I was recently asked by All4Women to put together my top 10 first aid tips for moms. I wanted to share these with all of you in this blog post. You can find more tips in my MiniKit Pocket Guide (https://www.oneaid.co.za/product/minikit/).
Keep emergency numbers on speed dial: Every parent should know who to call in an emergency. You should also teach this to your children. Write the numbers down and stick them on your fridge or somewhere near the phone.
Cuts and scrapes: Stop any bleeding by pressing firmly on the wound with a gauze or cloth. Then rinse the wound under cool running water before applying a dressing such as a plaster. Tap water is perfectly fine, you don’t need fancy antiseptic solutions.
Burns: Rinse burns under cool running water for up to 20 minutes. This will prevent any further damage and reduce pain. Do not use freezing cold water or ice
Bee stings: Remove the stinger if still attached and apply an ice pack to reduce swelling. Don’t use tweezers as this may squeeze out more poison. Rather scrape the stinger off with a flat-edged object such as a bankcard.
Nosebleed: Lean your child forward so they don’t swallow any blood and pinch the nose closed just below the bony part. Blood can irritate the stomach and cause nausea and vomiting.
Broken bones: If you suspect a broken bone don’t move the limb or apply any weight. Splint the injured limb to prevent any movement before going to the emergency room.
Seizures: Never put anything into the mouth of a child who is having a seizure. This includes medicines for fever if your child is having a febrile convulsion. Roll your child onto his or her side and wait for the seizure to stop.
Heat exhaustion: Get your child out of the heat and elevate his or her legs. Prevention is key so make sure your child drinks plenty of fluids before and during any activity in hot weather.
I am really looking forward to taking my little one to the beach for the first time this year. Whilst the beach is great fun for any child there are a few sea creatures that can ruin a holiday.
If your child gets stung by one of these little guys try not to panic. Most stings cause nothing more than a localised skin reaction and a whole lot of pain. If your child is prone to allergic reactions there is a possibility they could however develop a severe allergic reaction and you will have to be on the lookout for this.
There are many dangerous marine animals but fortunately South Africa doesn’t have too many that your little ones will come across on the beaches and in rockpools. Below, I will describe how to manage the stings and bites of the most common sea creatures on South Africa’s shores.
There are over 2000 different species of jellyfish and the toxins vary among them.
The nematocysts (cells inside the tentacles that release the toxin) from different species of jellyfish are either inhibited or stimulated to release more toxin depending on what first aid is applied which can make initial management challenging.
The jellyfish we encounter in South African waters are most commonly a relatively harmless type of box jellyfish. They most often only cause immediate pain, redness, tingling and itchiness.
How to treat jellyfish stings:
There is some debate as to how to treat jellyfish stings. Some suggest rinsing the wound in seawater others suggest vinegar or hot water and then there also seems to be some confusion about the order of steps. Based on a systematic review, which provides the best evidence, I have outlined the management of a jellyfish sting:
Always provide Basic Life Support first. Don’t try remove any tentacles unless your child is responsive and stable.
Flush the area with seawater to remove the tentacles that are stuck to the skin. You can use tweezers to gently remove tentacles whilst flushing. You can also use your hands provided you wear gloves. Don’t scrape away tentacles or rub with sand as the pressure will only release more toxin. Do not use fresh water as this causes more toxin to be released.
Apply a paste of bicarb (50% bicarb of soda and 50% seawater) for several minutes and rinse off with seawater.
Immerse the area in hot water (as hot as possible without burning the skin). Heat will help to reduce the pain. Apply for 30-90 minutes either in a hot shower, bath or by using heat packs.
If heat has not helped the pain apply ice packs.
Oral analgesics, anti-inflammatories and antihistamines are all effective.
Monitor for a severe allergic reaction.
Jellyfish sting don’t’s:
Vinegar: I don’t recommend rinsing with vinegar. Vinegar is only effective for certain species of jellyfish and since it is very difficult to identify the species responsible for a sting I would avoid it. Vinegar can cause nematocysts to release more toxin causing significantly more pain.
