5 month old scalded by boiling water-please help

[A1983]

My DD was scolded by boiling hot water in a flask placed on her pram yesterday by a close family member-it wasn't secure and leaked through. I'm distraught and don't want to talk to this person. She is 5 months old and ive just got home from Bristol burns unit, seems her usual self but im just so devastated for her, poor baby. She was placed under a cold running tap for 20 minutes then taken to hospital. This morning she had a bio-brane dressing put on her leg under GA and the Consultants say she has complete partial thickness burn (4% mid-deep burn). It's a waiting game to see if it heals by itself in the next 10-14 days-the outer area they believe will do but they say it's 50:50 for the middle area which is quite deep and may need a skin graft. I'm hoping and praying the burn will heal completely....and obviously ideally for her no scarring or discoloration of skin. It's such a large burn on a little leg. She is to eat a protein rich diet to aid healing so her breast milk and ill blend some fish, cheese, beans etc for her.

I'm in shock atm and just want answers now..but unfortunately we all have to wait. She has an appointment on Saturday to see if the bio-brane is still sticking, and will have her dressings changed every 2 days.

Thank you

X post with you there, hadn't refreshed.

So, she just put a flask of water onto the footmuff? That's bonkers.

db.tt/OeYEXhrV

Yep. This is a picture

link www.dropbox.com/s/h99cyaut2vytwfu/2014-01-14%2010.50.20.jpg

First: she is absolutely gorgeous!
Second: aren't this kind of cover hydro-repellent?
Last: it's not flat. How can you put something on it and not see that it will fall?

And according to your first picture, the liquid spillage was from top to bottom, not from bottom to top as it would be if the flask was placed at her feet.
How is she today, and how are you?

You put your daughter's name twice in your last post (lovely name by the way and it suits her so much). Copy and paste your post changing the name to DD and then report the original to MNHQ to have it deleted.

I am glad she isn't in any pain.

Thank you for providing the link Gordon. Yes she is absolutely gorgeous, a precious and beautiful baby-my world! :-)

As for the flask-she lay it down!! So therefore im presuming the exit place for the liquid poured right through the layers and into the leg-poor baby couldn't move away from it and obviously didn't understand what was happening. From then til she was removed and placed under the tap I can't even bear thinking about. When I wash my hands and the water turns very hot I burst into tears every time just imagining what shewentthrough.

No the cover is just fleece lined.

DD is her happy self-she hasn't even cried for any baby related reasons let alone to do with the pain. She is currently 'singing' away in the car (im not driving!) as I type. I know im biased, but she really is amazing.

poor mite hope all goes ok for her x

Poor little love, my brother burnt his hands as a teenager and his fingers fused together with the blisters, today he has no scarring, the only evidence of how bad it was is the before photos (and the stone in weight he put on as our hospital,advised he ate lots of cream ....)

Just got back from hospital yet again-i sent pics to outreach nurse of DD leaking dressings and after saying they're ok over the phone, on seeing them she said to come in. Biobrane still on but has come away at the top of her leg where it's wet and was oozing from. Dr made me feel better by saying 1) although she can see the deeper areas, she doesn't think a graft will be needed and 2) they will put a silver dressing on too which will kill off any bacteria to prevent infection as infection will make wound deeper and scar worse. Then nurse made me feel worse by saying were still in limbo as every day it can change and the biobrane fall off. She also said she'd have expected the biobrane to have dried by now ie no oozing. Its been on since Thursday morning. Then DD was screaming during the dressing change where they also 'applied pressure' by washing biobrane/burn and said that the fact she's crying means she's in pain and therefore the biobrane isn't doing its job as burn too deep. For goodness sake!!! I asked her if she based that on her crying and she said yes-so I said I think she's crying because she's hungry. Who knows. The worst bit is not having any answers still!! And every day has been a trip back there for unexpected dressing changes which is making me feel like we're taking one step forwards and two back. And im just so exhausted. Sorry to vent x

In my house, crying is not an indicator of the gravity of a wound.

DS1 10y who is a surfer and crazy skater, does mixed martial arts, .... cries like a baby whenever I have to remove an old plaster. Or when he cuts himself turning the page of a book!

DS2 7y didn't cry when they put him stitches without anesthesia on his forehead, didn't cry or complain when he broke his hand which had such a funny angle it made me feel the pain (but he did cry a little when they put the bones back in place again without anesthesia). Whenever I hear DS2 crying, I run, with DS1 I just say "it's ok sweetie, I am coming"

So take the nurse's words with a pinch of salt. The doctor said the burns looked fine.
The burns come qui high on her thigh. Maybe whenever you change her or strap her in her car seat or pram, there may be a rubbing, or a pressure, that could explain why it hasn't healed yet there. Ideally any wound should be left in peace and not touched. Easy said with a baby and in winter.

Exactly-and as an oblivious 5 month old she's moving her legs and also kicking her bad leg! I have to put a blanket between her legs so she doesn't rub her foot up and down the location of he burn. Hopefully the rest of the burn will continue to heal well and this top bit will need closer checks and different dressings.

Thanks for your help Gordon-your son's sound brilliant!

Did they give you any tips at the hospital? Suggesting that you dress each leg separately, so you don't need to pull trousers or pyjamas up and down rubbing the dressing several times per day? Just put one leg in one trousers / leggings / pyjama bottom and pin the empty leg on her back. Repeat with the other leg. So when she needs changing you can easily do it . Yes it will look strange but maybe you can give it a go for 24 hours and see if things improve.
Not sure if you understand what I mean.

