Burns and scalds - children

Children are curious and like to explore their surroundings. They don’t know that hot water and hot drinks burn like fire. A child’s sensitive skin burns far more easily than adult skin. Burns and scalds are a major cause of serious injury in children aged 0 to 14 years. Children under four years of age are at most risk, especially those aged between one and two years.

A severe scald can inflict a serious injury and may mean a long stay in hospital. It may also require painful skin grafts and years of treatment, and can result in permanent scarring. A severe scald over a large skin area can kill.

Common causes of scalds
Scalds are burns from hot liquids or steam. Any hot substances can scald a child. In fact, everyday items cause the most scalds. These include hot drinks such as cups of tea and coffee, running hot tap water, bath water, hot cooking oil, hot food, saucepans of hot liquid, steam and vapour.

Treat all hot things as if they were as dangerous as fire.

Times when injuries are likely to happen
Children are most at risk when you are:

• In a hurry or under a lot of pressure
• Entertaining, not feeling well or distracted
• Busy and have too many things going on at the same time
• Tired, or when your young child is tired
• Away from home, visiting friends or family or on holiday and out of routine.

• Avoid the high demands of families between 4pm and 7pm by feeding a hungry toddler their main meal at midday and serving something light that you don’t need to cook in the early evening.
• Arrange for the rest of the family to eat a later meal, once your toddler is safely in bed.
• Prepare the evening meal earlier in the day when you are less likely to be distracted by competing family demands.
• Occasionally give your baby a wipe instead of a bath if you don’t have the time to stay beside them. Alternatively, bath baby earlier in the day.

• Use a bath thermometer to ensure your child’s water temperature is always safe and comfortable. Around 37–38ºC is the maximum bathing temperature recommended for young children.
• A soft bath spout cover and non-slip suction mini bath mats can help prevent falls in the bath.
• Keep the bathroom door closed when not in use. You may wish to put a lock or bolt on the outside of the bathroom door, out of reach of children but accessible to adults.
• Always remain within arm’s reach of children in the bath.
• Take the child with you if you have to answer the door or telephone.

• At 60ºC it takes one second for hot water to cause third degree burns.
• At 55ºC it takes 10 seconds.
• At 50ºC it takes five minutes for hot water to cause third degree burns.

• Tempering valves – these are fitted to the water pipeline and mix hot and cold water to a specific temperature, adjustable between 35ºC and 50ºC.
• Hot water shutdown devices – these are fitted to the end of a tap and automatically cut off water flow once the water reaches the pre-set temperature.

• Keep hot drinks and handles out of reach.
• Put a baby down when drinking something hot.
• Use non-slip place mats instead of tablecloths.
• Turn the handles of saucepans towards the back of the stove, out of reach of small children.
• Keep hot drinks away from the edge of the table or bench. You never know when that supposedly helpless baby will be able to reach or when a crawling infant will start to toddle. Make it a habit from the moment they are born to keep hot drinks out of their reach.
• Never carry hot drinks while children are playing underfoot. Make sure your care extends outside your home, when visiting relatives and friends or attending playgroups.
• Use a cordless kettle to prevent a child pulling over the kettle. Empty any unused water out of the kettle.
• Use the back hot plates on the stove before using the front ones.
• Give toddlers their own special mug so they don’t drink from an adult mug or cup, which may contain liquid that is too hot.
• Carry plates to pots, not pots to plates.
• It is safer to serve cold drinks when children are present and to have a tea break when toddlers are sleeping.
• Your toddler may be safer in the playpen or in the highchair for a short time when you are very busy in the kitchen, or you could use a child safety gate.

• Apply lots of cold tap water (not ice or ice water) to the burn for at least 20–30 minutes.
• Remove wet clothing only if the skin is not blistered or stuck to the clothing.
• Take off anything tight such as jewellery. Burns cause swelling and it may hinder circulation.
• Cover the injury with a clean sheet, non-fluffy towel or tea towel.
• Keep the child warm and calm and dial triple zero (000) to call an ambulance, if the burn is severe.
• Burns are serious if they involve the face, hands, feet, genitals or bottom, or if the burnt area is larger than a twenty-cent piece.

• Never use butter, oils or ointments to cover the burn, as they may retain the heat.
• Never use ice. Children can be dangerously chilled in ice water.

• The Safety Centre Telephone Advisory Line, The Royal Children’s Hospital Tel. (03) 9345 5085
• Child Health and Safety Resource Centre, The Royal Children’s Hospital Tel. (03) 9345 6429
• Hardware and bathroom suppliers
• A qualified plumber or gasfitter

• Keep hot drinks and pot handles out of reach, and never leave children alone in the bathroom or kitchen.
• If a child is burned, apply immediate first aid. Dial triple zero (000) for an ambulance if the injury is severe.
• The best way to prevent scalds in the bathroom is to reduce the temperature of the hot tap water to 50ºC.
• The maximum bathing temperature recommended for young children is 37–38ºC.
• Don’t use butter, oils or ice to treat burns.

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