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Picking Scabs & Popping Blisters

I remember my mother telling me when I was a little girl that I shouldn’t pick my scabs because it would cause scarring. Now it is believed that the scabs themselves actually cause more scarring and the recommended treatment of skin wounds has moved away from dry healing towards moist healing.

What is dry healing?

This is when a wound is left open to dry out or it’s simply covered with a dressing. This method allows a hard scab to form over the wound on the outside. It was thought that the scab protected the damaged skin underneath and would eventually fall off once the skin defect had healed. The scab was also meant to protect the wound from infection.

What is moist healing?

This is when an ointment is applied to a wound and it is covered with a dressing. It has been proven that epithelialisation (formation of new skin) happens much faster in a moist environment when compared to dry one. Leaving a wound to dry out allows the new skin cells that are trying to grow and cover the skin defect to dry out and die resulting in more inflammation. This causes further pain, slows down the healing process and leads to more scarring. Previous beliefs that a moist dressing resulted in infection have not been proven.

When should you apply a moist dressing?

You should provide a moist, but not too wet, environment for cuts, scrapes and burns. Small cuts and scrapes that have already scabbed can be left open.

What is a blister?

A blister is a pocket of fluid collection within the superficial layers of the skin. They can develop when the skin is damaged by friction, extreme temperature (hot and cold) or certain chemicals that come in contact with the skin. The fluid acts as a barrier protecting the injured tissue underneath so it can heal.

How to treat a blister

Do not pop a blister! The blister protects the underlying skin from infection. The fluid within the blister also contains proteins that help promote healing. As the skin underneath heals the fluid in the blister disappears and the skin peels off. It is best to keep the blister covered with a dry dressing to avoid it getting scraped or torn open. If the blister does burst open, clean the wound gently without pulling off any skin, and apply a moist dressing.

How to clean a wound and apply a moist dressing

  1. Clean your hands thoroughly with soap and water or a hand disinfectant.
  2. Put on disposable gloves if available.
  3. If the wound is bleeding, stop bleeding by applying pressure with a clean gauze, bandage or cloth.
  4. Rinse the wound under running water for 10 minutes. Use a gauze pad or cloth soaked in water to gently wipe the wound and surrounding skin of any dirt and debris.
  5. Gently pat wound dry using a clean gauze or cloth. Do not use cotton wool as the fluff may stick to the wound.
  6. Apply a topical ointment such as petroleum jelly or equivalent. A thin layer of an antiseptic cream such as Cetrimide can also be used if the wound is at risk of infection.
  7. Cover the wound with a sterile dressing such as a non-adherent pad and bandage or a plaster.
  8. Clean the wound daily with running water and reapply a new moist dressing until the wound has healed.

Moist Healing plasters

Many brands have developed plasters that are designed to keep wounds moist without having to apply a topical ointment. These dressings provide a moist environment by absorbing and retaining fluid from the actual wound. Some of these plasters do not need to be changed daily. Make sure to read the directions on the box before applying your plaster.

As our little ones explore this world there is no doubt you will have to deal with many cuts and scrapes and even though wound healing is individualised most minor wounds will heal well with no complications if looked after from the very beginning.

RESOURCES

Elastoplast, (2018). 4 Reasons for Moist Wound Healing. [online] Available at: https://www.elastoplast.com.au/first-aid/wound-care/moist-wound-healing [Accessed 21 August 2018].

Field, C.K. & Kerstein, M.D. (1994). Overview of wound healing in a moist environment. The American Journal of Surgery, [online] 167 (1), pp. S2-S6. Available at: https://doi.org/10.1016/0002-9610(94)90002-7 [Accessed 21 August 2018].

Junker, J.P.E., Kamel, R.A., Caterson, E.J. & Eriksson, E. (2013). Clinical Impact Upon Wound Healing and Inflammation in Moist, Wet, and Dry Environments. Adv Wound Care, [online] 2 (7), pp. 348-356. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842869/ [Accessed 22 August 2018].

Everything You Need To Know About Safe Babywearing

Babywearing is becoming increasingly more popular with many different types and brands to choose from. All over the world women have fashioned slings out of various blankets, fabrics and cloths.