Tweezers: Trying to remove stingers with tweezers or by scraping can also cause them to discharge more toxin. It is now recommended to avoid this.
The blue bottle, also known as the Pacific or Portuguese man-o’-war, is very common along the coast of South Africa. Management of these stings is similar to that of the jellyfish sting described above.
These spikey creatures are like the hedgehogs of the sea and are commonly found in rock pools. If your little ones accidentally step on one or touch one, the urchin will shoot out some of their spines.
As with most sea creatures some are more poisonous than others, but most sea urchins cause nothing more than a painful puncture wound similar to that of a splinter. On the odd occasion there may be also be burning, swelling and numbess of the area that lasts a few hours.
What to do if your child comes into contact with a sea urchin:
Remove all the spines with tweezers or your hands if large enough. Do this very carefully as the spines are fragile and can break easily.
Stop any bleeding with firm pressure.
Rinse the wound with salt water.
Soak the wound in vinegar throughout the day or apply a cloth soaked in vinegar over the wound to dissolve any spines you were unable to remove.
Follow with warm compresses to help with the pain and swelling.
Analgesics and anti-inflammatories such as Ibuprofen.
If you don’t manage to remove the spines and they don’t fully disolve with vinegar they may need to be removed by a medical practitioner.
The spines would also have caused puncture wounds into the skin so its important to keep the area clean and watch out for any signs of infection.
These beautiful creatures, which live in rock pools, can be very tempting for our kids and thankfully most of their stings are harmless.
What to do if your child has been stung by an anemone:
Flush the area with seawater to remove as many stingers as you can.
Immerse area in hot water for up to 90 minutes.
Apply ice packs if heat does not help.
Oral analgesics, anti-inflammatories and antihistamines.
Monitor for a severe allergic reaction.
WHEN YOU NEED TO SEEK MEDICAL HELP:
Confusion and/or loss of consciousness
Nausea and vomiting
Muscles cramps severe bleeding
Severe pain that won’t go away
Stings on a large surface area, the face, throat or genitalia
Signs of infection over the next few days: increased pain, redness, swelling, pus and/or fever
SIMPLE SAFETY TIPS
Look for any warning signs at the beach about jellyfish and other dangerous marine life in the area and AVOID.
If you find any jellyfish or blue bottles on the beach it’s likely there will be more floating around in the breakers. Rather avoid the water.
Never touch a jellyfish or blue bottle, even if it looks dead. The tentacles can still sting even if they aren’t attached to the body.
Invest in some good quality swim shoes. They can be worn in and out of the water. These have a rubber sole and will protect little feet from nasties they may step on, as well as the hot beach sand, which can burn.
Don’t forget that tetanus prophylaxis is important for any break in the skin. Refer to my previous blog for more information.
It’s important your kids respect the little animals they may come across at the beach. Teach your children to look but NOT touch. There are so many fun things to do at the beach so don’t let bluebottles and sea urchins scare you. Just keep an eye out and initiate immediate first aid to prevent a small injury from turning into something much bigger.
This weekend I plan on doing a little baking with my daughter. We are going to make cookies for her friends at playschool. My daughter loves getting involved in the kitchen which usually means I have to be super vigilent about keeping an eye on her.
I think the kitchen is the most dangerous room in the house. It’s the room with the most appliances, utensils and where most of us keep the cleaning materials. For our cookie making masterclass this weekend we will be using the oven for baking and this is why I am going to be talking a little more about thermal burns in children. Of course children can also sustain chemical and electrical burns in the kitchen but for this blog I will only be looking at thermal injuries.
Thermal burns can occur from hot liquids, hot solids or flames. According to the WHO, burns are the “fifth most common cause of non-fatal childhood injuries” worldwide. However in South Africa things are a little more frightening. In children 1 to 4 years of age, thermal injury is the second most common cause of mortality, with toddlers and boys being at highest risk.
CLASSIFICATION OF BURNS
Burns are no longer classified as first, second or third degree and are currently being described according to the depth of the burn.
