Childproofing your home: falls, burns, drowning and poisoning

Most injuries to small children happen at home, and most can be prevented with a few simple changes. Toddlers move fast, climb, and put everything in their mouths. Below are the questions parents ask Dr Dutta about falls, burns, drowning, poisons and bites, with short answers and the first aid that matters.

What are the most common injuries to toddlers at home in India?

More than half of childhood injuries in India happen at home.¹ In toddlers, falls and burns are the most common.²

A large study by the Indian Council of Medical Research covered over 31,000 children in 11 sites, including West Bengal. It found that more than 50% of injuries happened in the home setting.¹ A study of children aged 1 to 5 years in Puducherry found falls and burns or scalds were the two most common injuries, and that about 3 in 4 families followed fewer than 85% of the recommended safety steps.²

Poisoning, drowning and dog bites are less common but can be far more serious. The good news is that each has a clear, low-cost fix.

How do I stop my baby from falling off the bed?

Never leave a baby alone on a bed, sofa or changing table, even for a moment. Babies roll earlier than parents expect.

• Change nappies on a mat on the floor if you need to step away.
• Put the baby down in a cot with the side rails up, or on a clean mat on the floor.
• Pillows lined along the edge of an adult bed do not stop a baby rolling, and they add a suffocation risk.
• Keep the floor around the bed clear of hard objects.

If your baby does fall, watch closely for the next 24 hours. See the last question for warning signs that need a hospital.

How can I make balconies, windows, roofs and stairs safe?

Stop children from climbing to a height. Fit window grills, keep balcony railings tall with gaps too small for a child's head, and gate the stairs.

• Move chairs, stools, buckets and air-conditioner units away from balcony walls and windows. Toddlers use them as steps.
• Block railing gaps with mesh or plastic sheet.
• Put a gate across the stairs, both above and below.
• Keep the door to the open roof (chhad) locked. Do not let older children fly kites on a roof without a parapet.
• Do not use a baby walker. It lets a baby reach stairs and hot things quickly.

Can a baby drown in a bucket of water?

Yes. A toddler can drown in a few centimetres of water in a bucket, tub or open tank, often silently and within minutes.

Worldwide, children under 5 make up almost 1 in 4 drowning deaths.³ An Indian review of news reports found 18 deaths of infants and toddlers in household buckets between 2016 and 2022. Most were 12 to 18 months old.⁴

Many Kolkata homes store water in buckets and drums because supply comes at fixed hours. Empty buckets after use, keep stored water covered with a tight lid, and keep the bathroom door shut.

How do I keep my child safe around tanks, ponds and bathrooms?

Put a barrier between your child and any water, and watch them yourself whenever they are near water.

The WHO lists covering wells, using door barriers and playpens, and supervised childcare for preschool children among its ways to prevent drowning.³

• Fit a firm lid on underground tanks and wells.
• Fence or gate any pond (pukur) near the house.
• Stay within arm's reach during baths. Do not leave a baby in the tub with an older sibling in charge.
• Keep toilet lids down.
• In the monsoon, waterlogged lanes and drains can be deep. Hold your toddler's hand outdoors.

What is the first aid for a hot tea or hot water burn?

Cool the burn under cool running tap water for 20 minutes, as soon as possible and within 3 hours.⁵ Then lay cling film or a clean, non-fluffy cloth over it and see a doctor.

An Australian study of nearly 2,500 children found that 20 minutes of cool running water lowered the odds of needing a skin graft by about 40%.⁶

1. Remove clothing and jewellery near the burn, but leave anything stuck to the skin.⁵
2. Hold the area under cool, not icy, running water for the full 20 minutes.
3. Keep the rest of the child warm with a towel.
4. Lay cling film over the burn rather than wrapping it round.⁵
5. Give paracetamol for pain if needed.

Do not burst blisters.⁵

Should I put toothpaste, ghee, oil or ice on a burn?

No. Do not put creams, oils or butter on a burn.⁵ That includes ghee, coconut oil and toothpaste.

These home remedies hold heat in the skin, make the wound dirty, and make it harder for the doctor to judge how deep the burn is. Dr Dutta also advises against ice, which can damage skin that is already hurt. Plain running tap water is the best first aid you have.

How can I prevent burns in the kitchen?

Keep children out of the cooking area, and keep hot drinks and pans out of their reach.

• Cook on the back burners and turn pan handles inwards.
• Never hold a baby while drinking tea or cooking.
• Do not leave cups of hot tea on low tables or on a cloth a toddler can pull.
• Keep pressure cookers, irons and hair straighteners well away from small hands.
• Run cold water into the bucket first, then add hot. Test bath water with your elbow.
• Keep matches, lighters, diyas and Diwali crackers out of reach.
• Cover unused electric sockets.

Which household products poison children most often in India?

In calls to India's national poisons centre about household products, insect killers and cleaning liquids topped the list.⁷ Kerosene is another common danger.⁸

Over ten years, the National Poisons Information Centre at AIIMS, New Delhi, received over 7,000 calls about household products. About 6 in 10 involved children. Across all ages, household pesticides made up 44% of these calls and cleaners 22%; mercury from thermometers and naphthalene balls were also seen.⁷ Kerosene poisoning is common in children in developing countries because of unsafe storage at home.⁸

Store all chemicals and medicines locked and high up, in their original labelled bottles. Never store kerosene in a cold drink or water bottle.⁸ Dr Dutta says the same for phenyl and acid.

My child drank kerosene. What should I do?

