Burn Aware: Staying Safe from Scalds

Research Blames Flimsy Packaging for Scald Injuries

Instant soup, including ramen, is a popular snack for children. It’s tasty, inexpensive and easy to prepare. However, the package design of many brands creates an incredibly dangerous burn hazard, especially for young children, research shows.

In Instant cup of soup: Design flaws increase risk of burns, published in the Journal of Burn Care & Research, David Greenhalgh, M.D., found that prepackaged soups are a frequent cause of scald injuries in children. Dr. Greenhalgh is the chief of burns at Shriners Children’s Northern California and former president of the American Burn Association. His research reveals important safety insights that all parents and caregivers should know.

Dr. Greenhalgh examined the source of burns among children treated for scald burns at Shriners Children’s Northern California.

He found that soup burns represented approximately 8% of all burn admissions during the study period and occurred mostly in very young children, those 4 and younger. More than 80% of the soup-burn injuries happened either at home or in daycare settings.

“Scald burns are typically the most common burn injury in children under the age of 2,” said Gene McGowen, advanced clinician RN for Shriners Children’s Texas. Infants have the tendency to reach and grab, so can easily grab a cup of hot liquid and spill it onto themselves.”

Water at a temperature of 125 degrees Fahrenheit or higher can cause a severe burn injury within 10 seconds of exposure, especially for small children and older adults. Scald injuries are often the result of split-second accidents around common household liquids, including tap water and food.

"Things that come out of the microwave, especially liquids, can be extremely hot," said Sara Higginson, M.D., chief of staff at Shriners Children's Ohio. "If a child is reaching up and pulling things down, often times they can tip and spill. So, it is important to think about safety in the kitchen and during food preparation."

To find out why there were so many soup scalds, researchers turned their gaze on the packaging. Dr. Greenhalgh examined the design of instant, ready-to-eat soup containers, where the soup is prepared by simply adding hot water or microwaving the contents. The study focused on 13 soups designed to eat or sip directly from the container.

Research readily identified a burn hazard: containers that easily tip.

“Instant soup containers are frequently tall, narrow at the base and wide at the top,” said Dr. Greenhalgh. “This makes them easy to tip over. When that happens, the hot contents spill out quickly, often on the child.”

Dr. Greenhalgh’s research concludes that the containers are highly unstable and that product design flaws are one of the leading causes for the risk of scald burns. One of the containers tipped over at an angle of just 23 degrees.

Simple changes to the design of the packaging could have a huge impact on the number of soup-related scald burns, the study shows.

Why Soup Burns Are so Dangerous

“When kids are hungry, or just curious, this type of burn can happen fast,” said Tina Palmieri, M.D.

Dr. Palmieri is assistant chief of burns at Shriners Children’s Northern California, and is a contributing author to the study.

“These accidents often happen because children knock over the container while sitting, or they pick up a hot, flimsy cup, which burns their hands, and they drop it on themselves,” she said. “One of the most common body areas burned with soup and noodles is the lap, including the genitals.”

While all the soups present a risk, it’s the noodles that create a particular hazard.

The combination of unsteady packaging and steaming hot noodles is what makes instant soup such a danger to young children. It is a common danger, one that caregivers may not easily recognize at first.

In a separate year-long study led by Dr. Palmieri, caregivers who had a child with a scald burn were surveyed. Of the 78 cases of scald burns seen in that time, 65% involved prepackaged soup and noodles.

“We’re not saying children should never eat soup or pre-packed instant noodles,” said Dr. Palmieri. “What we are saying is use caution. These foods may save you time and money, but in the long run, they can be incredibly costly.”

According to Dr. Palmieri’s research, while around 45% of children treated at Shriners Children’s Northern California for scald injury are cared for as outpatients, the majority of scald injury cases make up 8% of all admissions to the hospital. The mean burn size in those cases is greater than 7% of total body surface area.

Note: This study was published in 2006. Additional authors of the research include Peggy Bridges, Elena Coombs, Debbie Chapyak, William Doyle and Dr. Palmieri.

Seven Tips to Protect Children From Scald Burns

So, what can parents do to better protect children from food scald burns?

Dr. Greenhalgh, Dr. Palmieri, Dr. Higginson, and Jong Lee, M.D., chief of staff for burns at Shriners Children’s Texas, suggest these kitchen safety and burn prevention tips during Burn Awareness Week:

1. When serving soup, ensure the contents are warm, not hot.
2. Serve soup in bowls that are safe and sturdy. Avoid serving soup in the ready-to-eat containers.
3. Avoid setting hot foods on table cloths, because children can pull them down.
4. Avoid letting young children use the microwave or cook without adult supervision and assistance.
5. When using the stove, use the back burners and turn pot and pan handles away from the front edge, where children can easily grab them.
6. Make the kitchen a safe area by keeping appliances and their cords out of reach.
7. Avoid holding your children while cooking or eating hot food.

For more information on burn awareness, visit the American Burn Association, and if you are looking for pediatric burn care, learn more on the Shriners Children’s Burn Care webpage.