Superficial thickness – This burn involves only the epidermis (the outermost layer of the skin). Here you will only notice a reddening of the skin.
Partial thickness – This is further classified into superficial or deep partial thickness. This burn involves the entire epidermis and parts of the dermis.
Superficial partial thickness: appears red with blisters and is very painful.
Deep partial thickness: looks waxy white with some areas of red, wet and blistered. This depth of burn may be less painful.
Full thickness – This burn involves the entire epidermis and the entire dermis. The skin looks white and leathery. There is no pain as the nerve endings in the skin have all been damaged. However, surrounding areas of partial thickness burns will be painful.
Fourth degree – This is the deepest type of burn where there is damage to the structures underlying the skin such as the muscles and bones.
Full thickness and fourth degree burns almost always require surgical intervention and skin grafting. Some deep partial thickness burns may also require surgical management.
HOW TO TREAT A COOKING BURN
Act FAST:A child’s skin will burn much faster than adult skin.
The longer a burn remains open, the more likely it will get infected so get it covered as quickly as possible.
Remove your child from the source of the burn.
Remove any clothing near the affected area to expose the wound. Don’t try to remove anything that is stuck to the burn.
Place affected area under cool running water for up to 20 minutes. Do this as soon as possible to prevent any further thermal injury.
Pat dry gently with a clean cloth or gauze.
You can now apply a burn gel if you have one (if you don’t have this proceed to the next step). This will help cool the wound but should only be used short-term. Remove after a few hours and wash away any excess gel left on the wound with cool running water, then gently pat area dry.
Cover the wound loosely with a dry, sterile non-adherent dressing.
WHAT ABOUT BLISTERS?
It’s important to leave blisters alone. You can apply a burn gel over a blister. Just be careful when you rinse the wound of the gel once you remove it that you don’t rub too hard, as the skin on top is very thin. Cover the blistered wound with a dry dressing.
If the blister has popped the underlying skin is raw and exposed and at increased risk of infection. It is now even more important to keep the wound clean. There is new evidence to suggest that you can now cover the wound with a wet dressing until it heals provided you regularly wash the area and keep the dressings clean.
I have seen patients put all kinds of things on their burns. Superficial burns require nothing more than initial cooling, a dry dressing and some painkillers. If there are blisters you can manage the wound as described above. Applying home remedies can do more harm than good.
Antibiotic ointments for prophylaxis (prevention of infection) are an issue of debate. Many specialists don’t advocate their use as they can cause antibiotic resistance if the wound were to get infected.
GO TO THE ER!
Any burn, regardless of depth, bigger than the palm of your child’s hand;
Any burn, regardless of size, deeper than a superficial partial thickness burn;
Any burn, regardless of size, involving the head and neck, hands, feet, groin and joints;
Circumferential burns of any size around the chest, abdomen or a limb; and/or
When there was a risk of inhalation burns
SAFEGUARD YOUR KITCHEN AGAINST BURNS
Burns are preventable!
Make sure appliances that contain hot liquids such as kettles and slow cookers as well as hotplates are kept out of reach.
Make sure that electrical cords of these appliances are also out of reach. Exploring children can pull on the cords as well as trip over them if they are lying on the floor. I read about an incident where a young child tripped over a cord pulling a slow cooker and all the hot contents over her. She sustained serious full thickness burns over most of her body.
Use the furthest burner on the stovetop and keep pot handles turned away towards the back.
Don’t mix hot liquids in a blender as the contents can explode out onto whoever is standing nearby.
Be careful of long hair and loose clothing, which can catch on fire.
Keep paper towels, dishcloths and oven mitts away from the stovetop as they can catch on fire.
If you have little children running around you should never take your eye off the kitchen if you still have something cooking.
Cooking with your kids can be so much fun. It’s hands on and a great form of ‘messy play’. It’s also a great way to get your children to explore new flavours. I find that if my daughter has been involved in the prepping of her meal she is much more likely to eat it. Next time why don’t you let your toddler better their motor skills by cracking open some eggs or measuring out some flour.
