What to Expect the First Year (127 page)

see
#36
,
#37

36. Split lip.
Few babies escape the first year without at least one cut on the lip. Fortunately, these cuts usually look a lot worse than they are and heal a lot more quickly than you'd think. To ease pain and control bleeding, apply an ice pack, or let an older baby suck on a feeder bag filled with ice. If the cut gapes open, or if bleeding doesn't stop in 10 or 15 minutes, call the doctor. Also call if you suspect a lip injury may have been caused by chewing on a plugged-in electrical cord.

37. Cuts inside the lip or mouth.
Such injuries are also common in young children. To relieve pain and control bleeding inside the lip or cheek, give an older baby a feeder bag filled with ice to suck on. To stop bleeding of the tongue, if it doesn't stop spontaneously, apply pressure to the cut with a piece of gauze, a washcloth, or a cloth diaper. Call the doctor if the injury is in the back of the throat or on the soft palate (the rear of the upper mouth), if there is a puncture wound from a sharp object (such as a pencil or a stick), or if bleeding doesn't stop within 10 to 15 minutes.

38. Knocked-out tooth.
If one of your baby's teeth has been knocked out, there's no need to try to preserve it, since there's little chance that the dentist will attempt to reimplant it (such implantations rarely hold). But the dentist or doctor will want to see the tooth to be sure it's whole, as fragments left in the gum could be expelled and then inhaled or choked on, or the area could become infected. So take the tooth along to the dentist or to the doctor (before you tuck it into a memento box, that is).

39. Broken tooth.
Clean dirt or debris carefully from the mouth with warm water and gauze or a clean cloth. Be sure the broken parts of the tooth are not still in baby's mouth, since they could cause choking. Place cold compresses on the face in the area of the injured tooth to minimize swelling. Call the dentist or doctor as soon as you can for further instructions.

40. Foreign object in the mouth or throat.
Removing a foreign object from the mouth that can't be grasped easily is tricky. Unless done carefully, the effort can push the object in even farther. To remove a soft object (such as a piece of tissue paper or bread), pinch baby's cheeks to open the mouth, and use tweezers to take the object out. For anything else, try a finger swipe: Curl your finger (index or pinky) and swipe quickly at the object with a sideways motion. Do not attempt a finger swipe, however, if you can't see the object. If a foreign object is lodged in the throat, see choking rescue procedures, beginning
here
.

41. Nosebleeds.
Keeping baby in an upright position or leaning slightly forward (not back), pinch both nostrils gently between your thumb and index finger for 10 minutes. (Baby will automatically switch to mouth breathing.) Try to calm baby, because crying will
increase the blood flow. If bleeding persists, pinch for 10 minutes more and/or apply cold compresses or ice (or an ice pack) wrapped in a dampened washcloth to the nose to constrict the blood vessels. If this doesn't work and bleeding continues, call the doctor, keeping baby upright—to reduce swallowing of blood and the risk of choking on it—while you do. Frequent nosebleeds, even if easily stopped, should be reported to baby's doctor. Sometimes, adding humidity to the air in your house with a humidifier will reduce the frequency of nosebleeds.

42. Foreign object in the nose.
Difficulty breathing through the nose and/or a foul-smelling, possibly bloody nasal discharge may be a sign that something has been pushed up the nose. Keep baby calm and encourage mouth breathing. Remove the object with your fingers if you can reach it easily, but don't probe or use tweezers or anything else that could injure the nose if baby moves unexpectedly or that could push the object farther into the nasal canal. If this fails, take baby to the doctor or ER.

43. A blow to the nose.
If there is bleeding, keep baby upright and leaning forward to reduce the swallowing of blood and the risk of choking on it. Use an ice pack or cold compresses to reduce swelling. If swelling persists, or if there is a noticeable deformity, see the doctor.

44. Swallowed poisons.
Any nonfood substance is a potential poison. The more common symptoms of poisoning include lethargy, agitation, or other behavior that deviates from the norm; racing, irregular pulse and/or rapid breathing; difficulty breathing; diarrhea or vomiting; excessive watering of the eyes, sweating, or drooling; hot, dry skin and mouth; dilated (wide open) or constricted (pinpoint) pupils; flickering, sideways eye movements; and tremors or convulsions.