Exactly-and as an oblivious 5 month old she's moving her legs and also kicking her bad leg! I have to put a blanket between her legs so she doesn't rub her foot up and down the location of he burn. Hopefully the rest of the burn will continue to heal well and this top bit will need closer checks and different dressings.

Thanks for your help Gordon-your son's sound brilliant!

I completely understand, normally we'd use baby grows but since this she's actually just been in a vest and top only and socks. If we're out ill put on some really baggy and stretchy leggings for a one year old that doesn't rub along burnt area. I think it's where the nappy inevitably comes into contact with the top of the burn-plus the first night we got home, she pooped and her flippin nappy leaked onto the top of her dressing-just the tape part which under their instruction we changed with our dressing tape. That may have also got in a tiny bit-smaller than they eye can see-but it's not infected thankfully, just oozing and biobrane peeled off that bit. Anyway ill check her this morning when she wakes and outreach nurse coming this afternoon.

I think you deserve some . You're doing brilliantly. Keep the positive attitude and your lovely and precious DD will do just fine.

If you had to change the dressing on the top after it got soiled, even if only changing the tape, it makes sense that it slowed the process compared to the rest of the leg. And remember no two patients are alike and every body heals in an unique way. DS1 belly bottom fell after 3 days, DS2 after a month, so if you compare it should indicate a problem. But in fact, it just wasn't drying, it wasn't infected or anything, it just stood there.
So if on average Biobrane dries in n days, for your DD it may be n+1.
So let us know what the nurse said!

First off, your little girl is gorgeous!

Secondly, crying is no more an indicator of whether this is healing than what you had for breakfast generally. Babies cry for multiple reasons, hungry, pain, don't like the person faffing over them etc etc.

I used to work in a burns unit - we saw lots of little ones with these types of injuries and they mostly healed absolutely fine. Your doctor will probably be on the pessimistic side (I know we were very conservative when it came to talking to parents about grafting, better to prepare them for it than it come as a surprise).

Even if it comes to needing a graft, its not as bad as you probably think. Depends on what type of graft etc they use and as burns surgeons are also plastic surgeons they will be thinking of the cosmetic issues and will do their best for your little girl.

Lastly, I wonder if anyone has talked to you about the support team that they have? In our unit, we had two very lovely therapists who would talk through things with our patients because this kind of thing can really shake you up.

Hope all's well today.

Thank you both for replying-means a lot.

Well DD had top part of biobrane removed as it was oozing too much (sulfide?) Not infection anyway-but biobrane wasn't doing its job there anymore. She had a bath by me with the nurse and then a normal dressing put on the non-biobraned burn. I just looked it up on Internet as there were white pearly patches where it was beefy red-but this is apparently normal and will most likely heal in 3 weeks. Hope that's right.

It's the middle area they are concerned about but it continues to be a waiting game.

She's beautiful! I hope she continues to heal well. Keep giving her the magic breastmilk!!

Hope she continues to heal really well, A1983.

Oh honey I feel for you and your baby I also have a 5mo. I had a similar injury at about 14 and it took ages but eventually healed really well. At least the little mite wont remember this- I remember my injury well, it hurt like hell at the time but the pain very quickly subsided.

Good morning A1983,
Yes it will take time, but it won't left a scar if cared properly. This spring/ summer you must not allow sun rays on her leg, and I am not talking about holidays only but even the british sun on a bright day. Otherwise you risk to have darker marks. It won't be fun, but it's only for a couple of months.
Have a nice day!

I hope your DD continues to heal.

I wanted to post to say that I know how awful it is to look at your DD's perfect skin & think about it scarred for life & blemished, but that even if she does have a scar in the end that's fine. I have a 10cm scar on my forearm from an accident when I was a child - people occasionally comment on it but it's just part of me & my story... Whatever the outcome, whether she scars or not, it will be okay. Hope that comes across as well as I mean it!

Yes ill keep her leg/that leg well covered.

I'm just looking for the best creams I cam get for her scar which ill start using as soon as it's healed. I want to help her and give her the best chance of minimal scarring. There are a few around but I don't know which are the best. The nurse yesterday said she can't recommend parents to use any particular one but gave me a pot of epaderm-it's just a moisturiser though. When I mentioned aloe vera plant and lavender oil she said she'd heard good things about those.

So im looking at a silicone gel like kelo-cote, research says it works well for pigmentation and hypertrophic scarring. Also a good quality vitamin e and lavender oil and aloe vera plant. I don't mind how often im massaging these into her legs, I've always massaged her anyway and she deserves the best outcome.

Any known creams please state! Some say to use as it's still a burn ie before its healed to reduce further scarring but I wont. Ill start once it's healed. Ill send a picture later of the wound now.

Look, I know the person responsible was an idiot and I sincerely hope your little girl gets through this without any permanent scarring, but can I ask a question?

You say in your OP that the person responsible is a close family member. I assume by this you mean mother, grandmother, aunt or sister? :(

A couple of years I had surgery to remove skin cancer on my face and when I first saw the scar with the black stitches, the red skin I was horribly shocked. I treated it with Rosa Mosqueta Oil (also called Hip rose) and now, you can't see it at all, except if you know where to look and come very close. Mosqueta oil is very recommended for scarring.

By a quick read on Dr. Google, it seems to be good for burns as well.
I didn't buy any specific brand but had it prepared by a pharmacist in one of those little brown bottles. It stains, because it's dark yellow/orange.

What is proved to help as well is a diet rich in vitamins C, E and A, so, as soon as you start weaning her there are some food you can prepare such as squash, broccoli, carrots. For other food, you'll have to wait a little more.