THE BENEFITS OF BABYWEARING

  1. It is great for bonding with your baby.
  2. It supports breastfeeding.
  3. It helps reduce symptoms of reflux and indigestion in your baby.
  4. It provides deep touch pressure which helps calm your baby. Deep touch pressure affects the nervous system slows the heart rate and results in a calming affect.
  5. It provides vestibular-proprioceptive stimulation which also helps calm your baby by inhibiting the movement muscles and relaxing the body.
  6. It is convenient to have free hands.

HOW TO WEAR A BABY CARRIER

Before you buy a carrier it is important that you know how to wear one correctly so that your baby can be kept safe. Regardless of whether you decide to wear your baby on your back or in the front, facing in or facing out, Airway and Position are the two most important things you have to remember.

Keep Your Baby’s Airway Clear:

Young babies do not have good neck control. The head and neck need to be supported to keep the airway open as there is a real risk of suffocation in a baby carrier.

  • The chin must not rest on the chest but rather be angled up.
  • The face must not be pressing into the chest. Rather position the ear against chest.
  • Make sure there is no fabric covering the face. The face must be visible.
  • Carry your baby close and tight against your body. If your baby is loose, he or she can slide down in the carrier and obstruct their airway.

Position your baby properly:

Improper positioning can also result in airway compromise as well as increase the risk of hip dysplasia. 

  • Keep your baby upright at all times, except when breastfeeding (remember to reposition your baby again afterwards).
  • Position baby high enough to be able to kiss his or her forehead.
  • Your baby’s knees should be positioned higher than his or her bottom and the legs must be spread in order to support the hips and spine (much like a frog).

The Consortium of UK Sling Manufacturers and Retailers have developed an acronym (T.I.C.K.S) to help you remember the correct way to carry your child.

Tight

In view at all times

Close enough to kiss

Keep chin off the chest

Supported back

 

HIP DYSPLASIA EXPLAINED

Hip dysplasia is an abnormality of the hip joint where the ball part of the joint does not sit securely in its socket. An infant’s hip joint is made up of mostly soft cartilage unlike an adult’s hard bone. Therefore it’s easier for the ball part of the joint to slip out. Chronic poor positioning is an important risk factor for the development of hip dysplasia in infants, especially in the first 6 months of life. When the hips are not supported and the legs are kept straight the resulting forces make the joint unstable (fig. 1). As a child gets older the bones start to harden and the joint becomes more stable.

Fig.1: Understanding Position and Hip Dysplasia

CONCERNS ABOUT SLINGS

A sling is basically a tubular piece of fabric in which a baby nestles. They are great for skin-to-skin contact and bonding, however there are a few safety concerns:

  • It is difficult to support and control the position of the head and neck.
  • There is a risk of restricting airflow if the fabric completely encases the baby.
  • There is a risk of obstructing the airway if the face presses up against the fabric.
  • Slings do not allow for proper support of the hips and therefore there is a risk for hip dysplasia.

Fig.2: Incorrect

 

Fig.3: Correct

 

 

CHOOSING A BABY CARRIER

Make sure it is suitable for your baby’s age: Slings and outward facing carriers are not recommended for newborns up to around 4 months of age.

Make sure it can provide proper positioning:Some carriers do not support the spine and hips adequately. Take your baby along when buying a carrier and test it out. Have a look at the sitting position your baby adopts in both inward and outward facing positions. Some carriers are better for inward facing than outward facing. It is easier for an inward facing baby to lean against you and assume a frog-like position with the hips bent. In an outward facing position the hips may not be supported as much and the legs can then hang straight.

Make sure it is comfortable for you to wear: Babies grow very fast in the first few months. Make sure you choose a carrier that is ergonomic and helps take the increasing weight off your back.

Make sure the carrier is ASTM approved: Many baby products have to adhere to strict safety standards and baby carriers are no exception.

DOS AND DON’TS 

  • Do not drink hot fluids while wearing your baby.
  • Do not drive a car or ride a bicycle while wearing your baby.
  • Do not do any form of intense exercise while wearing your baby.

