From the April 2018 issue

How to Protect Your Baby From Dangerous Sink-Bath Burns

The injuries are more common than you'd think. A top local expert from Children's Hospital of Michigan offers prevention tips.

Bathing your newborn in the sink can be one of the most enjoyable moments of new parenthood. It’s often part of a calming bedtime routine or even a way to elicit some of baby’s first smiles and coos.

But it can also turn traumatic in a matter of seconds, especially when parents are distracted or haven’t taken the proper precautions, says Dr. Justin Klein, M.D., the medical director of the burn unit and pediatric general surgeon at the Children’s Hospital of Michigan.

Newborn sink burns happen when a baby’s delicate skin is scalded by water that’s hotter than parents realize or turns hot by accident. Usually causing a painful second-degree burn, these dangerous injuries unfortunately happen more often than you’d think.

“It’s pretty common,” he says. “It’s a lack of knowledge or understanding of how it can occur and how quickly it can occur.”

The surprising frequency is what prompted Children’s Hospital of Michigan to start studying the issue, looking back at previous cases and finding out how they could help protect babies from these burns.

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“We noticed that we’ve had a lot of these babies that get burned from sink bathing. It seemed like a very preventable injury or something that if we had the proper outreach and education, we’d be able to have a plan and make a change,” Dr. Klein explains.

By reviewing the hospital’s past 72 cases of infant sink burns, doctors found just one case that was due to abuse.

“These are people with the best intentions of bathing their baby who unintentionally, on accident, something happens or somebody got distracted,” he says. “When we looked at some of the circumstances of those patients, 73 percent of the time it was a supervised baby with a distracted parent.”

Even a quick moment of distraction can lead to a sink burn since babies can accidentally kick or nudge the faucet, turning the water hotter than it should be. A safe bathwater temperature is 100 degrees, but many homes have water heaters that reach 140 to 150 degrees.

“The telephone rings, you need to turn around or grab a towel or the soap or something that’s not within arm’s reach and just during that time the kids can kick the faucet and it turns to hot. They may be reaching and grabbing if they’re a little bit older,” Dr. Klein explains.

In 10 percent of cases, a parent mistakenly ran the water too hot and in another 10 percent of incidents, the water was running but the temperature changed quickly because a toilet flushed or another malfunction.

“Sometimes a toilet flushing in another part of the house can cause the water to get hot enough to burn the child,” he says.

And in seven percent of cases, the parent didn’t check the water temperature before putting baby in the bath.

All of this data will be presented this month at a national conference of the American Burn Association.

“Our next steps are developing pamphlets and information that we can put out to pediatricians’ offices and hospitals for new parents just to get the information out there and give them a few tips of things to watch for,” he says. “It really is something that happens quite frequently.”

When newborn sink burns do occur, you’ll want your child treated at a verified Pediatric Burn Center like Children’s Hospital of Michigan – the only children’s hospital in the state with a verified burn center. Treatment usually includes dressing changes and time, with most burns healing in about 10 to 14 days. Some babies do need to stay overnight at the hospital; in the 72 cases studied, the average length of stay was two and a half days.

“The good news is the need for a skin graft is very rare,” Dr. Klein says. “There are some that will leave a lasting scar even though the wounds heal without the need for a skin graft, but generally most of these fall into a superficial second-degree burn.”

To help prevent sink burns, water heaters should be set at a maximum of 120 degrees fahrenheit.

“At 120 degrees an infant will sustain a full thickness third-degree burn in 20 seconds,” he points out. “At 130 degrees, it’s 5 seconds. And at 140 degrees, it only takes one second. At 150 degrees, it’s a one second to almost instantaneous burn.”

Parents should gather all necessary supplies before starting the bath, and consider using a water thermometer to check if it’s safe.

“Turn the cold water on first and off last, and check the temperature before the child is put in,” Dr. Klein says. “The last tip is really to try and avoid distractions.”

Keep in mind that babies have a lower threshold for getting burned and certain parts of the body are even more sensitive.

“Kids will get burned easier and quicker than adults,” he says.

For more information on the Children’s Hospital of Michigan or to make an appointment, visit childrensdmc.org.

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