Whether it is a bumped head or a suspiciously puffy eye, find out what you need to know about some common childhood problems.
A toddler’s world is filled with exploration—touching, crawling, and walking their first steps into new and exciting environments. While this is a time for great learning and development, your child can also pick up a few bumps and bruises along the way to new discoveries.
Most commonly seen in children younger than five, nursemaid’s elbow occurs when bones in the forearm become partially dislocated from one another due to injury or pulling. It can happen quite easily and most often does while a parent or caregiver is holding the hand of a child. If the child slips, invariably the adult will pull up on the child’s arm to keep him or her from falling. Hence the dislocation.
Heather Scott of Massachusetts, the mother of a three-year-old daughter, shares, “Our daughter has been treated for nursemaid’s elbow. While walking with a preschool teacher, she slipped on a curb and the teacher pulled her arm to keep her from falling into the street,” she says. “The jerking motion caused the injury. We took her to the ER, and the attending doctor just pressed on the inside of her elbow with one hand while twisting her arm with the other. It didn’t appear to hurt at all and was fixed immediately.”
Symptoms: Your child may refuse to use his arm, keep it slightly bent and close to the body, or experience pain with or without swelling. Little ones may seem to have a floppy hand, wrist, or entire arm, and be unable to move it comfortably.
When to Call the Doctor: Dr. Seema Csukas, MD, director of Community Health Development and Advocacy with Children’s Healthcare in Atlanta, says you should call your child’s doctor right away.
Treatment: “The doctor may be able to fix the problem in the office and have the child back to normal,” says Dr. Csukas. “Sometimes, an X-ray may be needed if there is no improvement. Acetaminophen or ibuprofen may be given for pain.”
Dr. Csukas also suggests following up with the doctor if the child is not better in 24 hours.
Prevention: Kids who have had nursemaid’s elbow once are at a higher risk for having it again. Do not lift a child by the arms—instead always lift your child from under the arms.
A lip injury usually occurs when a child falls or bumps into something. More often than not, a child will catch his or her lip in his teeth during a fall, creating a split lip (luckily, most of these cuts don’t connect or go through the lip). In minor cases, extremely chapped lips, as little ones so often experience during colds, may create a split lip. Both injuries may produce swelling of the lip along with possible pain, soreness, and bleeding where the skin has been split.
Symptoms: If your child has split a lip, expect to see swelling. Acetaminophen or ibuprofen can be given to manage the pain.
When to Call the Doctor: If bleeding stops but there’s no improvement with other symptoms, you should call the doctor within one to two days, says Dr. Csukas.
Treatment: If your child experiences a split lip, “rinse the mouth and lip with cold water and clean area gently with a washcloth,” recommends Dr. Csukas. “Then apply a cold compress to the affected area or have the child suck on an ice pop if [he or she is] old enough.” You should also avoid salty or acidic foods as they can cause more pain.
Prevention: Lip ointments can help prevent dry and cracked lips from splitting. Keeping a safe distance between children and toys when playing also helps prevent lip injuries. For children involved in sports or physical activities such as skateboarding, consider mouth guards to prevent all types of oral injuries.
Bumps and bruises can occur at any time and any place—and sometimes, as in the case of North Carolina mom Sandy Bravo-Boyd, they can happen as soon as you step out the door. Bravo-Boyd stays busy with energetic 20-month-old son Jack. One day, the twosome got 10 steps out their front door when Jack fell, scraping the left side of his nose and face. “I was shocked that it happened so quickly,” says Sandy, who ran back into the house with a crying and slightly bleeding toddler. “I grabbed some cotton balls and a clean washcloth to gently clean his face and apply pressure,” she says. “I remembered to put on first aid cream and left the wound exposed so it could dry.”
Sandy called Jack’s pediatrician who told her to continue reapplying Neosporin to the affected area. Sandy also learned the injury might look worse before it got better.
Symptoms: What at first appears to be swelling and puffiness, or even just a scrape, can sometimes be more. Symptoms of a head injury can include swelling, bruising, pain in the affected area, and bleeding if the skin split where the injury occurred.
“If the skin is split, the child may require stitches to close the skin and therefore needs a medical evaluation,” says Dr. Csukas. Surface cuts and bumps may be the least of it—any trauma to the head could result in a concussion, so parents should be cautious. “Parents can check their child’s pupils to make sure they are equal in size and get bigger and smaller in reaction to a bright light. If this is not the case, a more serious problem may be involved and medical evaluation is needed.”