Do not make your child vomit. Take them to hospital straight away, with the bottle.

Kerosene is thin and slippery, so even a small sip can slide into the lungs and cause a chemical pneumonia. For this reason doctors do not induce vomiting or wash out the stomach.⁸ Even a child with no symptoms should be watched in hospital for at least 6 hours.⁸

Watch for coughing, fast breathing, fever or drowsiness.

What should I do if my child swallows medicine or a cleaning liquid?

Take your child to hospital at once with the bottle or strip, even if they look well. Some poisons cause harm hours later.

• Do not try to make them vomit unless a doctor tells you to.
• Do not give milk, salt water or home remedies.
• Rinse the mouth if a corrosive such as toilet cleaner or acid touched it.
• Count the missing tablets or estimate how much liquid is gone.

Camphor, used in pujas and chest rubs, can cause fits even in small doses.⁸ Keep grandparents' tablets and iron tablets in a locked box too, not on a bedside table or in a handbag.

Why are button batteries so dangerous if swallowed?

A button battery stuck in the food pipe can cause severe, life-threatening damage. Go to hospital immediately if you think your child has swallowed one.

European experts advise that a battery stuck in the oesophagus (food pipe) be removed at once, ideally within 2 hours.⁹ Honey may be given while waiting for removal, but it must never delay treatment.⁹ It is only for children over 1 year.¹⁰ Do not stop at home to find honey; go straight to hospital, and do not make your child vomit.

These coin-shaped batteries are in remote controls, car keys, weighing scales, musical cards and flashing toys. Tape battery covers shut, and store spare batteries out of reach. Early signs may be mild: drooling, refusing food, vomiting or a cough.

Is swallowing a magnet dangerous for a child?

One small magnet often passes, but two or more magnets, or a magnet plus a metal object, can pull together through the gut wall and cause serious damage. You usually cannot know how many were swallowed, so go to hospital now.

European guidance warns that the danger is highest when several magnets are swallowed, or a magnet is swallowed with other metal objects, especially button batteries. Strong earth magnets carry a higher risk.¹¹

Check toys, fridge magnets and magnetic building sets for loose small magnets, and keep magnetic balls away from young children.

How do I choose safe toys for my baby?

Choose toys that are too large to fit in your child's mouth, with no small parts that can break off. Children aged 3 years and under are most at risk.

Food, coins and small toy parts are the classic choking hazards at this age.

• Follow the age label on the box.
• Avoid toys with button batteries that are not screwed shut.
• Avoid deflated balloons, marbles and small rubber balls.
• Check old and hand-me-down toys for loose eyes, wheels and peeling paint.
• Remove long strings and cords from cots and toys.

How can my child be exposed to lead at home?

Lead can come from old paint, some toys, and certain traditional cosmetics and remedies. There is no known safe level of lead in the blood.¹²

The WHO says young children are especially at risk, partly because toddlers mouth their fingers and toys all day. Lead can permanently affect brain development and lower IQ.¹²

• Wipe peeling paint dust from windowsills and floors with a damp cloth.
• Buy toys from makers who meet safety standards.
• Dr Dutta advises against unlabelled kajal or surma for babies, and herbal or ayurvedic powders of unknown content.

What should I do if a dog, cat or monkey bites my child?

Wash the wound with soap and running water for at least 15 minutes, then go to a doctor the same day for rabies vaccine.¹³ Rabies is almost always fatal once symptoms start, so never wait.

Dogs cause up to 99% of human rabies cases, and about 4 in 10 deaths are in children under 15.¹³

Nibbles and small scratches without bleeding need a course of rabies vaccine. Bites or scratches that go through the skin, and licks on broken skin, also need rabies immunoglobulin or monoclonal antibodies.¹³ The Indian Academy of Pediatrics recommends 5 injections after a bite: on day 0, then on days 3, 7, 14 and 28.¹⁴ A child who has had a full rabies vaccine course before may need fewer doses; tell the doctor. Do not apply chilli, turmeric or lime, and do not stitch or bandage tightly before the doctor sees it.

How can I keep my child safe around pets and street dogs?

Never leave a baby or toddler alone with any dog or cat, however gentle the pet seems.

• Teach children not to touch a dog that is eating, sleeping or caring for puppies.
• Keep pets vaccinated against rabies and dewormed.
• Wash hands after handling pets and their bowls.
• Do not let children feed street dogs or monkeys by hand.
• Tell your child to stand still, not run, if a strange dog comes close.

Even a lick on broken skin or a small scratch from a street dog needs a doctor's assessment for rabies.

When should I take my child to hospital after an injury at home?

Go to hospital straight away for any of these:

• after a head injury: a fit, being very sleepy or unable to keep the eyes open, clear fluid or blood from the ears or nose, a change in behaviour, a fall from more than 1 metre or 5 stairs, or any bruise, swelling or cut on the head of a baby under 1¹⁵
• also after a head injury, in Dr Dutta's advice: any vomiting at all, or being knocked out even for a moment
• a burn on the face, genitals or bottom, a very large or deep burn, or one caused by electricity or a chemical⁵
• in her practice, also any burn bigger than your child's palm, or on the hands or feet
• any swallowed button battery, magnet, kerosene, pesticide, cleaner or medicine
• coughing, fast breathing or drowsiness after swallowing any liquid
• any child pulled from water, even if they seem to recover
• any animal bite or scratch that breaks the skin

In an emergency, call 112, or 108 for an ambulance. Take the product bottle or packet with you.