Thermal Burn (Child)

A child’s skin burns more easily than an adult’s. Thermal burns are caused by heat. They can be caused by hot liquids, fire, steam, or hot objects like cooking pots or pans. Most thermal burns are minor burns (also called first-degree or superficial burns). But burns can be quite serious.

Minor burns damage only the top layer of skin. The skin is painful, dry, and red. Minor burns heal in less than a week. They usually don’t leave a scar. More serious burns can swell and blister. Some more serious burns heal in 1 to 3 weeks without scarring, but the skin color may permanently change.

In the ER, burns are cooled with water, then carefully cleaned. The doctor may remove the damaged skin (debridement). Your child may be given acetaminophen or nonsteroidal anti-inflammatory medicines to control the pain. An antibiotic is often put on the burn. Minor burns are left open to air. More serious burns may be covered with a sterile bandage. Children with major burns or with burns around the face, genitals, hands, feet, or joints may need to stay in the hospital for treatment and observation. Or they may be transferred to a regional burn center, depending on how severe the burn is.

Home care

Follow these guidelines when caring for your child at home:

The healthcare provider may prescribe medicines for pain and infection. Follow the provider’s instructions for giving these medicines to your child. It's important to give your child pain medicine before changing a bandage.

General care

  • Follow the provider’s instructions when caring for the wound and changing a bandage.

  • Don’t put medical ointments or grease on the burn. This will hold in heat, make the burn more painful, and raise the risk for infection.

  • Don’t rub the burn.

  • Encourage your child to drink plenty of liquids, such as water, fruit juice, or clear soups. This will help prevent dehydration.

  • Keep your child from scratching and picking at the burn. Keep their fingernails trimmed short.

Prevention

  • Be sure that your child is not underfoot when you are cooking or drinking hot liquids. Don’t give a child scalding hot drinks or food.

  • Don’t leave a child unattended near an open flame. Don’t let children play with matches or lighters. Keep these out of children’s reach.

  • Put safety knobs on stoves and ovens.

  • Turn the water heater thermostat below 120°F (48.8°C).

  • Don’t smoke around your child. Keep lit tobacco products away from children.

  • Teach children fire safety. Be sure they know what to do if a fire starts in the house.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to seek medical advice

Call your child's healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Pain continues even after taking pain medicine

  • Your child isn’t interested in eating or drinking

  • Too little urine

  • Dark or strong-smelling urine

  • Sunken eyes

  • Redness or swelling that gets worse

  • Foul-smelling fluid drains from the burn

  • Wound doesn’t heal  

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds of digital thermometers. They include ones for the mouth, ear, forehead (temporal), rectum, or armpit. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Use a rectal thermometer with care. It may accidentally poke a hole in the rectum. It may pass on germs from the stool. Follow the product maker’s directions for correct use. If you don’t feel OK using a rectal thermometer, use another type. When you talk to your child’s healthcare provider, tell him or her which type you used.

Below are guidelines to know if your child has a fever. Your child’s healthcare provider may give you different numbers for your child.

A baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

A child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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