I remember my first OMG parenting scare. On the day after Thanksgiving, we were awkwardly navigating a packed airport. My husband was pushing a stroller piled with bags. I was wearing our 6-month-old in a front carrier, holding my toddler Julian's hand. Lured by a kiosk of snacks, Jules yanked my arm in another direction. I hung on, trying to keep him from launching us into the mob, when he suddenly started screaming that his arm was in pain. We calmed him down, but Jules wasn't moving his arm. Tentatively, we got on the plane.
We dialed the pediatrician when we landed and were directed to the ER. The doctor looked at Jules's arm, limp at his side, and made a diagnosis: a partially dislocated elbow. It's an injury that's so common, she said, that it has a nickname: "nursemaid's elbow." She popped his elbow back in with a quick twist, and he was fine.
"Babies and toddlers are prone to all sorts of trouble," says Mark Melrose, D.O., a board-certified emergency physician and cofounder of Urgent Care Manhattan. "It's all part of exploring the world around them by reaching, climbing, feeling, and tasting." Use this guide to handle six common—and scary—accidents.
It happened to Maria Brown when her son, Hudson, was 3 1/2 months old. "Fresh diaper on, all he needed was a new outfit," Brown recalls. "I placed my left hand on his belly and reached into the closet with my right. The outfit was just out of reach, so I leaned a little more to the right and lifted my hand for a second. At that moment, Hudson decided to try rolling over. When he hit the rug, the look on his face was total shock. Then he started crying like I'd never heard him cry before: It was a high-pitched shriek that was more fear than hurt." After a few minutes, Hudson stopped weeping, but Brown didn't. "I cried most of the morning," says the mom from Richmond, Vermont.
If it happens to you Pick him up, calm him down, and check for obvious injuries. If he's unconscious, call 911; otherwise, phone your doctor. "Even if everything looks okay, a baby who falls from a table or bed should be seen by a pediatrician," explains Ron San Juan, M.D., director of pediatric urgent care at Mercy Medical Center in Baltimore. In a worst-case scenario, the impact could cause a skull fracture, a concussion, or bleeding in the brain. Signs that it could be serious: decreased alertness, loss of consciousness, or significant vomiting. Fortunately, however, most babies who fall from a changing table or bed suffer little more than a bruise, says Dr. San Juan.
How to prevent falls
At 3 to 5 months, babies start grabbing for things, including hot foods. "Five minutes after I pulled a casserole out of the oven, my husband, holding our 6-month-old daughter, Isabella, walked over to get his plate," recalls Erica Saldivar, a mother of two in Albion, Michigan. "As soon as he picked the plate up, Isabella reached out and grabbed his food. It was hot, of course, and she started screaming."
If it happens to you Get the burned area under cool, running water, stat. "You want to remove the substance right away, because the longer it stays on the skin, the more damage it can do," says Dr. San Juan. Don't ice the area: It can further damage skin that's been injured by heat. Keep the burned extremity under cool water for ten or 15 minutes to soothe the pain, or, if your baby won't tolerate that, apply a cool compress. Then place a gauze bandage over the area and give him acetaminophen for pain relief, as directed by your doctor. As was the case for Isabella, a burn caused by hot foods or drinks usually isn't serious, says Dr. San Juan. "But it does tend to be painful." If the burn blisters, is larger than a dime, or is on the face, hands, feet, or genital area, a doctor will need evaluate it.
How to prevent burns
"When my 16-month-old, Brooklyn, tripped and fell into an end table, her mouth was gushing blood," says Autumn Pastore, a mother of two in New Castle, Pennsylvania. "I was nervous that her teeth had gotten knocked out, and there was so much blood, it was hard to see. I thought she might need stitches." (Brooklyn didn't—and her teeth were fine.) But mouth injuries often are terrifying for parents because they bleed like crazy, says Cheryl Wu, M.D., a pediatrician in New York City. It's because the mouth is full of blood vessels. That's a good thing, though, when it comes to healing. "The high blood flow to the area brings in nutrients, oxygen, and other healthy factors that repair the tissue quickly," Dr. Wu says.
If it happens to you Rinse out your child's mouth as best you can. Stop bleeding by applying pressure with a clean cloth or gauze. Or try some ice wrapped in a dish cloth. "The cold will help to reduce swelling and bleeding since it causes blood vessels to contract," says Dr. San Juan. Head for the ER if bleeding doesn't stop after ten to 20 minutes, there's a deep cut on the skin, or any teeth feel loose.
How to prevent mouth injuries
"When my son was 15 months old, he came toddling out of the powder room with a bottle of toilet-bowl cleaner in his mouth," recalls Melana Mears, a mother of two in Conneaut Lake, Pennsylvania. "I called the poison center and read off the ingredients from the label. We were lucky—none of them were harmful, but I was told he might have an upset belly."
If it happens to you Dial the nationwide Poison Help number (800-222-1222) immediately if you see, or even suspect, that your child has ingested something that's not food. Have the label of the substance handy when you call. Don't give your tot anything to drink or eat until you speak to a poison expert. Doing so could cause your baby to absorb more of the poison. And definitely don't induce vomiting, says Dr. Melrose: "What causes trouble on the way down could cause trouble on the way up."
