Dr. S.P. Ratnam

Two-year-old girl, Anita, was brought to the hospital with a one-month history of difficulty in breathing. She had been treated with antibiotics by local practitioners but showed no improvement. It was peanut season, and one day she had been eating peanuts from a plate. When the plate was taken away, she protested loudly with her mouth full of peanuts. Her breathing problems began soon after this incident. An X-ray confirmed the suspicion of a foreign body in the airway. A bronchoscopy was performed, and the offending peanut was removed. This is just one of many examples of accidents in children.

1. Foreign Bodies

a) Air Passage:

Foreign bodies lodged in the main airway (trachea) can be life-threatening and require immediate medical attention.

b) Nose:

A foul-smelling nasal discharge should always raise suspicion of a foreign body. Common items removed from children’s nostrils include tamarind seeds, slate pencils, pencil stubs, and peanuts. Children often admit to inserting these objects themselves. A simple first-aid measure is to induce sneezing using mild irritants like pepper fumes.

c) Ears:

School-going children may insert stones, colored paper, beads, or toffee wrappers into their ears. Garlic pods used as home remedies for earache may also get lodged. These can often be removed by syringing. However, syringing should not be performed if there is ear discharge or if the object is organic (such as a seed), as it may absorb water, swell, and damage the delicate eardrum.

d) Alimentary Tract:

Children may accidentally swallow coins, closed safety pins, or seeds (such as custard apple seeds). While these usually pass naturally in stools, they often cause significant anxiety for parents.

2. Drugs and Poisons

Kerosene and vinegar may resemble water and should always be kept out of children’s reach. Naphthalene balls look like sweets and should be stored securely.

Children from medical families may have easy access to medicines. All drugs should be clearly labeled and kept locked away. Overdoses of medications such as phenobarbitone (used in epilepsy), cough syrups, aspirin, metacin, antidiarrheal mixtures, and even multivitamins are not uncommon and require immediate medical attention.

3. Falls, Accidents, and Burns

From the age of three months, children should never be left unattended on beds, as they can roll over and fall once they begin to crawl. Doors should be kept closed, especially if they open onto roads. Older children should be taught road safety rules early.

Young children tend to imitate adults. Therefore, activities such as ironing, cooking, or shaving should ideally be done out of their sight. Simply saying “don’t do this” often encourages curiosity—many children will touch a hot iron just to “check” if it is truly hot. Positive instructions are more effective.

After cooking, ensure fires are properly extinguished. Hot liquids, cooking oils, and utensils such as dosa tavas and pans should be kept out of reach. Kitchens with half-doors can help keep toddlers out. Children enjoy turning knobs and may even open gas cylinders, so matches, knives, and blades should be stored safely.

Silence among children at play can indicate mischief—they may be spilling powders, emptying bottles, or even locking a younger child in a cupboard during play. Supervision is essential, and grandparents can be valuable caregivers.

Immunisation:

Children should be immunised according to the recommended schedule. Pets, especially dogs and puppies, should also be vaccinated.

4. Water Safety

Drowning is common, especially in rural areas where water is stored in open containers or wells. Toddlers can drown even in shallow water. All water sources, including bathtubs and storage vessels, should be covered.

Children may lock themselves in bathrooms while playing with water. Doors should be easy to open from outside in emergencies, and windows should be kept open for ventilation and visibility.

Older children can be taught safety measures and encouraged to look after younger siblings. They often take pride in this responsibility and learn valuable lessons in the process.

5. Habits

Parents serve as role models. Habits such as smoking and drinking can influence children, so it is important to set a good example.

Television and films also shape children’s behavior. While not all influences can be avoided, steady guidance and value-based education can help children develop proper priorities in life.

Children are a gift. What we make of them becomes our gift to the world.