Preventing Burns and Scalds in Young Children: A Guide for Health Professionals

Burns and scalds remain a significant and preventable cause of injury for tamariki, particularly those aged 0–4 years. In Aotearoa New Zealand, most incidents occur in the home environment and often happen while a caregiver is present. Common causes include hot liquids, accidental spills from food or beverages or hot appliances like ovens, stove tops and irons.

For pēpē and young children, the risk is heightened due to their thinner skin, smaller body size, and developmental curiosity. Even brief contact with hot surfaces or liquids can result in serious injury.

This article provides evidence-informed guidance that health professionals can use to support whānau in preventing burns and scalds in the home, alongside practical first aid and recovery advice.

Why Burns Prevention Matters

Young children are particularly vulnerable to burns due to:

Thinner skin, which burns more deeply at lower temperatures
Limited hazard awareness, increasing exposure to risk
Dependence on caregiver supervision, even in familiar environments

Importantly, many burn incidents occur during everyday routines like mealtimes, bathing, and food preparation, making prevention messaging highly relevant for whānau.

Who Is Most at Risk?

Tamariki aged 0–4 years

Young children represent the highest-risk group:

78% of burn hospitalisations occur in this age group
Within this, 1–4-year-olds account for 85%

This reflects key developmental factors:

Increased mobility (grabbing, pulling, climbing)
Limited hazard awareness
Thinner skin, which burns faster and deeper

Key Burns and Scalds Risks in the Home

Hot Drinks and Food

Hot liquids are a leading cause of scald injuries in young children. These often occur when a child pulls on a cup, tablecloth, grabs an item in the kitchen or reaches up to a surface.

Prevention strategies to reinforce with whānau:

Place hot drinks in the centre of tables, away from edges.
Avoid tablecloths that can be pulled down
Use small placemats instead
Encourage cold drinks when children are present
Suggest caregivers take hot drinks during rest times or when baby is placed somewhere safe or with another person

Infant Feeding (Formula and Breast Milk)

Microwaves are a common but unsafe method for warming milk due to uneven heating and the creation of hot spots.

Clinical recommendations:

Avoid microwave warming of breast milk or formula
Warm bottles by placing them in warm tap water
Do not use boiling water.
Check temperature on the caregiver’s wrist before feeding

Hot Water Safety

Tap water is a major contributor to severe scald injuries.

Best practice guidance:

Recommend setting hot water cylinder temperatures to 50–55°C
Advise caregivers to run cold water first when filling baths
Emphasise testing bath water before placing a child in it

Hot Water Bottles Hot water bottles can cause serious burns, especially in young children or those with reduced sensation. Risk reduction advice:

Avoid use for young children where possible
Ensure bottles meet safety standard BS 1970:2012
Replace bottles annually
Never fill with boiling water, use hot tap water only
Fill only two-thirds full and check for leaks or signs of wear and tear

Safe use messaging:

Always use a cover or towel wrap
Avoid direct skin contact
For children, use to warm the bed only and remove before bedtime

Cooking and Kitchen Safety The kitchen is a high-risk area for burns. Preventive measures:

Encourage caregivers to engage tamariki in safe activities away from cooking areas
Turn pot handles inward
Keep hot food and liquids away from bench edges
Support safe skill-building for older children

Fire and Clothing Safety Fire-related burns, while less frequent, can be severe. Key safety messages:

Install working smoke alarms in all sleeping areas and living spaces
Test alarms monthly
Store matches and lighters securely
Use fireguards around fireplaces
Promote snug-fitting, low fire-risk sleepwear

Household Appliances and Heating Everyday appliances can pose hidden risks. Advice for whānau:

Store hot appliances (e.g., hair straighteners and irons) out of reach after use.
Install safety covers on electrical outlets
Maintain at least a 1-metre safe zone around heaters

First Aid for Burns and Scalds

Prompt and appropriate first aid can significantly reduce injury severity.

Health professionals should reinforce the following steps:

Cool the burn immediately
- Use cool running water for up to 20 minutes.
- For infants, use lukewarm water to avoid hypothermia.
Seek urgent help if needed
- Call emergency services for serious burns, severe pain, or burns involving the eyes
- Contact Healthline (0800 611 116) for guidance if unsure.
Cover the burn
- Use a clean, non-fluffy dressing or plastic wrap
- Do not wrap the face
Refer for ongoing care
- Advise medical review if pain persists or complications arise

Supporting Children After a Burn Injury

Burn injuries can have long-term physical and psychosocial impacts.

Guidance for supporting recovery:

Encourage open kōrero about feelings and experiences
Support confidence, particularly where scarring is visible
Facilitate connection with peers who have shared experiences
Monitor emotional wellbeing across developmental stages

Community Support Resource

Camp Awhi – Burns Support Group Charitable Trust offers a national burns camp for tamariki, helping build confidence and resilience following injury.

Key Takeaways for Health Professionals