How to prevent poisonings
"When our son, Gus, was learning to walk at 11 months, he fell onto our dog, who was sleeping," says Louise Musial, a mother of two in Tyler, Texas. "In an instant, our sweet Lab who had never hurt a thing was on top of him growling. It all happened so fast and Gus ended up with a nick above his right eye."
If it happens to you Wash the wound well with soap and water and then phone your pediatrician. "If it's a deep bite or on the hands or feet, which are hard to clean thoroughly, your child might need to take antibiotics," Dr. San Juan says. "Animal bites carry a high risk of infection because the mouth has so much bacteria in it." If possible, you should also contact the veterinarian to check on the dog's vaccination records.
If a cat nips your child, follow this same advice. Even if the injury doesn't look bad initially, cat bites tend to be deeper since their teeth are fine and sharp. Also, cats might carry a parasite that causes toxoplasmosis, a disease that can be dangerous for babies and pregnant women. "It is unusual to contract toxoplasmosis from a cat bite," Dr. San Juan says. But play it safe and notify the pediatrician: "Cats' mouths also contain other bacteria that can infect your baby."
How to prevent animal bites
"My 1-year-old daughter, Lila, was eating an animal-shaped cereal," recalls Katie Webster, a mom of two in Richmond, Vermont. "Suddenly Lila started making choking noises and flapping her arms in the high chair. I remembered hearing that you're supposed to turn a choking baby upside down and whack her on the back, so that's what I did. Nothing happened, so I slapped her back again. This time, the cereal all came out in a big throw-up mess. I called the American Red Cross that very afternoon and signed up for the next available child CPR class."
If it happens to you Have someone call 911 for help while you begin first aid. If you're alone, follow these steps for one minute, stop and call 911 yourself, then resume first aid. Here's what to do: Hold your baby face-down on your forearm—or on your lap if you can't manage the forearm position because you're too nervous or Baby is too big. Hold her jaw with one hand to support the head, which should be positioned lower than her chest. Then deliver five firm back blows between her shoulder blades with the heel of your other hand. If she still can't breathe, turn her over and place your index and middle fingers in the center of her chest just below the nipples, and give five quick chest thrusts, compressing the breastbone about 1 1/2 inches each time. Alternate between doing sets of five back blows and five chest thrusts until the object is forced out, your baby can cough, cry, or breathe, or help arrives. (Don't try to remove an object you can't see—you could push it farther down.) If your baby loses consciousness, you'll need to perform infant CPR. Call 911 for advice on how to do it while you wait for paramedics. Each time you open the airway, look for a foreign object. Remove it only if you can see it.
How to prevent choking
Keep this important info handy for yourself and caregivers.
On the Saturday of his first birthday party—Emmett Rauch, of Phoenix, Arizona, was running a fever and acting unusual. His parents took him to pediatric urgent care where the medical person on duty said it was just a cold or flu, recalls his mother, Karla. But things got worse: On Sunday Emmett didn't want to eat. By early Tuesday morning, he was coughing up blood. After speaking with their pediatrician, the Rauches took Emmett to the ER where a chest X-ray revealed a button battery in his esophagus. An ambulance rushed him to Phoenix Children's Hospital and surgeons removed the battery, but much damage had already been done.
When a coin lithium button battery gets stuck in the throat, saliva triggers a chemical reaction that can severely burn the esophagus in as little as two hours. The battery Emmett swallowed went undetected for more than two days. (It was from the remote control to a DVD player that Karla found about a week later, tucked halfway underneath the couch, with the case open.) As a result, Emmett had to have several inches of his esophagus removed, and eventually his entire esophagus had to be replaced with a portion of his intestine. At last count, he'd had more than 40 medical procedures. Four years later, Emmett is slowly learning to eat by mouth but still relies on a feeding tube for most of his nutrition. He also needs a tracheostomy tube to breathe.
From 1997 to 2010, more than 40,000 kids were treated for battery-related injuries, most involving button batteries; 12 children died after ingesting button batteries. The frequency of the ingestions has increased significantly, the CDC reports. The severity of the damage is also increasing, says Toby Litovitz, M.D., executive and medical director of the National Capital Poison Center. This is directly related to the increased use of 20 millimeter lithium-coin-cell button batteries, she notes. "They have a higher voltage compared with traditional button batteries and a larger diameter," Dr. Litovitz says. "That combination of factors means that these batteries get stuck in children's throats more frequently, and they cause damage much faster." Head to the ER immediately if you suspect your child has swallowed a button battery, and tell the staff that's what you think may have happened. You can also call the National Capital Poison Center's 24-hour battery ingestion hotline: 202-625-3333. Symptoms include fever, coughing, and drooling. "If we can get it out quickly, no permanent damage may be done," says Mark Melrose, D.O., cofounder of Urgent Care Manhattan.
Don't let the child eat or drink until after the doctor takes an X-ray. If a battery is lodged in the esophagus, it must be removed within two hours using an endoscope, inserted directly into the esophagus, and anesthesia is required. Sedation is safer on an empty stomach. If the X-ray reveals the battery has already moved into the small intestine, the battery is typically allowed to pass. Yes, this is good news, but you'll need to carefully examine diapers for a few days.
These common items may contain button batteries. Keep them away from children, make sure the battery compartment is screwed tightly shut, and use strong tape to secure a compartment that might easily open.
Originally published in American Baby magazine in September 2014.