Transcription:
At Home Safety

Melanie Cole (Host):  There’s no handbook for your child’s health. But we do have a podcast featuring worldclass clinical and research physicians covering everything from your child’s allergies to zinc levels. This is Kids Health Cast by Weill Cornell Medicine. And our topic today is at home safety for children. My guest is Dr. Michael Defeo. He’s an Assistant Professor of Clinical Pediatrics at Weill Cornell Medicine. Dr. Defeo, it’s a pleasure to have you joining us today. I love talking about all things kids. So, as we get going, what is the first most important thing you’d like parents to know and new parents to know about at home safety for our little kiddos?

Michael Defeo, MD (Guest):  At home safety it really is such an important topic. There are approximately about four million household injuries per year among children and teenagers. That’s a high number. What I really like parents to know is there are so many simple measures which can be applied in their homes to decrease an injury. I don’t want parents to feel like distress or defenseless which you hear this high alarming number. This is something that we discuss at our well-check care visits and I try to calm the parents down as much as I can.

Host:  Well I think that that’s such an important point. So, let’s go around the rooms of the house. Let’s start with the bathroom. What should we be aware of that can be dangerous in there? Bathing, showers, cosmetics, medications. So many things in the bathroom.

Dr. Defeo:  Yes, a bathroom is a known dangerous room in the home. The potential dangers are slips, falls, electric shocks, exposure to hazardous chemicals and drowning also. Parents have to be aware. And so, what I tell the parents is supervision is the simplest way to really avoid bathroom injuries. The child should never be alone in the bathroom. Some parents in my practice, they try and make this room not accessible to children. It’s all hard and difficult to enforce but they do try.

Simple measures that I tell the parents are do not leave your child alone in the bathroom, not even for one minute. If the doorbell goes off or the phones are ringing, they should disregard them. They should just concentrate on the child in the bathroom. Another simple measure is adjusting the water heater to 120 degrees Fahrenheit. This would avoid scalding skin burns to children. Children tend to just go into the water without testing the temperature. And so, it’s very important that you adjust the water heater in your home.

The toilet seat is another danger. As adults, get in the habit of closing the toilet seat. You can also purchase a lid lock if needed. As you said before, medications, cosmetics, cleaners. They all should be stored in a locked cabinet well above the reach of the child. Now, one word about medications. Medication containers, they should have safety caps and today, most do have safety caps when you get them from the pharmacy. But I tell parents they must remember; safety caps are not 100%. Somehow these little kiddos get into their medications and they find a way of opening them even with safety caps. So, even though medication containers have safety caps; they still should be stored in a locked cabinet out of reach.

Lastly, about bathroom safety, I think parents need to inspect the bathroom. Go in, they need to look for electrical devices like razors and hair dryers. Anything that’s plugged into a socket needs to be pulled out. And keep them out of the reach of the children. I also suggest sometimes in my practice to parents take the electrical appliances and just put them in another room. Completely take them out of the bathroom setting.

Host:  That’s a really good advice. And so important for parents to hear. And as we’re talking about moving around the house; I’ve heard people say that you should crawl around when you’ve got a little one that starts crawling and toddling to see what is pointy or where those plugs are or what they can trip and hit their head on. Let’s talk about children and falling. How can we protect them from head trauma and serious falls? There’s table edges, and stairs and all kinds of things around. What do we do?

Dr. Defeo:  In preventing head injuries I think the number one way of preventing a head injury is simply wearing helmets. We frequently see in our practice head injury from kids riding bicycles or skateboarding. The statistics show that parents may not realize the importance of helmets. When you look at the numbers, 85% of bicycle related head injuries could have been prevented by wearing a helmet.

Now in the practice, it seems the one question I frequently am asked is how do I get my child even teens, how do I get them to wear a helmet? They refuse to wear the helmet and they don’t want to wear a helmet. It produces anxiety between the child and the parent. Some simple tips are basically start at an early age. Encourage them to wear it at all times. And the parents should be a good example. The parents should wear a helmet and show the child the safety concerns. Allow the child to pick out his or her own helmet. It may be the design. It may be the color. And both these factors may contribute to the child wearing the helmet. In addition, the helmets should be properly secured or properly fitted for the child. A helmet that’s not properly secured, could be more dangerous to the child if they were to fall and hit their head.

Looking at other ways. Home safety prevents head injuries. Like you stated before, a few simple measures like children should not be jumping on and off beds. We see so many times in our practice that a child jumps off a bed, fooling around and the next thing you know, they hit their head on the floor and they have to go to the emergency room. The toddler beds, the rails should be always kept up. I don’t truly advise bunk beds but if a parent does have a bunk bed, I tell them to make sure the rails are up all the time. Placing bumpers and guards on furniture. A child can fall, hit into a sharp edge of a piece of furniture and lacerate their forehead or their head. So, it’s very important that you have these guards.

Another one is safety gates at the top and bottom of staircases. This will prevent the child from freely being able to go up and down steps and there is a risk for falling down the steps at a younger age. Lastly, is installing window guards, making sure that a child cannot open a window and fall out. These are just simple measures to prevent head injuries.

Host:  Well they are pretty simple measures and as a parent who did have those bumpers on all the sharp tables and chair edges and people thought I was nuts, but I think it’s such a great bit of advice. It’s such a great idea. Are we still using baby walkers Dr. Defeo, because back in the day, we’d put the little guy in there and they’d cruise around the house. But now people have like to steps down to the living room or basement stairs. Are we still using those things?

Dr. Defeo:  Great question Melanie. We are not. We do not recommend any type of walkers due to the potential for a serious injury. Baby walkers send thousands of children to the ER per year due to injuries. The walkers basically they increase risk for head injury, broken bones, due to falls. They also place a child at a higher level. A child can reach onto a stove and burn themselves so they can reach and grab an object and ingest it that they should not be able to do so. And so, baby walkers create potential for a serious injury.

