Trauma has only been recognised as a significant health issue for the last 50 years, says Professor AB van As from the Department of Paediatrics and Child Health at the University of Cape Town and Childsafe in Cape Town; and Ashley van Niekerk of the Violence, Injury and Peace Research Unit, South African Medical Research Council, in a report titled Prevention of Childhood Injuries. Children represent 40% of the South African population and are considered to be the most vulnerable. “The impact of childhood trauma, whether intentional (interpersonal violence, homicide or suicide) or unintentional (road traffic crashes, drowning, burns, poisoning or falls), has become a major health and social problem.” According to the World Health Organization, trauma is officially the number one killer of children globally.
Van As adds: “In SA, children continue to be threatened by injuries of various kinds, although this is often overshadowed by the impact of infectious and nutritional diseases. The greater recognition of injuries as a major challenge to childhood health has, however, stimulated concerted efforts worldwide through, for example, the adoption of the 64th World Health Assembly resolution on child injury prevention. There have, consequently, also been local efforts by means of strategies directed at enhancing the management of trauma through specific mechanisms, such as courses for the management of paediatric trauma, like the Advanced Paediatric Life Support course. Unfortunately, childhood injuries have not yet been included in national health priority lists, especially with regard to their preventability.”
According to Netcare, there is a marked increase in the number of toddlers who are treated in emergency departments over the summer holidays due to accidents, trauma and near-drownings, with children under the age of six most at risk. Statistics reveal there’s about a 12.7% increase in the number of injuries in this group over the summer holidays.
The most common injuries during this time include cuts, sprains and strains, bone fractures, stings and bites or burns, with the majority of the injuries sustained to the face, fingers, hands and head. Other major causes of concern are car accidents, the ingestion of harmful objects and near-drownings.
This means childminders and parents need to be extra vigilant, especially if you are in an unfamiliar place or holiday destination.
Leading cause of toddler injuries
Research reveals that falls from soft furniture are the leading cause of toddler injuries. “Parents, family members and caregivers need to be mindful of the risk of leaving an infant or child unattended on a bed or sofa, regardless of how soft the furniture appears to be or how far from the edge they place their child,” said study co-author, Dr Viachaslau Bradko, an orthopedic surgeon at Texas Children’s Hospital in Houston. The findings were presented recently at the American Academy of Pediatrics annual conference. The study found that babies younger than 12 months were most at risk, accounting for 27.7% of the total injuries reported. This age-group were also twice as likely to need medical attention or hospitalisation.
What you can do
Childsafe South Africa (formerly known as the Child Accident Prevention Foundation of Southern Africa), reports children under five are most vulnerable to injuries. The organisation warns that parents and caregivers need to be aware of their baby or toddler’s developmental stages since children are vulnerable to certain injuries at different ages. It’s also essential to know what to do in an emergency.
Birth to six months:
During this time, your baby develops the ability to roll, move and grasp objects. Childsafe warns that parents often underestimate their babies’ abilities.
- Do not leave your baby unattended on a changing table, bed, chair or sofa.
- Keep cot sides up at all times.
- Babies usually start crawling at six months, so make sure this happens in a safe and secure environment.
- Try to avoid using a baby walker as this enables him to move quickly and may expose him to dangers. If you do use a baby walker, make sure there is constant adult supervision.
- Make sure your baby is in an age-appropriate car seat, securely fastened into the car.
- Never travel with your baby on your lap.
- Avoid carrying your baby and hot liquid or food at the same time.
- Always put cold water in the bath first and check the temperature with your elbow before putting your baby in.
- Never leave your baby unattended in the bath. Childsafe warns that a small child can drown in just 5cm of water within 30 seconds.
- Don’t leave small objects within reach of your baby.
- Remove bibs before your baby goes to sleep.
- Avoid ribbons and cords on sleepwear.
- Avoid pillows in the cot.
- Make sure the cot bars are evenly spaced and your baby’s head can’t fit through.
- Make sure you always read labels before giving your baby any medication and always follow the correct dosage.
Six to 12 months:
Your baby becomes more mobile and is crawling, pulling himself up on objects or furniture and taking his first steps. He will likely try to put anything he can get his hands on in his mouth.
- Use safety gates if you have stairs (top and bottom).
- Make sure he is securely strapped into his high chair or pram.
- If he is trying to pull himself up, make sure the furniture and objects are stable and will not topple over on him.
- Keep hot food and liquids out of his reach.
- Place safety plugs or guards in wall sockets and open plug points.
- Empty the bath after use, and don’t keep open buckets or containers of water.
- Use non-slip mats in the bath.
- Never leave your baby unsupervised around water.
- Keep all dangerous substances, such as medications and household cleaning supplies securely locked away out of your baby’s reach.
- Put safety latches on cupboards that contain potentially harmful substances.
- Make sure your baby has age-appropriate foods to avoid choking hazards.
- Keep all small objects, like buttons and coins, out of reach.
- Make sure your baby is always secured in an age-appropriate car seat.
One to two years:
Your toddler is curious and wants to learn about his environment. He will be very active and want to explore.
- Make sure windows and balconies are secured.
- Use safety guards on beds to prevent falls.
- Supervise your toddler when climbing as he is still learning coordination.
- Keep pot handles turned towards the centre of the stove.
- Keep matches and flammable objects out of reach.
- Make sure he is warned about and stays away from hot objects, such as irons, oven door, heaters, etc.
- Keep kettle and iron cords out of reach.
- Never leave your child alone near water.
- If you have a pool, make sure it is covered with a pool net or secure covering. Make sure the pool gate is always latched and teach your baby to swim as soon as possible.
- Keep all poisonous substances securely locked away.
- Make sure your toddler’s toys are age-appropriate and all parts are secure and not choking hazards.
- Don’t give your baby hard sweets or peanuts as he can choke on these.
- Make sure all gates and outside doors are secure to prevent your child getting out onto the road.
- Never leave a child alone in the car.
- Always check carefully before reversing your car.
Tip: Start teaching your toddler safety rules form a young age.
Kim Bell is a wife, mother of two teenagers and a lover of research and the way words flow and meld together. She has been in the media industry for over 20 years, and yet still learns more about life from her children everyday.