Hair loss Treatment Center

• Poisoning
• Choking
• Falls
• Burns

PARTICIPANTS Mary Ann P. Limbos, MD, MPH Children's Hospital of Los Angeles

Joining me to discuss injury prevention for one to two year olds is Mary Ann Limbos. She's a general pediatrician at Children's Hospital Los Angeles. Thank you so much for being with us to talk about this important topic.

I know when my kids started getting older and moving around it was a really scary time. Because they were old enough to move and not old enough to really understand what they were doing. Talk about some of the big problems that they have, with poison for example.

MARY ANN LIMBOS, MD: Well you mentioned several important things. Between one and two years old, children are learning to walk, and then to run, and then to climb. And this, paired with a child's natural curiosity, makes it a very developmentally exciting time, but also really puts children at risk for certain injuries. And one of them, as you mentioned, is poisoning or choking also.

One of the ways children explore their environment is to put things in their mouths. And they will put anything in their mouths or drink anything that they find around the house. So it's really important that things like medicines have child safety caps on them. Parents shouldn't rely on these child safety caps as completely protecting their children. So these medicines, as well as household cleaners, if you can put these in cabinets that are either locked or out of reach will be an added protection to the child safety caps.

BONNIE BOSWELL: What kinds of things should parents have around just to make sure, just in case a child does get into trouble, that they can get help right away.

MARY ANN LIMBOS, MD: Well I think the most important thing is to have the phone number of the poison control center readily available. It needs to be by a telephone where a parent can access it quickly, rather than having to search through lots of papers to find it.

Another thing that has been recommended is to have syrup of Ipecac. And that is a compound that can make children vomit. But the important thing about syrup of Ipecac is to call the poison control center before actually using it because it can actually make some poisonings worse.

And one of the other things that parents may do, which really isn't a good idea, is putting poisons, or household cleaners, in different containers. For example, like a plastic soda bottle. And a plastic soda bottle in and of itself makes it very tempting for a child to open it up and drink it. But if a child were to get into it, it's important that poison control know what the chemical is. And if you have transferred a chemical from its original container into another container, you're not going to have those readily available.

BONNIE BOSWELL: That's a really good point. I think a lot of people don't know that. One thing about children, too, is as soon as they get old enough, they try to unlock those child safety caps. So that's one of the challenges. If they have an older brother or sister, for example, they're kind of keyed into doing that aren't they?

MARY ANN LIMBOS, MD: Right. They are. And older brothers and sisters can be very helpful. But they can also help their little siblings get into danger.

BONNIE BOSWELL: Well let's move and talk about choking, because that is certainly a really big problem. Tell us about what kinds of situations that come up where children are in danger.

MARY ANN LIMBOS, MD: Well one of the things that children choke on are food items. And especially between one and two years old where children are wanting to have more textured foods. They're going to try to eat those little crunchy things that they really can't chew very well. So parents should avoid giving their children hard crunchy things like little carrot chunks, peanuts, grapes, objects such as that that children can choke on.

BONNIE BOSWELL: And they move around a lot, too. That's a secondary danger because they have a hard object, but then they're usually running or, you know, just doing what they do.

So how do you control a child like that?

MARY ANN LIMBOS, MD: You don't.

BONNIE BOSWELL: You don't?

MARY ANN LIMBOS, MD: And it's important to see what your child sees and what they can get into. So what we recommend is actually getting down at your child's level, which can be one or two feet, for a one or two year old, and crawling around on your hands and knees and looking at all the little dangers around the house. And you'll be surprised what you will find under tables or chairs or at a child's level on a coffee table that they can put in their mouths and choke on.

BONNIE BOSWELL: Yeah, I think the idea like you said of going down on the floor is really important. And one of the things that kids can get into, sometimes there's dust that happens. And sometimes maybe in certain situations, that's actually caused some lead poisoning and so forth like that. So that kind of relates to both of these issues.

MARY ANN LIMBOS, MD: Yes, yes it does.

BONNIE BOSWELL: So what can parents look out for that, to make sure that's not occurring?

MARY ANN LIMBOS, MD: Well you know, when you're getting down on your child's level and you're looking for certain things, the things you're looking for are like little pen caps, small household items, such as screws. These are all things that children can choke on. And as far as the lead dust, depending on the age of your house and occupations that parents are involved in that may or may not be a problem. But that is something that, you know, certainly is an environmental hazard and something that we check for in young toddlers at 12 months to 24 months of age.

