What to Expect the First Year (125 page)

see
#51
,
#52
,
#53

see
#1

8. Possible broken arms, legs, or fingers.
It's hard to tell when a bone is broken in a baby. Most “broken” bones in babies are usually just bent or buckled, not snapped, making a break harder to detect visually. Signs of a break can include inability to move or put weight on the part, severe pain (persistent crying could be a clue, or an extreme reaction of pain when the area is tapped), numbness or tingling (neither of which a baby would be able to communicate), swelling, discoloration, and/or deformity (though this could also indicate a dislocation,
#17
). If a fracture is suspected, don't try to straighten it out. Try to immobilize the injured part by splinting it in the position it's in with a ruler, a magazine, a book, a roll of newspaper, or another firm object, padded with a soft cloth to protect the skin. Or use a small, firm pillow as a splint. Fasten the splint securely with bandages, strips of cloth, scarves, or neckties, but not so tightly that circulation is restricted. If no potential splint is handy, try to immobilize the injured limb against your arm. Check regularly to be sure the splint or its wrapping isn't cutting off circulation. Apply an ice pack to reduce swelling. Take your child to the doctor or ER even if you only suspect a break.

9. Compound fractures.
If bone protrudes through the skin, don't touch it. Cover the injury, if possible, with gauze or with a clean diaper, control bleeding with pressure (
#52
), and get emergency medical assistance (call 911).

10. Possible neck or back injury.
If a neck or back injury is suspected, don't move baby at all. Call 911 for emergency medical assistance. (If you must move baby away from a life-threatening situation, such as a fire or road traffic, splint the back, neck, and head with a board, a chair cushion, or your arm. Move him or her without bending or twisting the head, neck, or back.) Cover and keep baby comfortable while waiting for help, and if possible, put some heavy objects, such as books, around the child's head to help immobilize it. Don't give food or drink. Treat severe bleeding (
#53
), shock (
#48
), or absence of breathing and/or pulse (
click here
) immediately.

see
#49

IMPORTANT: If a child's clothing is on fire, use a coat, blanket, rug, bedspread, or even your own body to smother the flames.

11. Limited burns from heat (first degree).
Immerse burned fingers, hands, feet, toes, arms, or legs in cool—not cold—water (50°F to 60°F). If baby is cooperative, hold the burned part under running cool water. Apply cool compresses to burns on the face or trunk. Continue until baby doesn't seem to be in pain anymore, usually 15 to 30 minutes. Don't apply ice, butter, or burn ointments (all of which could compound skin damage), and don't break any blisters that form. After soaking the burned area, gently pat it dry with a soft towel and cover it with a gauze pad, a cloth bandage, or another nonadhesive bandage. If redness and pain persist for more than a few hours, call the doctor.

Call the doctor immediately for burns that look raw, that blister (second-degree burns), or are white or charred looking (third-degree burns), any burns on the face, hands, feet, or genitals, or burns that are the size of your child's hand or larger.

12. Extensive burns from heat.
Call 911 for emergency medical assistance. Keep baby lying flat. Remove any clothing from the burn area that does not adhere to the wound (cut it away as necessary but do not pull). Apply cool, wet compresses (you can use a washcloth) to the injured area (but not to more than 25 percent of the body at one time). Keep baby comfortably warm, with burned extremities higher than the heart. Do not apply pressure, ointments, butter or other fats, powder, or boric-acid soaks to burned areas. If baby is conscious and doesn't have severe mouth burns, nurse or offer sips of fluid to prevent dehydration.

13. Chemical burns.
Caustic substances (such as lye, drain cleaner, and other acids) can cause serious burns. Using a clean, soft cloth, gently brush off dry chemical matter from the skin (wear rubber gloves to protect your hands) and remove any contaminated clothing. Immediately flush the skin with large amounts of water. Call a physician, Poison Control (800-222-1222), or the doctor for further advice. Get immediate medical assistance (call 911) if there is difficult or painful breathing, which could indicate lung injury from inhalation of caustic fumes. (If a chemical has been swallowed, see
#44
.)

14. Electrical burns.
Immediately disconnect the power source, if possible, or separate baby from the source using a dry, nonmetallic object such as a wooden broom, wooden ladder, rope, cushion, chair, or even a large book—but not your bare hands. If baby isn't breathing and/or has no pulse, initiate rescue techniques (
click here
) and call 911. Even a minor electrical burn should be evaluated by a physician, so call your baby's doctor as soon as possible.

15. Sunburn.
If your baby gets a sunburn, treat it by applying cool compresses for 10 to 15 minutes, 3 or 4 times a day, until the redness subsides—the evaporating water helps to cool the skin. In between these treatments, apply a baby-safe sunburn relief spray or a mild moisturizing cream. Don't use Vaseline or baby oil on a burn, because it seals in heat and seals out air, which is needed for healing. Acetaminophen may reduce pain of sunburn, but if there's swelling and the baby is over 6 months, ibuprofen (which is anti-inflammatory) is a better choice. Antihistamines shouldn't be given unless they are prescribed by the doctor. When sunburn is severe—there is blistering, pain, nausea, or chills—call the doctor immediately.

see
#13

click here

see Frostbite and Frostnip,
#31
, Hypothermia,
#35

16. Symptoms of a seizure or convulsion
s include collapse, eyes rolling upward, foaming at the mouth, stiffening of the body followed by uncontrolled jerking movements, and in the most serious cases, breathing difficulty. Brief convulsions are not uncommon with high fevers (
click here
for how to deal with febrile seizures). For nonfebrile seizures: Clear the immediate area around baby or move baby to the middle of a bed or carpeted area to prevent injury. Loosen clothing around the neck and middle, and lay baby on one side with head lower than hips (elevate the hips with a pillow). Don't put anything in the mouth, including food or drink, breast or bottle. Call the doctor.

