Even with every precaution, injuries still happen in day care centres. By nature, children are very active, and some may be aggressive or anxious. They may push, shove or even bite another child in the playroom. If your child is bitten by a playmate, you may be worried about the possibility of infection. This information sheet provides accurate information about the risks of human bites and how to care for bite wounds properly.
MY CHILD WAS BITTEN BY ANOTHER AT THE DAY CARE CENTRE. DOES THAT HAPPEN FREQUENTLY?
Children in day care centres often bite, but most bites are harmless and don’t break the skin. Surveys have shown that up to half of all children in day care centres were bitten during a one-year period. Most bites happened in September at the beginning of the day care year. Toddlers (age 13 to 24 months) were bitten most frequently. Bites were most often to the arms and the face. Only one bite in 50 (2%) broke the skin. No child had to be taken to the doctor because of a bite.
IS THERE A RISK THAT THE BITE WOUND MIGHT BECOME INFECTED?
Only rarely do wounds from human bites become infected, and these infections usually result from fights among adults. Severe bites are unusual in day care centres and almost never lead to bacterial infections.
Hepatitis viruses and human immunodeficiency virus
Hepatitis B is usually transmitted by contact of the mucous membranes, such as the mouth or the eyes, with blood or saliva from infected people. The virus is not transmitted by simple contact of saliva with normal skin. Only a bite that breaks the skin can transmit hepatitis B virus. A child with hepatitis B who bites another and breaks the skin may expose the child who was bitten to hepatitis B infection. Another high risk situation occurs when an unvaccinated child bites an infected one, and the blood from the infected child enters the biter’s mouth. If that happens, a child who is not vaccinated against hepatitis B should be treated by a doctor.
The risk of transmitting human immunodeficiency virus (HIV) through a bite in the day care centre, even when the skin is broken, is extremely unlikely. Treating a child with anti-HIV drugs is not recommended.
HOW TO CARE FOR BITE WOUNDS IN A DAY CARE CENTRE?
If your child was bitten by another at the day care centre, here is what you should do. If the skin is not broken, clean the wound with soap and water, apply a cold compress and soothe your child gently. If the skin is broken,
let the wound bleed gently;
clean the wound carefully with soap and water;
apply a mild antiseptic;
check whether your child has been vaccinated against tetanus and make sure that the shot is up-to-date;
watch the wound over the next few days;
if it gets red or begins to swell, call your doctor; and
talk with your doctor about whether your child needs a vaccine against hepatitis B.
Footnotes
This information should not be used as a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.
This information may be reproduced without permission and shared with patients and their families. (Reviewed by the Canadian Paediatric Society Board of Directors)
Canadian Paediatric Society, 2204 Walkley Road, Suite 100, Ottawa, Ontario K1G 4G8 telephone 613-526-9397, fax 613-526-3332, http://www.cps.ca