BONNIE BOSWELL: And you want to encourage children while they're eating to be stationery, to be sitting, and not running around.

MARY ANN LIMBOS, MD: Right. And that harkens back to having children eating safely. It's important to give them the-to avoid the foods that they can choke on. And when they are eating, to have them sitting down at a table rather than running and playing because running and playing with food in your mouth is also another risk for choking.

BONNIE BOSWELL: Okay. Another one of the risks is falling. Tell us about, again, those kind of situations that come up. They do fall.

MARY ANN LIMBOS, MD: Children will fall. They will fall all the time. And they can fall on the same level. And what I mean by that is they're running and they trip. Or they can fall from a height. So you know, a fall from a second, third story window. And because children are going to fall as a regular part of walking and running, what's important is to, when they're falling from the same level, to keep them safe when they do fall. And then to prevent the major falls, which are the falls from multiple stories.

BONNIE BOSWELL: So specific things that parents can do. They can put gates up.

MARY ANN LIMBOS, MD: Gates up at the top and at the bottom of stairs. Window guards on stories above the first floor. So if you have a two or three story home or live in a higher story in an apartment, making sure that there are window guards. Not having beds and cribs near a window-near an open window where children can actually climb out of their crib or bed and fall out the window.

BONNIE BOSWELL: Sharp edges.

MARY ANN LIMBOS, MD: Sharp edges. Yes, and that would relate to children falling while they're running. In your living room, for example, looking at your coffee table and making sure that if they were to fall against it that they're not going to fall against a sharp edge.

BONNIE BOSWELL: And what about those railings? Sometimes kids can get their heads stuck in those, too.

MARY ANN LIMBOS, MD: Right. And those should be less than four inches so little bodies and heads can't get stuck in between.

BONNIE BOSWELL: Okay. Well let's talk about burning and scalding, because that's another issue that comes up. I mean, in the kitchen a lot of times or maybe running hot water. Just tell us the kind of situations that they find themselves in.

MARY ANN LIMBOS, MD: Well commonplace burns and scalds happen is actually in the bathtub from the hot water tap being turned on and a child sitting in the bathtub and getting burned. And one of the things that parents can do to prevent that and protect their child as well as everybody else in the house is to turn the hot water temperature down to 120 degrees. And that will decrease the amount of time it takes-or increase, I'm sorry, the amount of time it takes for a child to sustain a really serious burn from just a few seconds to even 30 seconds, up to minutes.

BONNIE BOSWELL: And what about when they do come to the kitchen, because they will be in the kitchen. Should there be rules established or how do you really manage that?

MARY ANN LIMBOS, MD: Yeah, and you know, it would be great if you could keep your child out of the kitchen. But there isn't always somebody to watch your child while you're cooking. So if you can place them in a high chair or a playpen so they can watch you safely while you cook, that would be a safe perch.

BONNIE BOSWELL: And you should have on hand some ointment I would suspect. Right? There are certain burn ointments that you can use in case that does occur?

MARY ANN LIMBOS, MD: Well what we recommend is to flush the burned area quickly with cold water. And not put any ointments on. Cold water and then a quick phone call to the physician.

BONNIE BOSWELL: Well let's go on. Talking about drowning, because that does occur as well.

MARY ANN LIMBOS, MD: In the home, the bathtub is surprisingly a common place for children to drown.

BONNIE BOSWELL: And it doesn't take much water. About four inches or something?

MARY ANN LIMBOS, MD: Or less. And it doesn't take very much time. So if the phone rings while you're bathing your child, let it ring. If it's very important, the person will call back. What's important is to never leave a child unattended in the bathtub.

BONNIE BOSWELL: And then what about guns? People are more and more conscious of that now.

MARY ANN LIMBOS, MD: Sure. The best thing is to not even have a gun in a home where there are children. But if a parent does have a gun in the home, it should be stored, unloaded and locked. And there are also trigger locks available as another added protection. But you know, what I would recommend is to not even have a gun in the home.

BONNIE BOSWELL: Well thank you. These are all very important safety tips. I know people are really listening and want to take seriously everything that you've said. So I want to thank you, Mary Ann Limbos, for being with us.