Children’s Bath Safety

Keeping Kids Safe in the Bathroom

Bathtub and Bathroom Injuries in Children

Father Giving Baby Daughter Bath

Most injuries that occur to young children happen in the bathroom. Understanding how to prevent slips and falls, scalds and drowning are imperative to children’s bath safety. (Photo courtesy of IstockPhoto.com)

In the United States, from 1990 to 2007, an annual average of 43,600 bathtub and shower related injuries occurred to children aged 18 years and younger. The greatest number of injuries occurred in children less than two years of age, and 54% of all injuries were to children under the age of four. 97.1% of all injuries occurred at home.

Lacerations from slips and falls made up 59.5% of the injuries. 79% of those injuries occurred in the bathtub and the remainder in the shower. Burns are also a major source of injury in children. The majority of children aged four and under who are hospitalized with burn-related injuries suffer from scalds (65%). Hot tap water burns cause more deaths and hospitalizations than burns from any other hot liquids.

With such sobering data available, it’s important that parents and other childcare providers understand what precautions they can take to minimize the risk of injury to kids in the bathroom.

Children’s Bathtub and Shower Safety

Slips and Falls

Slips and falls account for the majority of bathroom related injuries in children. An August 2009 study by Pediatrics Journal showed that slips and falls in the tub and shower are the most common causes of bathroom injury in children, and many happen even while the parent is present and watching. Children have high centers of gravity and tend to topple forward. Some falls happen so fast that even vigilant parents aren’t quick enough to react so it’s important to keep the tub as safe as possible in the event a fall does happen. There are many steps you can take to minimize the risk of injury to children as a result of slippery tub and shower surfaces.

American Standard Children's Temporary Bath Conversion

The American Standard Children’s Temporary Bath Conversion has many safety features designed into the product including a molded seat, gentle sloping basin and high counter height. (Photo courtesy of ©American Standard)

  • Ensure bathtubs are fitted with non-slip mats, treads or tape that are specifically designed and placed for toddlers and babies.
  • Bathe children in tubs that are designed specifically for their age ranges, like the award-winning American Standard FunBath™ Children’s Temporary Bath Conversion from American Standard. These tubs often have integrated features like tub seats and gently sloping surfaces that make bathing children easier for the parents and safer for the children. The American Standard FunBath™ Children’s Temporary Bath Conversion model actually elevates the tub surface to 36” in height, eliminating kneeling and strains on the back and allowing parents to more securely position the child in their arms before moving them in or out of the tub, thereby decreasing the risk of a slip or fall. The tub comes in unique “child friendly” designs with a custom fit tub lid that converts the tub deck into a large changing station or storage compartment. The tub installation is quick and temporary. It can easily be placed over existing tubs and quickly removed when no longer needed.
  • Encourage children to sit while being bathed. Discourage standing, jumping or rough play in or around the tub during bath time.
  • Cover faucets and bath controls with Faucet Covers or other soft, secured materials to lessen the chance of lacerations if a child does fall while in the bathtub.

Hot Water Burns

Burns from scalding water cause a significant proportion of bathroom injuries each year in the United States, mostly to children and the elderly. Babies under 5 years of age are at particular risk because their skin is 15 times thinner than an adult’s, making it far more sensitive to pain and more prone to injury. To keep babies and young children as safe as possible from hot water scalds, be sure to do the following:

Bathtime-baby

Scalds cause a significant number of bathroom injuries in children each year. Be sure your faucets are equipped with anti-scald devices and never leave children unattended in the tub or shower. (Photo Courtesy of IstockPhoto.com)

  • Be sure your faucet is equipped with an Anti-Scald Device. There are two types of scald control, one that monitors temperature, and another that monitors pressure. The temperature version is the more sensitive of the two, though it is more expensive. Devices that combine both types of control are best, and it is highly recommended that households with children employ these devices to ensure bath safety.
  • Always test the water temperature before placing a child in the bath or shower, and never run the water to fill a bathtub while the child is sitting in the bath.
  • Set the maximum hot water setting on your hot water tank to 118 degrees F.
  • Do not bathe your child in a shower if you can instead bathe them in a tub. Shower water temperature is harder to control, as water temperature can suddenly change and burn the skin before a child can move out of the water stream.

Drowning

Every year, sad reports are published about parents who leave children unattended in tub for a few minutes and come back to find their children unconscious or worse, even in water only a few inches deep. Children can drown quickly in the smallest amounts of water so it is absolutely imperative that they never be left alone while being bathed or near water.

