee machines.
Keep saucepans turned inward on the hob or cooker so that the handles don't stick out. This is actually a good idea even if you don't have kids, because sticking-out handles can easily be caught by hips, elbows and clothes (especially in a busy kitchen), and best case scenario you just spill your dinner on the floor.
Things like kettles and coffee machines get incredibly hot when in use and for a period of time afterwards. Keep them pushed to the back of the counter, and make sure wires and cables are safe and secure behind anything that might be taken from the counter. A wire sitting in front of something highly desirable, like a bottle of ketchup, or a profiterole pyramid is likely to come down as collateral damage.
Anything with a chord can be a danger, so don't let my lack of imagination limit the possibilities of things that could injure your children. Rice cookers, electric steamers, slow cookers, bottle sterilisers, wax melters (for DIY cosmetics), oil fryers, and anything else that plugs in and gets hot could be the cause of your next visit to the hospital. I'm absolutely not suggesting you throw out all your appliances and only eat raw cold food, but just be aware that just because YOU are smart enough to exist safely in the kitchen doesn't mean your child has quite figured it out yet.
Don't discount the danger to the 'good child'. Be honest, if you've got more than one child, there's one who causes you headaches and one who wants to bring you cups of tea. The good ones are at an even greater risk of getting hurt because they're more likely to try to do things independently, even if it's above their skill or competence level.
When your child starts to express a desire to help out around the house, teach them how to do it safely and make sure that the things they need are in easy reach so that they don't need to do things like climb up on to the counter next to the boiled kettle to get the teabags down.
2
Soaking Injuries
Tap water in the UK is not recommended to be hotter than 50°C, but that is still hot enough to do some serious damage, especially if a child is submerged in water and can't get out. The best way to avoid this unfortunate situation is to start with cold water in the bath first, and then add hot water after. If you keep the room warm, there is less need to raise the temperature of the bath water as the child won't get cold as quickly getting out.
If you have a bath thermometer, use it. Get your partner to use it. Get your parents, babysitters, aunts, uncles, and close friends who love kids but love giving them back at the end of the day to use it. Between 37-38°C is the ideal temperature to bathe a child.
If you don't have a bath thermometer (and you have no intention of buying one, though I think you should because they're great), you can dip your elbow in the water and see how it feels. It should be warm but not hot.
You need to be careful with hot water bottles, the rubber degrades over a couple of years and can burst, especially when under pressure. They should be replaced every two to three years. There's a little flower stamped on the rubber somewhere on each hot water bottle, that tells you the year and month it was made.
2
Food and Drink Scalds
We've all taken a sip of tea or coffee before it had cooled down enough and gotten a little burn on our tongue. I recently heard the term 'NHS Mouth', which is where doctors and nurses get so used to throwing back hot drinks in their limited breaks that their mouths are practically fireproof.
Children, not so much. Especially babies. When heating milk bottles, it's best not to use a microwave as they can create hotspots that can provide a (not so) fun surprise mid-meal. If possible, use a hot water bath or a bottle warmer. If you DO need to use a microwave, make sure you mix the liquid well so it's heated evenly all the way through, and test the temperature with a few drops on your wrist.
Once your child is on solid food, be aware that foods with a high water content like potatoes and vegetables, tube or other shaped pasta, and boiled eggs act like hot water bombs.
WE know to cut them down to size and give them a minute to cool so we don't have to do the 'Hoo Hoo Haa Haa' song, but kids need reminding. Every single time. Sometimes multiple times in a single sitting.
It's exhausting but necessary.
Sun Safety
Everyone who goes out in the sun is vulnerable to UV sun damage, no matter the level of pigmentation of their skin. Though it's true that the more melanin a person has, the lower their chances of getting sunburn, dark skin only absorbs 30-40% more sunlight than fair skin, and all skin takes sun damage to some degree.
Children have particularly sensitive skin and burn extremely easily. Having just one blistering sunburn in childhood or adolescence doubles a person's chance of developing melanoma (skin cancer) later in life. Skin damage builds up throughout your life, and the more often you burn, the greater the risk.
To minimise the chances of this happening, remember these three things:
1
Stay out of the sun between 11am to 3pm. There's a reason hot countries like to take a midday snooze, and it's mostly to avoid being out and about during the hottest, most unforgiving hours of the day. You don't have to stay inside, but try to stay in the shade.
2
Cover up with suitable clothing. Long sleeved, breezy clothes (preferably in cotton or linen) are perfect to keep your kids (and yourself) protected during the summer. There's a reason British tourists are so easy to spot on holiday. We're the only ones in tank tops and shorts. Wearing loose clothing has the added benefit of keeping you cool, as air can circulate, and the fabric creates shade that protects your skin from the worst of the heat.
3
Wear sunscreen. Factor 50 sunscreen should be used on all children, and it's good to use at least 30spf on adult skin too. My mother would die if she knew I was recommending this, she grew up putting olive oil on her skin to try and tan more, and she used to send me on school trips with SPF 4 cream she would buy especially from Italy. Now I wear a minimum of factor 30 all year round (50 if I'm actively sunbathing) as part of my skincare routine, and wouldn't you know it, I haven't burned in years.
How to Treat a Burn or Scald
Despite all your best efforts sometimes your kid is just determined to get hurt, and unless you've got four extra arms and eyes in the back of your head, you might not have the resources to stop them.
So if little one gets burned, here's what you're going to do:
If clothes are on fire or smouldering, use the 'Stop, Drop, and Roll' procedure.
Cool down the burned area as quickly as possible. Use cool but NOT COLD running water, and keep the water flowing for 20 minutes.
Remove all clothing and jewellery unless melted or stuck to the wound. If you cannont remove an item of clothing or jewellery, make sure it is thoroughly soaked by the flow of cool water.
Call for help for any burn or scald larger than a 50p coin - 999 or 111 depending on how severe the damage is. Use your best judgement and trust your instincts.
Cover the wound with clings film or a sterile non-fluffy dressing or cloth.
Good first aid can make a big difference in recovery times and severity of scarring in burns. In some cases, seconds can make a huge difference. So if you even SUSPECT a burn, act immediately. Better a cold, wet child than trip to the hospital.
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