When to Call the Doctor: Call your doctor if your child complains of severe headaches, acts fussy or confused, is difficult to arouse, or seems dizzy.
Treatment: Dr. Csukas suggests watching your child if she bumped her head and to involve her in quiet and calm activities for the rest of the day. “Limit a child’s intake to sips of clear liquid and bland foods for the rest of the day as well,” adds Dr. Csukas. “Vomiting may occur once or twice, but if the child has multiple episodes of vomiting, call your doctor immediately.”
Dr. Csukas says not to give children medicine that may make them sleepy. “You’ll want to be able to observe your child for any unusual change in behavior or activity,” he explains.
Prevention: Closely monitor your child in any situation where he or she may experience a fall that could cause head injury. Be sure kids wear helmets while riding tricycles, bikes, scooters, and so on. Childproofing the home is a good way to prevent run-ins with sharp corners, and gates protect children from staircases.
Charity Snyder, mom to boys C.J. and Jared, can still remember three-year-old Jared pretending to be Evel Knievel and hitting the table with a closed mouth. “He ended up bumping his tooth, and after a call to the doctor he told us to watch so that it didn’t get wigglier,” recalls Charity. In cases where a child is injured and the situation is not life threatening, Dr. Lee says parents should first examine the face and mouth with clean hands to evaluate the situation.
Symptoms: Check your child’s mouth for bleeding and swelling. A tooth may be loose, bumped out of place, or misplaced.
Treatment: “Use a clean washcloth pressed on any bleeding sites and gently clean dirt or debris from the injured area,” advises Dr. Lee.
When to Call the Doctor: “If the parent sees the child fall or get hit in the mouth and they get up crying and the worst injury appears to be oral trauma, then the person to call first is the family dentist,” says Dr. Lee. “If the parent or guardian is not sure about the extent of injury or wasn’t present when the child was injured, a call to the child’s pediatrician could help steer the parent to the proper place of treatment. The pediatrician will ask questions about how the injury occurred and how the child is responding and will be able to triage the situation when things are not clear,” adds Dr. Lee.
If the child’s tooth is out, parents of older children (who aren’t at risk of choking on the loose tooth) can either place it back into the socket, assuming it is free of dirt or debris, or bring the tooth to the dentist with the child. “Preferably the tooth will be in a small container with [your child’s] spit, or some milk or water” (in descending order of preference), adds Dr. Lee.
At that point, a pediatric dentist will try to replace the tooth in the socket and splint it into position with the other teeth. Dr. Lee explains that a tooth’s response can be unpredictable after trauma. “Many permanent teeth need root canal therapy, and most of the primary teeth either require pulpotomies (removal of nerve tissue) or removal sometime after the injury.”
Dr. Lee also says, “It is important to try and save the tooth because premature tooth loss allows shifting of other teeth and severe orthodontic and esthetic problems can result if a tooth is removed and a space maintainer is not placed. My best advice is to call the family dentist immediately and never ignore a trauma problem,” she adds.
Injuries to teeth often require several visits for an in-depth look at the problem with X-rays and examinations as well as close monitoring of the situation.
Prevention: Monitoring your children during playtime and discouraging rough play decrease chances of injury. Dr. Lee adds that mouth guards can protect teeth and gums during sporting events. “Your dentist can advise you about the type of mouth guard best suited for the sport your child is involved in—they vary depending on sport, age of child, and level of physical contact. Research has shown that a well constructed and excellent fitting mouth guard can not only save teeth, but also can lessen the severity of head injuries during sports play,” says Dr. Lee.
Bug Bite on the Eye
Bug repellents help protect kids from a wide variety of bites including those that carry disease such as ticks, and common bugs like mosquitoes, fleas, and flies. But what happens when your child is bitten in an area where repellents cannot be used—such as the eyes? The venom that insects inject into the skin can cause kids to itch and leave redness, bumps, and irritation.
Symptoms: Your child may have a bug bite on the eye if you can see a red, white, or pus-filled bump on the eyelid or surrounding area. Your child’s eye may be puffy, swollen, and sore.
Treatment: To decrease swelling, Dr. Csukas recommends applying a cold compress to the area. If swelling and itchiness worsen, an over-the-counter antihistamine can help relieve symptoms.
When to Call the Doctor: “If there is no improvement in one to two days, or the child develops a fever, increased pain, drainage from the site, or change in vision, call your doctor,” suggests Dr. Csukas.