Whatever carrier you do go for, remember to wear it safely!

RESOURCES

Babyslingsafety, (n.d.) The T.I.C.K.S Rule for Safe Babywearing. [Online]. Available from: http://babyslingsafety.co.uk [Accessed15 August 2018].

Esposito, G. et al., (2013) Infant Calming Responses during Maternal Carrying in Humans and Mice. Current Biology. [Online] 23, pp. 739-745. Available from: http://dx.doi.org/10.1016/j.cub.2013.03.041 [Accessed 14 August 2018].

International Hip Dysplasia Institute, (2015) Baby Carriers, Seats, & Other Equipment. [Online]. Available from: http://hipdysplasia.org/developmental-dysplasia-of-the-hip/prevention/baby-carriers-seats-and-other-equipment/ [Accessed 14 August 2018].

Ludington-Hoe, S.M. (2011) Evidence-Based Review of Physiologic Effects of Kangaroo Care. Current Women’s Health Reviews. [Online] 7, pp. 243-253. Available from: http://eurekaselect.com/88428 [Accessed 14 August 2018].

10 Essential Tips To Prevent Poisoning In Your Home

I was recently prescribed some analgesics for a small day procedure. That afternoon, when I got home, I placed the packet of meds on my dresser and later found my daughter sitting on the floor inspecting the packet. My heart stopped! This careless mistake could have had devastating consequences.

Unfortunately poisoning data in South Africa is lacking. One study dating back to 2012 found that the most common cause of accidental poisoning in SA children is pesticides. However, the list of potential poisons throughout our homes is extensive; here are just a few more obvious ones:

  • Medications
  • Household cleaners and disinfectants
  • Cosmetics and toiletries
  • Insect and rodent repellants
  • Weed killers and other outdoor chemicals
  • Swimming pool chemicals
  • Flea and tick shampoos and other products for pets

I have put together a list of some useful tips to prevent accidental poisoning at home. Some of them may seem fairly obvious but as I have recently experienced it is easy to forget.

  1. Keep all potential household and other hazards in their original containers. DO NOT transfer into coke bottles or Tupperware’s.
  2. Make sure seals of potential hazards are tight and secure before locking away. Please note that child resistant packaging of medications is NOT childproof.
  3. Keep potential hazards locked away in the highest cupboard with a childproof lock. The cupboard should even be high for you, as little minds can get quite creative with boxes and stools and climb up onto countertops.
  4. Keep potential hazards out of reach of children when in use and never leave bottles or buckets unattended.
  5. Never call medicine sweets/candy. This is a common mistake parents make in order to get their kids to take medicine when sick. This could lead to a child one day consuming an entire bottle of ‘sweets’.
  6. Never leave your handbag lying around and be extra cautious when you have visitors over as many people keep painkillers in their bags.
  7. Alcohol is often overlooked and is very dangerous to your little ones if consumed in excess. Keep alcohol out of reach of children especially when hosting parties.
  8. Any kind of battery can be dangerous if leaking or ingested. Keep remote controls and other battery containing devices away from children.
  9. If you are unsure about whether or not a household item is hazardous, assume it is and keep it locked away. Things that seem harmless are most often extremely dangerous.
  10. Most importantly TEACH your children about the dangers!

It may be a good idea to identify what potential hazards you have in your home. Do a check of every room in the house including your garage and make sure your home is safe.

RESOURCES

Balme, K., Roberts, J.C., Glasstone, M., Curling, L. & Mann, M.D. (2012) The changing trends of childhood poisoning at a tertiarychildren’s hospital in South Africa. South African Medical Journal. [Online] 102 (3), pp. 142-146. Available from: http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742012000300023&lng=en&tlng=en [Accessed 8 August 2018].

Veale, D.J.H., Wium, C.A. & Müller, G.J. (2012) Toxicovigilance I: A survey of acute poisoning in South Africa based on Tygerberg Poison Information Centre data. South African Medical Journal. [Online] 103 (5), pp. 293-297. Available from: http://www.samj.org.za/index.php/samj/article/view/6647/5054 [Accessed 8 August 2018].

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