If your baby has some of these symptoms and there's no other obvious explanation for them, or if you have evidence that your baby definitely has swallowed a questionable substance (you saw it happen) or possibly has (you found your child with an open bottle of pills or hazardous liquid, found spilled liquid on clothing or loose pills on the floor, smelled chemicals on his or her breath), immediately call (or have someone else call) Poison Control (800-222-1222) or the ER for instructions. Call promptly for suspected poisoning even if there are no symptoms—they may not appear for hours. When calling, be ready to provide the name of the product ingested, along with the ingredients and package information, if available (if part of a plant was ingested, supply the name, or at least a description, of the plant); the time the poisoning was believed to have occurred; how much of it you know or believe baby ingested (give an estimate if you don't know for sure); any symptoms that have appeared; and any treatment already tried. Have a pad and pen handy to write down exact instructions.

If your child has excessive drooling, breathing difficulty, convulsions, or excessive drowsiness after the ingestion (or suspected ingestion) of a dangerous substance, call 911 for emergency medical assistance. Begin emergency treatment immediately if your baby is unconscious (
click here
).

Do not try to treat poisoning on your own without expert advice, and don't rely on the directions on
the product label. Get explicit medical advice before giving anything by mouth (including food or drink, or anything to induce vomiting). The wrong treatment can do harm.

45. Noxious fumes or gases.
Fumes from gasoline, auto exhaust, and some poisonous chemicals, and dense smoke from fires, can all be harmful. Symptoms of carbon monoxide poisoning include headache, dizziness, coughing, nausea, drowsiness, irregular breathing, and unconsciousness. Promptly take a baby who has been exposed to hazardous fumes into fresh air (open windows or go outside with baby). If baby is not breathing and/or doesn't have a pulse, begin rescue techniques (
click here
) immediately. If possible, have someone else call 911. If no one else is around, call 911 yourself after 2 minutes of resuscitation efforts—and then return immediately to CPR, and continue until a pulse and breathing are established or until help arrives. Unless an emergency vehicle is on its way, transport baby to a medical facility promptly. Have someone else drive if you must continue CPR or if you were also exposed to the fumes and your judgment and reflexes may be impaired. Even if you are able to successfully reestablish breathing, immediate medical attention will be necessary.

46.
Most children who come in contact with poison ivy, poison oak, or poison sumac will have an allergic reaction (usually a red, itchy rash, with possible swelling, blistering, and oozing) that develops within 12 to 48 hours and can last from 10 days to 4 weeks. If you know your baby has had contact with one of these plants, protect your hands from the sap (which contains urushiol, the resin that triggers the reaction) with gloves, paper towels, or a clean diaper and remove his or her clothes. To prevent resin from “fixing” to skin, immediately wash it with soap and cool water for at least 10 minutes and rinse thoroughly. In a pinch, use a wipe. The rash itself is not contagious and won't spread from person to person or from one part of the body to another once the sap has been washed away. Also wash anything else that may have come in contact with the plants (including clothes, pets, stroller, and so on), since urushiol can remain active on them for up to a year. Shoes can be thoroughly wiped down if they aren't washable.

If a reaction occurs, calamine lotion, or better yet, an anti-itch lotion that contains pramoxine (such as Caladryl), will help relieve the itching, but avoid lotions that contain antihistamines (such as Benadryl). Topical hydrocortisone cream can be applied to decrease inflammation. Cool compresses, and/or a colloidal oatmeal bath may also offer relief. Make sure your baby's nails are cut short to minimize scratching. Contact the doctor if the rash is severe or is causing a great deal of discomfort because of its location (around the eyes, on the genitals).

see
#54

see
#11
,
#12
,
#13

see
#50

see
#16

47.
Such serious injuries are rare, but knowing what to do when one occurs can mean the difference between saving and losing an arm, leg, finger, or toe. Take these steps as needed immediately:

• Control bleeding. Apply heavy pressure to the wound with several gauze pads, a maxi pad, or a clean diaper or washcloth. If bleeding continues, increase pressure. Don't worry about pressing too hard. Do not apply a tourniquet.

• Treat shock if it is present (
#48
).

• Check for breathing and a pulse, and begin rescue techniques (
click here
) as needed.

• Preserve the severed limb or digit. As soon as possible, wrap it in a wet clean cloth or sponge, and place it in a plastic bag. Tie the bag shut and place it in another bag filled with ice (do not use dry ice). Do not place the severed part directly on ice, and don't immerse it in water or antiseptics.

