The danger of scald burns

A few years ago, I cared for a toddler who had severe burns to his scalp, face, shoulder and trunk. Despite very large doses of sedation he was in excruciating pain every day for weeks as his wounds were cleaned and his dressings were changed.

He required several surgeries to cover third-degree burns with new skin and then he had to endure months of daily rehabilitation. For more than a year he had to wear a special body suit that helped his scars heal better.

He received the best care at one of the country’s top burn centers, yet he still has significant and lasting limitations. He has trouble raising his arms over his head because of burn scars that limit his movement. His face is disfigured and will remain so for the rest of his life even with the best reconstructive surgery.

This little boy was not the victim of a house fire. Tragically, he tugged on his mother’s sleeve as she carried a pot of boiling spaghetti from the stove to the sink. The pot slipped and the water cascaded onto the little boy, causing severe scald burns.

Every year, about 4,000 kids get a scald burn. Many occur in the bathtub from tap water that is too hot. A toddler can turn on the hot water and get a significant burn in the time it takes a parent to reach over and turn it off.

The kitchen also poses dangers from hot coffee or tea or from a boiling pot of liquid on the stove or in the microwave.

The average toddler has enough strength to open a typical microwave door, and it only takes a few seconds for an injury to occur. Because microwave ovens heat unevenly and the center of the liquid gets much hotter than the edges, a child who spills the item may get a severe burn. Children can also get mouth burns if they try to drink liquid that feels warm to the touch, but has a scalding center.

Parents may unwittingly expose their children to these hazards because they don’t realize that burn injuries can occur from just a small amount of very hot liquid.

Water boils at a temperature of 212 degrees Fahrenheit, but at a temperature of only 150 degrees it takes just two seconds to cause a burn. When the water is at 120 degrees, just 30 degrees cooler, it takes 10 minutes.

To avoid scald burns:

• Turn down your hot water heater to 120 degrees. If you are renting, ask your landlord to do it. To see if your water is too hot, allow the tap to run for two minutes, then fill a cup with the hot water. Measure the temperature using a candy thermometer or a water thermometer. Water thermometers were developed to help parents find the right bath temperature for a child and can be purchased where children’s products are sold. If the temperature is less than 125 degrees you are in a safe zone. If it is higher than 125 degrees, turn down the thermostat on your hot water heater and re-test after 24 hours.

• Always check the water temperature of the bath by moving your hand back and forth in the water before putting your child in. If it feels hot to you, it is too hot for your child.

• Keep children away from hot liquids like tea and coffee and do not put cups of hot liquid on the edge of tables or counter tops.

• Turn pot handles toward the back of the stove when cooking.

• When carrying a hot liquid from one area to another make sure the kids aren’t around.

• Never hold children and hot liquids at the same time as your child may reach for the liquid and cause a spill.

• Never let children remove hot items from the microwave.

• When heating with a microwave, always stir foods and shake liquids before giving them to your child.

Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago. E-mail her at

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