  • Always use the smallest and most shallow amount of water possible when bathing your child.
  • Never leave your child unattended in the bathroom, even when filling the tub. If you have to leave the bathroom, take your child with you.
  • Never leave your child unattended in a tub or shower. If you use a bath seat or bathing cradle, do not be lulled into a false sense of security and keep an eye on them at all times. Children have drowned in tubs while strapped into these devices that have tipped over and trapped their faces underwater.
  • Always keep your hands on your child while they’re in the bathtub or shower. Not only will this help to help prevent a slip or fall, it will also ensure their face never has the opportunity to slip underwater.
  • Keep all bathing equipment – like sponges, soaps and towels – nearby and within arm’s reach so you do not need to let go of your child or turn your back on them while they are in the tub or shower to retrieve that equipment.
  • Keep toilet lids shut and use toilet locks to prevent toddlers from climbing or falling into the toilet. Children have actually drowned in toilets by climbing on them and falling in headfirst, where they get stuck and are unable to lift their heads above the water to breathe.

Shampoos/Soaps/Bubble Baths

Baby Washing Hair in the Bath

Natural, organic soaps made specifically for babies and young children are best for use on their sensitive skin, which can be irritated by fragrances and chemicals. (Photo courtesy of IstockPhoto.com)

Shampoos, soaps and bubble baths can be irritating to children, particularly young babies. It is not advisable to bathe them everyday, as their skin is very thin and sensitive. How often a baby is bathed is partly up to the parent and doctor, but once or twice a week is usually sufficient. Toddlers who may get dirtier quicker can generally tolerate more frequent bathing.

Soaking in bath water that contains soaps or fragrances can cause irritation to the sensitive skin in genital areas and can also cause internal infections, particularly in girls, so the amount of time a child is exposed to these substances while being bathed should be limited.

  • Be sure to bathe an infant or small child using very mild soaps and cleansers made specifically for children. Natural, organic products are best as some popular baby soaps and shampoos still contain chemicals that can irritate a baby’s or child’s sensitive skin.
  • If bath time is also play time, let the child play first and then use soaps and shampoos at the end. Remove the child from the soapy water as quickly as possible. Soaking in soapy water for extended periods can lead to genital irritation or infection, and skin rashes.
  • The American Academy of Pediatrics does not recommend giving bubble bathes to girls of any age due to the increased risk of bladder and vaginal infections.

Spas and Hydrotherapy Tubs

Never bathe your child in a spa-like tub. Water currents in spa tubs are often too strong and kids will have problems keeping themselves upright, regardless if they are sitting or standing. Because these types of tubs require jets and intakes be submerged beneath the water to operate correctly, the level of water in the tub is often too deep for children and poses a significant drowning hazard. Spa tubs often have heaters that heat the water, and children can become overheated very quickly due to their small size. Heat stroke and burns are a real and dangerous possibility in tubs with spa temperature water.

Glass Doors

If your shower or tub is equipped with glass doors, be sure the glass is safety glass to prevent dangerous shards from scattering about the bathroom in the event a glass door breaks.

Toilet Safety

Climbing

As kids become mobile, any surface becomes a potential place to crawl, walk or climb. Toilets are no exception. Because they are just about even in height with a one or two year old toddler and have interesting moving parts, they provide an enticing object with which to play and climb for most young kids.

  • Be sure toilets are safely and securely bolted to the floor, and do not slide, rock or tilt with weight transfer.
  • Keep the tank cover on at all times and be sure it is firmly secured in place. A tank cover that slips and falls on a toddler is heavy enough to cause serious injury.
  • If a toddler succeeds to climb atop a toilet, they may try to climb up higher onto towel racks, countertops or tub rims, where falls can be extremely dangerous or life threatening. Be sure that towel racks, other types of wall installations, countertops or tub rims are not within climbing reach of the toilet. If they are, keep the door to the bathroom closed at all times when it is not in use.

Toilet Injury

Keep toilet lids down and closed, and use toilet locks to prevent children from accessing the toilet bowl. Raised seats or lids can fall down and hurt a child’s hand, head or other body part. A 2008 study by Pediatrics Journal revealed that a high number of unsuspecting male toddlers were injured when toilet seats fell on their penises, some causing severe injuries.

Drowning and Water Safety

In addition, toddlers may try to climb the toilet with the lid open and fall face forward into the water. Children drown every year in toilet bowls that were left open and unlocked. Remove “self cleaning” toilet products from toilet tanks as well, so the water does not contain bleach or other harsh chemicals.

General Bathroom Safety

Slips & Falls

Baby Infant Bath

Making sure your bathroom is safe for children and adults will provide peace of mind and an enjoyable, stress-free bath time for child and parent alike. (Photo courtesy of IstockPhoto.com)

Bathrooms often have tile or hardwood floors that become slippery when wet and lots of fixtures attached to walls that look fun to climb, so it’s important to help protect kids from slips and falls in the bathroom that happen outside of the bathtub and shower.