We recently went to a very popular restaurant for lunch and to my astonishment there were vending machines with gumballs and other small toys, right next to the jungle gym. This is a disaster waiting to happen!
Children under 3 are at the highest risk of choking because their airways are so small. Plus, chewing and swallowing is a lot more difficult for them. They also love to put foreign objects in their mouths. There is a cylindrical tool in the US used to measure toy parts that is the same size as a young child’s throat. If a toy part fits into this cylinder it’s a choking hazard and a warning label has to appear on the toy packaging. Therefore any object smaller than 3 cm wide is a choking hazard for small children.
WHAT IS A CHOKING HAZARD?
Any object that can get caught in a child’s throat and block the airway is a choking hazard.
TOP 10 HOUSEHOLD CHOKING HAZARDS
Once your baby starts to crawl and explore, choking hazards are all of a sudden everywhere.
Small caps of bottles e.g. juice and water bottles
Small round batteries
Toys and toy parts
Balloons (uninflated or popped)
Nails and screws
Stationary e.g. staples, paper clips and pen lids
If you have older kids too, you should keep their toys separate and make sure they learn to pack their toys away.
There are countless more choking hazards. You should probably get down on your knees and have a look at your child’s eye level. How many more choking hazards can you find?
TOP 10 FOOD CHOKING HAZARDS
Hotdogs, grapes and popcorn are the top 3 causes of choking in children under the age of 3. Young children have a hard time chewing their food since they lack the proper dentition (canines for tearing and molars for grinding). They are still trying to coordinate chewing, and as a result, often just swallow their food whole. This makes smooth, slippery, round and hard foods especially dangerous.
The foods in the list below are not recommended for children under 4 years of age. The American Academy of Pediatrics (AAP) goes even further and recommends that hotdogs, grapes and popcorn not be given to children until they are at least 5 years old.
If you do however want to give your children some of these foods, then cut them in such a way that you change their round shape. Hotdogs should be cut lengthwise before slicing and skins of other sausages removed. Grapes and other round fruit should be cut into quarters.
Whole grapes, cherry tomatoes and other round balls of fruit (blueberries are ok for toddlers as they are soft to chew)
Hot dogs and other sausages
Tough, large pieces of meat
Fruit pips and stones
Nuts and seeds
Hard round sweets and caramels
Raw vegetables, especially carrots
Children can trip and choke more easily if playing and eating at the same time. Your child should not walk, run or lie down while eating. Children should not be distracted whilst eating. They must sit upright and concentrate on what they are doing.
It is also not advisable to have your young child eat in their car seat whilst you’re driving. You might not even notice if they’re choking.
You should always supervise your child when they are eating.
It’s important that all parents and caregivers learn first aid for choking and CPR. There are many training academies that offer such courses around the country that are usually done over one day and will make you feel more confident when dealing with childhood emergencies.
South Africa has updated its pool safety regulations this year and now all private swimming pools not only need to be fenced off, but they also need to be fitted with either a pool cover or safety net when not in use. The new regulations form part of the SANS 10134 which is a SABS standard for the safeness of private swimming pools.
Lets take a look at the regulations and some additional measures that can be taken to safetyproof your swimming pool. No single safety measure is foolproof therefore its better to rather use as many as you can together.
1. Swimming Pool Fence
According to the South Africa Bureau of standards (SABS) a fence must surround a body of water that holds more than 30 cm of water.
The fence gate must be self-closing and self-locking. The fence must be at least 1.2m high and sunk into the ground by at least 50cm. The vertical slats should be no more than 100mm apart.
Children should not be able to climb over or through the fence and should not be able to open the gates themselves.
2. Swimming Pool Cover
The SA safety standard also requires a swimming that holds more than 30cm of water to be covered by a cover or safety net. DIY installed nets are no longer allowed. An “accredited responsible party” must professionally install a cover and a cover is not approved if a child can unfasten it.
