scald-burns-children-bathing

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Scald burns from bath water are a known risk for young children. Three studies checked for this guide describe how these burns happen, what bath temperatures were found in homes, and how well prevention measures have been tested. One of the three studies is a review of childhood scald prevention. It found more evidence for interventions that lower tap water temperature than for interventions that reduce the number of scalds. Readers should treat the figures below as the studies report them. The 1994 study is a review of 68 hospital admissions, and the saved copy of the 1998 study contains only the abstract and references.

Quick answer

Toddlers and preschool children are the most frequent victims of tap water scald burns, according to one study of hospitalised children (Feldman et al., 1998).
In that study, 80% of the homes tested had bath water at 54°C (130°F) or hotter. The authors state that this carries a risk of full-thickness scalds with 30 seconds of exposure.
In a retrospective review of 68 children treated at one burns unit, the majority were injured by falling into the bath. The tap was turned on by seven children themselves and by 10 siblings (Yeoh et al., 1994).
The systematic review found “little evidence that interventions are effective in reducing the incidence of scalds in children.” It found more evidence that interventions lower hot tap water temperature (Zou et al., 2015).

How the children were hurt

Tap water scalds are a known source of hospital admissions for children. The 1998 study describes them this way: “Tap water scald burns account for 7% to 17% of all childhood scald burns that require hospitalization. Often the burns are severe and disabling. Toddlers and preschool children are the most frequent victims.” The study does not give the total number of children it examined in the abstract, and the saved copy does not include the full article.

The study also reports who turned on the water. “In 45% of the injuries, the unsupervised victim or a peer turned on the tap water; in 28% the cause was abuse.” The abstract describes tap water scalds generally, and it does not separate bath scalds from other tap water scalds in these figures.

The 1994 study looked at bath scalds only. Its authors reviewed the records of 68 children admitted to a specialist burns unit over two years and six months. Their figures are: “Bath scalds in children under 5 years of age was the cause of 14.7 per 100,000 children being admitted to the specialist burns unit in a year.” The authors also report how the children were hurt. “The majority of the children were injured by falling in the bath but the tap was turned on by seven children themselves and by 10 siblings.” Six children put their hands in hot water, and two were accidentally put into water that was too hot and were quickly withdrawn.

The 1994 study is a retrospective review of hospital admissions at one unit. It cannot show how common bath scalds are in the general population, and it does not describe homes or water heaters.

The same study also records four children whose injuries were, in the authors’ view, probably non-accidental, and it calls for a multidisciplinary response to these cases. This guide does not go further into that topic.

Bath water temperatures in homes

The 1998 study tested bath water in homes. Its abstract reports that “Eighty per cent of the homes tested had unsafe bathtub water temperatures of 54°C (130°F) or greater, exposing the occupants to the risk of full thickness scalds with 30 second exposure to hot water.” The abstract does not state how many homes were tested, how they were chosen, or how the temperatures were measured. Those details are in the full article, which was not in the saved copy, so this guide cannot assess them.

The same abstract makes a recommendation. “Such burns may be prevented passively by limiting household water temperatures to less than 52°C (125°F).” The authors suggest that “New water heaters could be preset at this temperature and families could be taught to turn down the temperature on existing units.” The word may matters here. The abstract presents this as a likely benefit, and the saved text does not contain a trial of it.

The 1994 study reaches a similar conclusion. Its authors write that “The best way to achieve this would be by reducing the temperature in domestic hot water tanks.” This is their conclusion from the admissions they reviewed, not a result of a temperature trial.

What the systematic review found

The review by Zou and colleagues is the most detailed of the three. It combined an overview of earlier systematic reviews with a systematic review of primary studies on interventions to prevent scalds in children. The search ran to October 2012. The authors included 14 systematic reviews and 39 primary studies. Most of the primary studies were randomised trials, and most tested several measures together, such as home visits, education and safety devices.

The authors state the main result as follows. “There is little evidence that interventions are effective in reducing the incidence of scalds in children.” They also found more evidence on water temperature. “More evidence was found that inventions are effective in promoting safe hot tap water temperature, especially when home safety education, home safety checks and discounted or free safety equipment including thermometers and thermostatic mixing valves were provided.” The source’s wording, including the spelling of inventions, is reproduced as printed.