• Get help. Call or have someone else call 911 for immediate emergency medical assistance, or rush to the ER, calling ahead so they can prepare for your arrival. Be sure to take along the ice-packed limb, finger, or toe, since surgeons may attempt to reattach it. During transport, keep pressure on the wound and continue other basic life support procedures, if necessary.

48.
Shock can develop in severe injuries or illnesses. It occurs when an inadequate amount of oxygen-containing blood is getting to the brain and body tissues to meet their needs. Signs include cold, clammy, pale skin; rapid, weak pulse; chills; convulsions; nausea or vomiting; excessive thirst; and/or shallow breathing. Call 911 immediately for emergency medical assistance. Until help arrives, position baby on his or her back. Loosen any restrictive clothing; elevate hips and legs on a pillow, folded blanket, or folded piece of clothing to help direct blood to the brain, and cover baby lightly to prevent chilling or loss of body heat. If breathing seems labored, raise baby's head and shoulders very slightly. Do not give food or water.

IMPORTANT: Exposure to tetanus is a possibility whenever the skin is broken. If your child gets an open skin wound, check to be sure his or her tetanus immunization (part of the DTaP vaccine) is up-to-date. Also be alert for signs of possible infection (swelling, warmth, tenderness, reddening of surrounding area, oozing of pus from the wound), and call the doctor if they develop.

49. Bruises or black-and-blue marks.
If the injury is painful, apply cold compresses, an ice pack, or cloth-wrapped ice (do not apply ice directly to the skin) to reduce bruising and swelling. Half an hour of soaking is ideal, but unlikely to be accomplished with a baby, and isn't necessary for a minor bump. If the skin is broken, treat the bruise as you would an abrasion (
#50
) or cut (
#51
,
#52
). Call the doctor immediately if the bruise is from a wringer-type injury (for instance, from catching a hand or foot
in the spokes of a moving wheel), no matter how minor it looks. Bruises that seem to appear out of nowhere or that coincide with a fever should also be seen by a doctor.

50. Scrapes or abrasions.
In such injuries (most common on knees and elbows) the top layer (or layers) of skin is scraped off, leaving the underlying area raw and tender. There is usually slight bleeding from the more deeply abraded areas. Using gauze, cotton, or a clean washcloth, gently sponge the wound with soap and water to remove dirt and other foreign matter. If baby resists this treatment, try soaking the wound in the bathtub. Apply pressure if the bleeding doesn't stop on its own. Apply a spray or cream antiseptic, if your baby's doctor generally recommends one, and then cover with a bandaid that is loose enough to allow air to reach the wound. If there is no bleeding, no bandage is necessary. Most scrapes heal quickly.

51. Small cuts.
Wash the area with clean water and soap, then hold the cut under running water to flush out dirt and foreign matter. Some doctors recommend applying an antiseptic spray before applying a bandaid. A butterfly bandage will keep a small cut closed while it heals. Remove the bandaid after 24 hours and expose the cut to air; rebandage only as necessary to keep the wound clean and dry. Check with the doctor about any cuts that show signs of infection (redness, swelling, warmth, and/or oozing of pus or a white fluid).

52. Large cuts.
With a gauze pad, a fresh diaper, a maxi pad, a clean washcloth—or, if you have nothing else available, your bare finger—apply pressure to try to stop the bleeding. At the same time, elevate the injured part above the level of the heart, if possible. If bleeding persists after 15 minutes of pressure, add more gauze pads or cloth and increase the pressure. (Don't worry about doing damage with too much pressure.) If the wound gapes open, appears deep, or is jagged; if blood is spurting or flowing profusely; or if bleeding doesn't stop within 30 minutes, call the doctor for instructions or take baby to the ER. If there are other injuries, try to tie or bandage the pressure pack in place so that your hands can be free to attend to them. Apply a nonstick bandage to the wound when the bleeding stops, loose enough so that it doesn't interfere with circulation. Do not put anything else on the wound, not even antiseptic, without medical advice. If the cut is deep or large, or on the face or the palm, stitches may be needed. In some cases the doctor may be able to use Dermabond (skin glue) instead of stitches. If the cut is on the face, consider having a plastic surgeon take a look at it.