If your pool is small (less than 2.4m at the widest point) the cover must be able to hold the weight of one adult and one child. If you have a larger pool then the cover must hold the weight of two adults and one child in case the first adult falls into the pool during a rescue mission.
3. Swimming Pool Alarm
A swimming pool alarm is an additional safety measure you can have installed. Detectors with sensors that extend into the water are mounted onto the sides of the pool. You can also get free floating alarms. Waves form on the pool surface when a child comes into contact with the water, which triggers these alarms.
You can also have a pool alarm installed on the swimming pool gate, which is activated when the gate is opened.
4. Swimming Pool Chemicals
Make sure all pool chemicals are locked away out of sight and out of reach. Children may mistakenly drink these and contact with the skin can cause chemical burns.
DO NOT FORGET
The same rules apply to water features and fishponds. Cover these with safety nets as children can drown in as little as 2.5cm of water.
It’s also a good idea to keep the pool brush or net nearby. The pole can be used to help someone in the water if needed.
Regularly inspect your safety measures. It’s not uncommon for dogs to chew the safety nets causing them to become lax and ineffective.
There are many different products and brands available. Make sure whatever you choose is SABS approved.
I have attended to many children in the ER who have taken a tumble. In the US, falls account for around half the injury-related ER visits in children under 5 years of age. Most of these falls involve furniture such as changing mats, high chairs, baby walkers and beds.
Parents are almost always concerned about head injuries. Majority of head injuries from a fall are usually minor.
Children under one who fall are more likely to sustain head injuries regardless of the height from which they fall. Whereas older children are more prone to extremity fractures. This is because an infant’s head is much larger than the rest of their body. As a child grows, their head mass becomes more proportional and they develop upper body strength, which enables them to brace falls with their arms or legs.
WHEN TO SEE A DOCTOR
If your child is awake, alert and behaving normally after a bump to the head with no other signs and symptoms then he or she will most likely be fine and you don’t have to rush to hospital right away. It’s a good idea to observe your child for 1-2 days afterwards, since symptoms of a brain injury may present late.
Seek Medical Attention:
For any bump to the head in an infant;
If your child has lost consciousness, even if brief;
If your child has any signs and symptoms of a concussion (see below);
If your child is inconsolable;
If your child is vomiting;
If your child is difficult to wake;
If your child has a seizure; and/or
If you suspect a broken bone.
If your child has had a bad fall and you suspect a neck injury DO NOT move your child. Call an ambulance right away! Always trust your gut. If you are unsure rather head straight to your nearest emergency room.
A concussion is a brain injury caused by a blow to the head. The signs and symptoms may be vague and may even take a few days to develop. It’s important to know that not all concussions cause a loss of consciousness.
Concussions can be more difficult to diagnose in children, as they are not as vocal about their symptoms. Children older than 2 years will show more behavioural symptoms.
Signs & symptoms will therefore depend on age and include but are not limited to:
Irritable and fussy;
Crying more than usual;
Change in appetite;
Nausea and/or vomiting;
Lack of interest in play;
Child is unsteady on his or her feet;
Sensitivity to light and noise;
Blurred or double vision;
Unusual speech e.g.: slow or slurred;
Poor concentration and memory; and/or
Problems with co-ordination.
DIAGNOSING A CONCUSSION
The doctor will do a thorough evaluation. A CT scan and MRI cannot diagnose a concussion. A CT scan will however, most likely be ordered to exclude a brain bleed or skull fracture depending on the mechanism of injury and presenting symptoms.
The majority of falls in children are caused by modifiable factors and are therefore preventable. It’s impossible to bubble wrap our kids and we shouldn’t have to. Falls and tumbles can teach our children valuable lessons, but we can spend time baby proofing our homes and being more cautious to prevent serious injury. Remember to always buckle your baby in their high chair and never leave him or her unattended on a changing mat, not even for a second – it takes seconds for an accident to happen.
I’m sure many of you have heard of SIDS, which is also known as cot death. SIDS is defined as the sudden unexpected death of an infant, which appears to happen during sleep, where the death can’t be explained even after an autopsy.
