Bottle-warming hazards in child care centers

Young children are more likely to sustain injuries from scald burns caused by hot liquids or steam. In child care centers, some of the most common and severe burns happen when scalding hot liquids or food come into contact with a child’s skin. Therefore, centers should address the significant hazards associated with bottle-warming practices to reduce the likelihood of burn injuries to children. 

Potentially hazardous bottle-warming methods

• Heating bottles in a microwave - Bottles heated in microwaves can leave pockets of scalding liquid that can cause severe burns to infants’ mouths. The liquid can also burn a child’s face and body if the bottle spills. Child care risk management professionals have warned against using microwaves to heat bottles. 

• Heating bottles in a slow cooker appliance - As a result of the problems using microwaves to heat bottles, many child care centers began using slow cookers to warm bottles. Slow cookers used to heat water to warm bottles have been blamed for several life-changing burn injuries. Examples include:  
  - The appliance’s cord being pulled and spilling scalding water onto children. 
  - Cups of scalding water intended to warm a bottle spilling or being splashed on a child. 
  - Drops of scalding water from a bottle taken out of a slow cooker dripping on a child. 

• Heating bottles in commercial bottle warmers - Many child care providers switched to commercial bottle warmers designed to heat one bottle at a time. Unfortunately, there have been several severe burn injuries to children where cords have hung low enough for a child to pull the bottle warmer and spill scalding water onto themselves. 

Reducing the risk of bottle-related burns

One recommendation to help reduce the risk for these types of burn injuries is to remove the source of the burns: scalding hot water. Since young children have thinner skin than adults, hot liquids spilled on a child result in deeper burns than those sustained by an adult from liquids of the same temperature. Guidance from the CDC supports serving bottles at room temperature or cold and advises against using a microwave for bottle warming purposes (Centers for Disease Control and Prevention (2022)). 

A critical step for the child care industry to progress in eliminating burn injuries from scalding liquids is to discontinue practices that heat liquids to scalding temperatures. If parents insist that their child’s bottles are warmed before serving, tap water in a sink or allowing the bottle to warm to room temperature before serving are alternative methods to reduce the risk of burns. 

References

Centers for Disease Control and Prevention. (2022). Proper storage and preparation of breast milk. https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm#Guidelines 

Centers for Disease Control and Prevention. (n.d.). Burns fact sheet. https://www.cdc.gov/injury/pdfs/fact_sheets/burns-fact-sheet-a.pdf