If baby isn't breathing or has no pulse, begin rescue techniques (
click here
) immediately. If someone else is with you, have them call 911. If you're alone, wait until breathing has started again to call, or call if breathing hasn't resumed within a few minutes. Also call 911 if the seizure lasts more than 2 to 3 minutes, seems very severe, or is followed by one or more repeat seizures.

Seizures may be caused by the ingestion of prescription medicines or toxic substances, so check the immediate vicinity for any sign that your baby may have gotten into any. If it's clear that he or she has swallowed something hazardous, see
#44
.

see
#51
,
#52

17. Elbow dislocations
(also known as nursemaid's elbow) are not as common among babies as they are among toddlers, who get them mostly because they are often tugged along by the arm by adults in a hurry (or “flown” through the air by their arms). Inability or unwillingness to move the arms, usually combined with persistent crying because of pain, is typical with a dislocation. A trip to the doctor's office or the ER, where an experienced professional can easily reposition the dislocated part, will provide virtually instant relief. If pain seems severe, apply an ice pack and splint before leaving.

see
#3

18.
Even a child who quickly revives after being taken from the water unconscious should get a medical evaluation. For one who remains unconscious, have someone else call 911 for emergency medical assistance, if possible, while you begin rescue techniques (
click here
). If no one is available to phone for help, call later. Don't stop CPR until the
child revives or help arrives, no matter how long that takes. If there is vomiting, turn baby to one side to avoid choking. If you suspect a back or neck injury, immobilize these parts (
#10
). Keep the baby warm and dry.

19. Foreign object in the ear.
Try to dislodge the object with these techniques:

• For a live insect, use a flashlight to try to lure it out.

• For a metal object, hold a strong magnet at the ear canal to draw the object out (but don't insert the magnet into the ear).

• For a plastic or wooden object that can easily be seen and is not deeply embedded in the ear, dab a drop of quick-drying glue on a straightened paper clip and touch it to the object (don't touch the ear). Don't probe into the ear where you can't see. Wait for the glue to dry, then pull the clip out, ideally with the object attached. Don't attempt this if there's no one around to help hold baby still.

If you're not comfortable attempting the above techniques, you don't have the necessary equipment to try them, or you try them and they fail, don't try to dig out the object with your fingers or with an instrument. Instead, take baby to the doctor's office or the ER.

20. Injury to the ear.
If a pointed object has been pushed into the ear or if your baby shows signs of ear injury (bleeding from the ear canal, sudden difficulty hearing, a swollen earlobe), call the doctor.

21.
Break contact with the electrical source by turning off the power, if possible, or separate baby from the current by using a dry nonmetallic object such as a wooden broom, wooden ladder, robe, cushion, chair, rubber boot, or even a large book. If baby is in contact with water, do not touch the water yourself. Once baby has been separated from the power source, call 911. If he or she isn't breathing and/or has no pulse, begin rescue techniques immediately (
click here
). For electrical burns, see
#14
.

IMPORTANT: Don't apply pressure to an injured eye, touch the eye with your fingers, or administer medications without a physician's advice. Keep baby from rubbing the eye by holding a small cup or glass over it or, if necessary, by restraining his or her hands.

22. Foreign object in the eye.
If you can see the object (an eyelash or grain of sand, for example), wash your hands and use a moist cotton ball to gently attempt to remove it from baby's eye while someone else holds baby still (attempt this only in the corner of the eye, beneath the lower lid, or on the white of the eye—stay away from the pupil). Or try pulling the upper lid down over the lower one for a few seconds. If those techniques don't work, and if baby is very uncomfortable, try to wash out the object by pouring a stream of tepid (body temperature) water into the eye while someone holds baby still. Don't worry about your little one crying—tears may help wash out the object.

If after these attempts you can still see the object in the eye or if baby still seems uncomfortable, the object may have become embedded or may have scratched the eye. Don't try to remove an embedded object yourself—proceed to the doctor's office or ER. Cover the eye with a small cup, a gauze pad taped loosely in place, or with a few clean tissues or a clean cloth to alleviate some of the discomfort en route. Do not apply pressure.

23. Corrosive substance in the eye.
Flush baby's eye immediately and thoroughly with lukewarm water for 15 minutes, holding the eye open with your fingers (see
illustration
). If one eye is involved, keep the chemical runoff out of the other eye by turning baby's head so that the unaffected eye is higher than the affected one. Don't use drops or ointments, and keep baby from rubbing the eye or eyes. Call Poison Control (800-222-1222) for further instructions. Depending on the substance, Poison Control may recommend a follow-up with an eye doctor to be safe.

Baby won't enjoy an eye bath, but it's necessary to wash away a corrosive substance.

24. Injury to the eye with a pointed or sharp object.
Keep baby in a semireclining position while you seek help. If the object is still in the eye, do not try to remove it. If it isn't, cover the eye lightly with a small cup, gauze pad, clean washcloth, or tissue, but do not apply pressure. In either case, get emergency medical assistance (call 911) immediately. Though such injuries often look worse than they are, check with the doctor any time the eye is scratched or punctured, even slightly.