In the developed world, SIDS and suffocation are the most common cause of sudden unexpected infant deaths (an infant is a child under 1 year of age). Unfortunately, in South Africa, we don’t know the stats since most infants that die unexpectedly don’t undergo routine autopsies to identify cause of death.
You all probably know that back sleeping is the safest for your baby, but there are other additional ways you can reduce the risk of SIDS and other sleep-related causes of death. I have put together some tips in which to create a safe sleep environment for your baby from birth up until 1 year of age.
Always place your baby to sleep on his or her back, for night sleeps AND naps. There is no evidence to prove that your baby is more like to choke if he or she vomits or regurgitates in this position, compared to a baby that sleeps in any other position. Placing your baby to sleep on their side is also not recommended, unless indicated for medical reasons by your practitioner.
Once your baby starts to roll, continue to place them to sleep on their backs but do not drive yourself mad by constantly repositioning them if they do roll over in their sleep. Once babies have mastered the art of rolling they can roll themselves right out of trouble if their breathing becomes difficult.
It’s important to also talk a little bit about flat head syndrome (plagiocephaly). Back sleeping is associated with this condition. Babies’ skulls are soft and constant pressure on the same spot can cause the head to change shape. You can avoid this deformity by repositioning your baby’s head to face opposite sides with each sleep.
Your baby should sleep on a firm flat surface. Not a soft surface like a couch, pillow or blanket. Babies should not sleep in car seats, baby swings and carriers either (this is not back sleeping). If your baby does fall asleep in one of these, it’s better to place them flat in their cot or bassinet as soon as possible. I spoke about recline angle and heads blocking airways in my post about car seat safety.
In addition to floppy heads its important to realise that a baby’s head is very large compared to their body. So if you elevate the head too much the airway can also become obstructed.
It’s hard to avoid decorating your little one’s room when there are so many gorgeous accessories available. Just remember to remove all loose items from their beds before naps and bedtime. Such items are a potential entrapment, strangulation and suffocation hazard. Pillows, blankets, stuffed animals and even cot bumpers should not be in your baby’s bed whilst they sleep. There is no evidence to even prove that cot bumpers actually do prevent injury and infants don’t need pillows.
Please also be aware of mobiles. Depending on how high your mobile is your little one may be able to reach for it, as he or she gets older. Then the strings and other components could become a choking and/or strangulation risk.
This tip is debatable since there is mixed evidence in the literature. The American Academy of Pediatrics (AAP) recommends that your baby share your room but not your bed. This recommendation was introduced after many infants who co-shared died by either becoming trapped in the bedding or smothered by a parent.
Interestingly in African and Asian countries, this has not been seen. These countries, where co-sharing is the norm, actually have lower rates of sleep-related infant deaths than Western countries. Researchers suggest that co-sharing is actually protective because infants who sleep next to their parents are constantly stimulated. This stimulation keeps them in a more aroused state so they spend less time in deep sleep and are therefore at a lower risk of stopping breathing.
Your baby should not get too hot in their sleep. Dress your baby in only ONE extra layer than you would comfortably wear. A sleep sack is a safe option. No blankets please!
The room temperature should also be kept comfortable. Most baby monitors have a built in temperature function but if yours doesn’t, keep an indoor thermometer in the room and don’t let the temperature go higher than 22o Celsius.
It has been shown that a pacifier reduces the risk of SIDS. You can try giving your baby a pacifier but only once breastfeeding has been well established (if you choose to breastfeed). The nipple can confuse your baby if given too early and you may then have problems with latching.
Remove dummy chains or strings before giving your baby a pacifier to sleep. Also, don’t stress if the dummy falls out during sleep (it most probably will), you don’t need to replace it.
Don’t force a dummy. It’s ok if your baby doesn’t like it, not all babies do.
Now take a step back and look around your baby’s room. Make sure all electrical cables, window blind cords and any other potentially hazardous items within arms reach from the cot are removed.