The review also says that bath scalds differ from other scalds. “Bath water scalds are more likely to involve a greater body surface area”, especially in infants and toddlers, and the review adds that they are more likely to lead to hospital admission or transfer to a burns unit. This is the authors’ background statement, and it cites earlier work.

On environmental changes in the home, the review is blunt. “None of the studies focusing on children demonstrated a reduction in injuries that might have been due to environmental adaptation in the home.” Another line in the review says that “There is very little high-grade evidence that interventions to modify the home physical environment affect the likelihood of sustaining an injury in the home.” In plain terms, the review did not find good evidence that changing the home physical environment reduces scald injuries.

The review’s authors recommend that “Education, home safety checks along with thermometers or thermostatic mixing valves should be promoted to reduce tap water scalds.” They also state that “Further research is needed to evaluate the effectiveness of interventions on scald injuries and to disentangle the effects of multifaceted interventions on scald injuries and safety practices.”

What the studies support for parents

The three sources do not provide a complete guide to bathing safety, and they do not test a bathing routine. The steps below follow only what the studies say.

Keep the water heater below 52°C (125°F). The 1998 study gives this as the limit it associates with preventing burns, and the 1998 authors recommend presetting new heaters at that level. The review supports education and temperature testing, but it does not give a number of its own.
Check bath water with a thermometer before a child gets in. The review recommends thermometers to reduce tap water scalds, and the 1998 study found that 80% of the homes it tested had water at 54°C or hotter. These sources do not show how often a thermometer prevents a scald on its own.
Supervise young children in the bath. The 1998 study reports that in 45% of the injuries, the unsupervised child or a peer turned on the tap. The 1994 study reports that seven children turned the tap on themselves and 10 siblings did so. The sources describe these events; they do not test supervision as a prevention measure.
Do not treat one step as enough. The review’s own conclusion is that the evidence for preventing scalds is limited, and its authors call for more research on interventions and their combined effects.

Some included studies measured parent behaviour, such as whether a parent checked the water temperature, put a child into a bath before checking it, or left a running bath unattended. These are outcomes the studies recorded. The review does not show that any of these behaviours, on its own, prevents a scald.

How we chose

This guide uses three sources, all opened on 2026-10-28 from PubMed Central. The 1998 study was chosen because it reports bath water temperatures found in homes. The 1994 study was chosen because it reports how children were injured in bath scalds. The 2015 review was chosen because it is the only systematic synthesis among the sources checked. Together they cover the injury pattern, the water temperature and the evidence for prevention. They were not ranked against each other.

What the sources do not say

How many homes the 1998 study tested, how they were chosen, and how the temperatures were measured. The saved copy contains the abstract only.
How common bath scalds are in the general population. The 1994 study covers admissions to one burns unit, and the 1998 study covers homes tested.
Whether a thermometer, a lower water heater setting, or supervision prevents a scald in a given home. The review did not find robust evidence for most interventions, and the 1998 study’s claim of prevention is hedged with the word may.
Whether these findings apply to baths in other countries. The 1994 study covers children from south and west Wales. The 1998 study’s authors are based in Seattle, and the abstract does not say where the homes were.
How the review’s behavioural outcomes relate to injuries. The review’s own text says that more research is needed.

Sources

Feldman K, Schaller R, Feldman J, McMillon M. Tap water scald burns in children. Injury Prevention. 1998;4(3):238-242. https://pmc.ncbi.nlm.nih.gov/articles/PMC1730399/ (opened 2026-10-28)
Yeoh C, Nixon JW, Dickson W, Kemp A, Sibert JR. Patterns of scald injuries. Archives of Disease in Childhood. 1994;71(2):156-158. https://pmc.ncbi.nlm.nih.gov/articles/PMC1029951/ (opened 2026-10-28)
Zou K, et al. Preventing childhood scalds within the home: Overview of systematic reviews and a systematic review of primary studies. Burns. 2015;41(5):907-924. https://pmc.ncbi.nlm.nih.gov/articles/PMC4504085/ (opened 2026-10-28)