Host:  Well while you are talking about ingesting things and I want to get into choking, button batteries are something we’ve been hearing about from the American Academy of Pediatrics. What are they and where are they found?

Dr. Defeo:  Button batteries, there’s about 3000 button battery ingestions each year. It’s not uncommon when I’m on call to receive a call from a parent that their child may have swallowed a button battery. Or even may have placed in their ears or their nose. Unfortunately, these button batteries, they are small, they are round, they are shiny, and they are very appealing to young children. The problem is that they are easily accessible through common household products. I’ll give you an example like remote controls, toys, games, hearing aids. Grandparents come over and they leave their hearing aids out. There’s tiny button batteries in hearing aids. Scales, people in the kitchen like to weight their food on scales. Garage door openers. These are all common household products that everyone has in their home and this is where the potential comes for the child to get ahold of on and ingest it.

Now what the parents need to know, it’s a very serious concern. If can cause a major injury. For example, a lithium battery, the size of a nickel can cause serious injury. So, if a parent feels a child may have ingested a button battery; they need to look for symptoms like coughing, drooling, even wheezing, gagging episodes indicate a serious concern. If they are at all any suspicion, they need to take the child immediately to the emergency room. It’s been shown that complications from button batteries can be seen in as little as two hours after they ingest it. Parents should also know not to give the child anything to eat or drink if they suspect that the child has swallowed a button battery.

Host:  Wow, that’s so important to know.

Dr. Defeo:  Yeah. And Melanie again, another very simple measure for parents who do is just to prevent this type to injury is just ensure that there is no lose batteries, that they are stored out of reach of the children. Look at the battery holder compartment, make sure they are tightly sealed because if a child gets ahold of an object and they shake it really hard, they can open up that battery compartment and some parents even they pursue when they buy toys that are- have tightly screwed in the battery compartments so that if they are shaken or they are hit against a piece of furniture, that the battery will not fall out.

Host:  Well thank you so much Dr. Defeo for that great advice. And we don’t have a lot of time in these, but let’s move to the kitchen because burns, and scorches. It used to be one of my biggest fears. I mean it still is and I have teenagers and I’m like get out of the kitchen when I’m boiling water or frying things. And then there’s also chocking for our littler ones when we are feeding them solids, and this could be a topic all in itself. But give us a brief overview of the kitchen and what you want us to know as the most important parts of the dangers in the kitchen.

Dr. Defeo:  The kitchen is probably one of the most dangerous rooms in the household. Why? Well we spend a lot of family time in the kitchen. And the children really want to be in the kitchen with us. They want to be part of that – the action. And so, I know some parents do try to exclude a child from the kitchen but again, that’s difficult to enforce. But there are so many potential dangers in the kitchen.

As you stated. I’m not sure parents realize it but 30% of all fires start in the kitchen. You can have an electrical fire; you could be cooking in a pan and hot grease could cause a fire. Leaving a stove on. The front burners can be also a problem. Another serious concern is burns. Scalding type burns again, the child gets into that kitchen and he’s a toddler and he’s able to now walk and then reach up and he touches the front burner, he can burn himself just by touching the front burner.

Other scary stuff in the kitchen, knives. Sharp instruments. Cleaning chemicals. Hot ovens. Dishware. These are all safety concerns. If you remember Melanie, back in 2015, approximately, there were many children that were involved in accidents involving concentrated single use laundry detergent packets. What was happening is the children were ingesting these packets. They thought it was candy. And so, they would end up very sick, having gastrointestinal symptoms, breathing symptoms. But taking it more, when they looked at the report it was showing that 50% of the parents did not store the packets out of the reach of the children. Again, Melanie, a simple measure that could have prevented many children from getting into these laundry detergent packets.

What are some other simple measures I recommend? Have the child sit in the high chair or set up a play pen in the corner of the kitchen so the child does feel part of the action. You want to store all your cleaners, your furniture polish, dishwash soaps. You want to put these all in high locked cabinets. I always tell the parents purchase safety locks for all the lower cabinets. Their children should not be able to get into any lower cabinets. Place the pot handles towards the back of the stove. And use the back burners when cooking. These are just simple measures that one can apply to their kitchen and hopefully decrease the risk for an injury to a child.

Host:  Well certainly that is what we are here to talk about really, because it can be so scary for parents and we don’t always think of all of these little simple details that you are pointing out for us. Wrap it up Dr. Defeo, with your best advice for parents about keeping our little guys safe at home and when they are cruising around and really what you would like them to know as a pediatrician.

Dr. Defeo:  I want the parents really to understand it’s impossible to protect their children 100% of the time. I know they feel they can, but it’s really not realistic. However, with the proper guidance and providing them with the most up to date recommendations as a team, we can significantly lower the risk of injury. This is a topic that at every well check the parents should be discussing with their pediatrician. There are so many well checks during the first two years of a child’s development so, this is a topic that should be discussed, and they should ask their questions. If they have any concerns about their home, they can get into more detail with their pediatrician and I think that, more than anything, will significantly reassure the parents and hopefully decrease if they have any stress about the situation and lower the risk for injury in their household.

Host:  Well thank you so much Dr. Defeo and you’re absolutely right. They need to discuss this with their pediatrician at every well visit and ask any questions that they have, and you’ve given us so much great advice today. Thank you so much Dr. Michael Defeo and to our listeners. This concludes today’s episode of Kids Health Cast. Please remember to subscribe, rate and review this podcast and all the other Weill Cornell Medicine podcasts.  For more health tips and updates on the latest medical advancements and breakthroughs, please follow us on Facebook and Twitter. I’m Melanie Cole.