Looking after our babies is a lot of work and we always need to be on call and think 2 steps ahead. But now that your little one is sleeping SAFELY, go and put your feet up and have a cup of coffee… or maybe go take a nap yourself!
Koren, A., Reece, S.M., Kahn-D’angelo, L. & Medeiros, D. (2009) Parental Information and Behaviors and Provider Practices Related to Tummy Time and Back to Sleep. Journal of Pediatric Health Care, [online] 24 (4), pp. 222-230. DOI: 10.1016/j.pedhc.2009.05.002 [Accessed 26 September 2018].
We all know how long it can take for a child to fall asleep. So when you reach your destination and your little one has finally fallen asleep you couldn’t feel more relieved. You wouldn’t dream of disturbing them by removing him or her from the car seat. Instead you do what is the most convenient, and move your child from your car into a pram chassis or straight into your home without ever moving them from the car seat.
Whilst car seats have saved many lives, they do have some hidden dangers. A study in 2015 found that out of all the sitting and carrying devices for young children, car seats were responsible for the most number of deaths. Hypoxia and suffocation from either poor positioning in the car seat or strangulation by the straps and buckles was the cause of death in all these cases.
This is when there is a loss of oxygen in the blood which reduces the amount of oxygen reaching the tissues. When there is an extreme loss of oxygen a child will suffocate.
The developing brain is very sensitive to a decrease in oxygen. Loss of oxygen can cause brain injury and result in a range of developmental problems as well as seizures.
The position of your car seat is important. The Recline Angle of a rear-facing car seat is critical and an angle between 30-45o from the vertical is recommended. A recline angle more than 45o offers very little protection in the event of a crash.
A newborn or young infant’s head is heavy and the neck muscles are weak. If the recline angle becomes less and the car seat more upright, the head will flop down and obstruct the airway. A newborn should therefore be positioned in the lowest possible position, which still offers crash protection. As babies grow their neck muscles get stronger and the angle of the car seat can become more upright since their head and neck control improves.
A number of studies have looked at the level of oxygen in an infant’s blood whilst in their car seat. A level of oxygen less than 90% is considered dangerous. It was shown that children’s oxygen levels dropped as far down to 83.7% when in incorrectly positioned car seats. The authors also found that the longer the child remained in the car seat the lower the oxygen level would drop.
Another study found that a child in a correctly placed rear-facing car seat is still at risk of suffocation. The vibration produced by a car could cause newborns and young children’s head and shoulders to fall forward, despite correct use of the straps and buckles. This risk was also similar for both term and preterm infants.
Some specialists recommended that young babies spend no more than 30 minutes to an hour in a car seat at a time. If a long journey is unavoidable it may be wise for someone to sit in the back with your child to keep an eye out.
STRAPS AND BUCKLES
Always make sure your child is properly securely in a car seat. If the straps are too loose a child can easily slip or even wriggle down far enough to become strangled by the straps. If the child falls lower down in the seat the child may also suffocate from an obstructed airway if the head falls onto the chest.
Never place your baby in a car seat on a soft surface such as a bed or couch. This type of surface could cause the recline angle to change resulting in your child’s head falling forward and obstructing the airway.
Never loosen or unbuckle any straps if you do decide to keep your baby in a car seat outside of the car. A child can wriggle and slip down far enough to be strangled by the straps and even fall out of the car seat altogether.
Never leave an infant or young child unsupervised in a car seat if they are asleep or even if they are awake.
Never place your baby in a car seat on an elevated surface such as a table. A baby can wriggle enough to cause the seat to move and fall off the surface.
Never place your baby in a car seat on the floor without looking at the recline angle. Some car seats may become more upright when placed on the floor.
Always make sure your car seat is installed correctly. Most car seats come with a built-in indicator that allows you to see if the seat is installed at the proper angle.
Read the manual carefully and if in doubt contact the local manufacturer or distributor. You can also contact Julie at Precious Cargo (www.preciouscargo.co.za) to book a professional car seat installation.
