Materia Medica Malaysiana

Keeping baby safe at home

With the heatwave that we have been experiencing, stringing a hammock for a bed seems a cool alternative. That was what many of us had as infants – swaying to the breeze in our sarong cradles. However, paediatricians like Dr Zulkifli Ismail are now advising parents not to use these sarong cradles, or “buai”, as they can cause brain damage to our infants.
Dr Zulkifli, who is the President of the Malaysian Paediatric Association (MPA), says they have found that most cases of sub-dural haemorrhage (bleeding beneath the skull) in babies that are not directly related to non-accidental injuries, such as child abuse, to be associated with the use of the buai. He adds that they have also documented cases where the buai was pushed, hitting the baby's head against the wall.
In one case, the infant's two-year old sibling loved to swing the buai, not realising the baby's head was hitting the wall. The baby's head was resting on a pillow inside the buai and there were no obvious signs of bleeding and, as is so often the case, the injury went undetected until much later. Dr Zulkifli says that internal bleeding is not visible but is found during a medical examination. Such an injury is referred to as a "contra coup", a French word for an injury caused when the brain moves within the skull, tearing blood vessels that join the surface of the brain to the skull causing sub-dural haemorrhage. The up-and-down movement of the sarong cradle can cause the same kind of injury, as it is almost like shaking the baby vigorously in your hands. Zulkifli explains that the brain of the baby is actually floating within the skull and when you move the baby vigorously, the brain moves in the opposite direction of the head, resulting in brain damage "If it is done gently, that is fine, but the bouncing movement of a sarong cradle with a spring is enough to injure your baby. There have been cases where the buai with the metal stand fell over and the stand hit the baby. This is why the MPA says it is not safe to put your baby in it." The best bed for the baby is a baby cot, not a sarong cradle or your bed.
Baby walkers are also dangerous and Dr Zulkifli advises parents not to use them: "A child usually falls off the baby walker in a very awkward manner resulting in more injuries.
"Walkers give a baby mobility before he is ready and can make him more prone to potentially fatal injuries such as falls, burns and scalds. Baby can walk into the kitchen and pull on dangling wires. We had a case where the child pulled the kettle wire and scalded himself. Walkers do not make baby walk earlier or faster, it should be noted." Children below the age of four are at a higher risk of injuries at home compared to even motor vehicle injuries. Some of these home injuries, which in some cases can be fatal, can be prevented.