  • If a floor is made of tile or other smooth material, be sure to place non-slip/non-trip mats or rugs on the floor to provide kids and parents carrying children with a well gripping surface for proper footing.
  • If towel racks and other wall fixtures are reachable by toddlers, move them so they are out of reach. This will not only prevent children from trying to climb or hang off them, but will keep them out of the way if a child does trip and fall, removing the opportunity for head injury or lacerations.
  • While children are being bathed, keep pets from inside the bathroom. Pets may get aggravated if a child is stressed or crying and may act out aggressively either at the parent or child, and they can get underfoot and trip toddlers and parents as they walk about.

Medicines and Poisons

As any parent or child caregiver knows, children are infinitely curious and will get into anything they can. The first place foreign objects usually end up is in their mouths. As such, it is vastly important that harmful medicines, cleaners and other substances are kept in child-resistant containers behind safety-latched cabinet doors, particularly in the bathroom where many cabinets and drawers are at toddler level.

  • If possible, keep all medicines, cosmetics, vitamins, personal care items, cleaners and chemicals placed in cabinets that are out of reach to children.
  • Be sure all medications, vitamins and other similar items are in child-resistant packaging.
  • Install childproof cabinet locks on all cabinets to keep children from accessing them.

Electrical Appliances

Keep hair dryers, curling irons and other electrical appliances out of the bathroom if possible. If you prefer to keep them in the bathroom, make sure they are well away from open sinks, tubs and showers and remain unplugged except when in use. Be sure to keep hot appliances well out of the reach of children while they are cooling off.

Be sure your bathroom appliances contain immersion protection devices. These devices shut off the flow of electricity to the appliance if they fall into water, keeping electrocution injury to a minimum. Products made prior to the mid-1990’s do not have these devices installed, so be sure to replace any old appliances with new ones.

Laundry and Waste Baskets

Keep wastebaskets inside cabinets with child safety locks. Always immediately dispose of harmful objects – like old medicine bottles, cleaning bottles or razor blades – in an outside trashcan instead of in household wastebaskets.

Tall laundry baskets can topple over and hurt your child if they try to climb on them. Keep hampers and laundry baskets locked in closets if possible. If you have a hamper with a weighted lid, be sure to latch it shut with safety straps.

If you have laundry chutes in your house, be sure to securely latch them shut to prevent toddlers from crawling into them and severely injuring themselves.

Phones

Bring your phone into the bathroom so you have it handy in case of an unforeseen emergency but place it in a secure place away from the tub or sink. Do not answer the phone while you are bathing your child. Besides it being a dangerous distraction, you can also mistakenly drop it in the tub or sink.

Sources:

1. Injury Prevention: Bathroom Safety, by Dr. PaulTM; http://www.drpaul.com/injprev/inj-bath.html

2. Bathtime Safety For Babies and Children, by safekids.co.uk; http://www.safekids.co.uk/BathSafetyChildren.html

3. Half of all bathtub injuries involve toddlers, by LiveScience Staff, Kids and Parenting on msnbc.com; http://www.msnbc.msn.com/id/31892607/ns/health-kids_and_parenting/

4. Child Safety in the Bathroom, by Dan Vandervort’s HomeTips.com; http://www.hometips.com/diy-how-to/child-safety-bathroom.html

5. Injuries Associated With Bathtubs and Showers Among Children in the United States, by Shengyi J. Mao, BS; Lara B. McKenzie, PhD, MA; Huiyun Xiang, MD, PhD, MPH; Gary A. Smith, MD, DRPH; http://pediatrics.aappublications.org/cgi/content/abstract/124/2/541

6. Parent Tips: Bathtub safety tips for young children, by Rebecca Scarlett; http://www.helium.com/items/1911933-parent-tips-bathtub-safety-tips-for-young-children

7. Bathtub Safety, by Donald A. Davis; http://www.familycorner.com/archives/safety/1.shtml

8. Toddler Bath Safety, by Jamie Malone, eHow Contributor; http://www.ehow.com/about_6659275_toddler-bath-safety.html

9. Facts About Burn Injury, by Children’s Hospital of Pittsburgh of UPMC; http://www.chp.edu/CHP/P02796

10. American Standard’s Children’s Temporary Bath Conversion, by American Standard; http://www.safetytubs.com/tubsforkids/boys_description.php

11. American Standard’s Children’s Temporary Bath Conversion, by American Standard; http://www.safetytubs.com/tubsforkids/girls_description.php