Arya, R., Williams, G. and Kilonback, A. et al. (2017) Is the infant car seat challenge useful? A pilot study in a simulated moving vehicle. Arch Dis Child Fetal Neonatal Ed, [online] 102, pp. 136-141. Available from: https://fn.bmj.com/content/fetalneonatal/102/2/F136.full.pdf [Accessed 13 September 2018].
Batra, E.K., Midgett, J.D. and Rachel Y. Moon (2015) Hazards Associated with Sitting and Carrying Devices for Children Two Years and Younger. The Journal of Pediatrics, [online] 167, pp. 183-187. Available from: http://dx.doi.org/10.1016/j.jpeds.2015.03.044 [Accessed 13 September 2018].
Rholdon, R. (2017) Understanding the Risks Sitting and Carrying Devices Pose to Safe Infant Sleep. Nursing for Women’s Health, [online] 21 (3), pp. 225-230. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28599744 [Accessed 13 September 2018].
We recently celebrated my daughter’s two-year birthday and, of course, decorated the house with balloons. No children’s birthday party is complete without balloons and although they are very popular with kids, they can also be extremely dangerous. Which is why I wanted to do a post on the potential dangers of balloons:
Children can choke on balloons if they breathe them in whilst trying to blow them up. This happens when a child takes in a deep breath before inflating the balloon and accidently sucks the balloon back into his or her mouth. A child can also choke if they swallow deflated balloons or pieces of popped balloons they may chew on. If a balloon pops in a child’s face the child can also inhale the balloon pieces as they fly through the air.
Latex is a dangerous material to choke on as it can fit tightly in the throat and cause a complete airway obstruction very quickly. Whilst foil balloons are usually blown up with helium they can also become a choking hazard if deflated balloons or broken pieces are swallowed. There was a widely reported incident in 2016, where a three-year-old suffocated after putting the foil balloon over her head.
Balloons can pop without warning. They can pop if children play with them roughly or if little children chew on them. Poor quality balloons can also pop more easily even if they aren’t being rough-handled. Children can also trip over balloon strings and fall onto the balloons popping them. If balloons pop near a child’s face they can cause serious damage to the eyes as well as cuts to the face.
This may be an overlooked hazard. The colourful strings and ribbons that are tied to balloons can become a strangulation hazard as children become tangled.
ALWAYS KEEP IN MIND
Keep uninflated balloons away from children
Do not let children blow up balloons
Inflated balloons should be kept out of reach of children
Children should never play with inflated balloons
Always supervise children when inflated balloons are around
Throw away deflated and popped balloons immediately
Throw away balloon strings immediately when balloons deflate and pop
In the United States the Child Safety Protection Act requires a warning to be placed on any latex balloon or toy containing a latex balloon. This warning states that children under eight years of age are at risk of choking or suffocating on uninflated or broken balloons. Similarly, in the EU, children under the age of eight are actually legally banned from blowing up balloons without adult supervision.
However, children as old as 10 years have been found, on autopsy, to have suffocated from a balloon, which makes it difficult to define what age is actually safe for kids to handle balloons.
I think its important to stress to your kids that party balloons are not toys. They are purely for decoration and should always be properly secured and disposed of after use.
Francis, P.J. & Chisholm, I. H. (1998) Ocular trauma from party balloons. British Journal of Opthalmology, [online] 82 (2). Available from: https://bjo.bmj.com/content/82/2/203.1 [Accessed 6 September 2018].
Meel, B.L (1998) An Accidental Suffocation by a Rubber Balloon. Medicine, Science and the Law, [online] 38 (1), pp. 81-82. Available from: https://doi.org/10.1177/002580249803800113 [Accessed 6 September 2018].
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
It is great for bonding with your baby.
It supports breastfeeding.
It helps reduce symptoms of reflux and indigestion in your baby.
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.
It provides vestibular-proprioceptive stimulation which also helps calm your baby by inhibiting the movement muscles and relaxing the body.
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.
In view at all times
Close enough to kiss
Keep chin off the chest
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.
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.
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!
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].
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].