If my house were a workplace, it would be an emergency department. We operate 24-7, there are frequent tears and sometimes blood, and always a little too much to do in the allocated time. We have also recently experienced a surge in workload, which has arrived in the form of a soft cheeked, downy haired, sweet smelling, all around delightful baby boy. We jokingly refer to him as The Royal Baby, for he is indeed a teeny dictator, but a benevolent one who bestows smiles generously upon his subjects, and is happy to converse with one and all, albeit with a limited vocabulary.
Prior to the arrival of His Highness, we were busy, but managing. Like most families we had fallen into a functioning routine which revolved around school drop off and pick up, yet this 000 sized bundle of joy has gleefully blown apart the rhythm of our life. He feeds frequently and with gusto, usually at a time when I need to be somewhere. His nappy always needs changing. He falls asleep suddenly and inconveniently, but sometimes not at all. He has unsettled nights without the courtesy to warn his mother she should keep it simple the following day. He is, that is to say, a perfectly normal newborn baby.
But again like most families, we are resilient, and are finding our new groove. We are trading in my beloved Subaru Forester XT (with leather seats and sunroof) for a less sexy but far more practical people-mover that can fit bikes AND a pram in the boot. While with Firstborn I preferred to feed in a nice, ergonomic position in a comfy chair with a cool glass of water, I am now a practitioner of “Guerilla Feeding”: Anywhere, any place, anytime. I have learnt that you CAN actually wake a sleeping baby and the earth will not tilt on its axis. And I may have single handedly driven up the share price of McDonalds due to a newfound appreciation of drive-through coffee.
So by all important KPIs we were doing ok. The kids were dressed and fed and never (ok, rarely) late for school. Our baby was tracking nicely along his growth curve and UTD with immunisations. We were still married and talking to each other. Until one day, when there was a Near Miss.
It felt like an ordinary home day with the baby and four year old, but in retrospect the signs were there that I was under increasing strain. My husband was away for a few days and I was feeling the extra load. We had had a string of bad nights and while outwardly I was coping, I was more distractible than usual, and displaying some poor decision making. That is probably why I decided it would be an excellent time to assemble our new Ikea TV unit.
As I dragged the flatpack in from the garage I could hear my baby crying in his bassinet, so I leant the hefty weight up against the dining table and went to him. We then went about our usual waking routine: feed on the couch, nappy change, followed by tummy time on the playmat, where he attempts to lift his head with a ferocity that is both endearing and mildly alarming to watch. During the whole process my older son tagged after me, delivering a constant running commentary interspersed with random facts gleaned from either kinder or Octonauts, ie “Did you know that the mummy seahorse lays the eggs and the daddy seahorse looks after them?!”
I was putting away clothes in the kids’ room when I heard my son call out to me, but didn’t pay too much attention as he talks so much at times I tune out, a bit like the monitor alarms at work. On my return to the family room he informed me, “The furniture almost fell, but I stopped it.” That’s when I realised what I had done, and almost vomited. The baby’s playmat is next to the dining table, and the heavy, unstable box of flatpack furniture was propped upright directly next to him. If it had fallen it would have landed directly on my tiny, beautiful baby.
There are times in life when it is most handy being an emergency physician, like when a child has gastro at 2am, and you can raid your secret stash of ondansatron wafers. On that day, however, it was a curse to know exactly how a heavy weight could traumatise the soft skull and exposed organs of a very small human. Shush, shush, it didn’t happen, I tried to soothe myself as I soothe my infant. Everyone is fine. Everything is ok. But the images were so distressing I felt unable to cope alone, and was deeply grateful for the kind friendship of fellow medical mums, as sharing made the whole experience seem a little less awful. One came over simple to keep me company. Another confessed she had once been so sleep deprived she had run a red light with her newborn in the car.
How on earth could I do something so monumentally stupid? Quite easily, in fact. The emergency department environment has been described as a petri dish for error, and I was in a similar situation. Sleep deprivation. Tick. Multi-tasking interspersed with distractions and interruptions. Tick. Falling into autopilot mode and losing situational awareness. Tick. You’ve been here, haven’t you? I certainly have, in my other world. One particular incident springs to mind with a slight chill, a 2am ten fold insulin dose mal-prescription. Thank God the nurse showed more vigilance in administering it than I did in my hasty transcription from a poorly written nursing home drug chart, treating it as a mere clerical job and not worthy of my grossly stretched mental attention.
Many, many other parents of small children have been there too. According to the child accident prevention organisation Kidsafe, preventable injury is the leading cause of death and disability of children under five in Australia, and paediatric trauma as a disease is more deadly than asthma, cancer and infectious diseases combined. While the incidence is decreasing, around 150 children still die of preventable injury in Australia each year, the majority in or around the home. Common mechanisms include drowning, choking and driveway motor vehicle accidents. “Forgotten Baby Syndome”, where children are left in cars for prolongued periods due to parental forgetfulness, has also led to numerous deaths both in Australia and overseas.
Some great systems level injury prevention measures have been put in place, such as car seat laws and mandatory securing of curtain cords to prevent accident strangulation. But in an unpredictable environment, these only go so far. Kidsafe refers to the “Split Second”, those moments in our busy, adult focused world where our smallest people slip through the safety net, sometimes with truly awful consequences. What was rammed home for me in my own frightening incident is that little children aren’t just dependent but highly vulnerable. They are incapable of looking out for themselves and need us to do it for them, and this is certainly deserving of our mental attention.
So that’s the moral of the story, but who’s the hero? That would be my sweet, smart four year old son, who was looking out for his tiny brother. He saw a hazard and rather than ignore it, stood up and said something. He should be in an ad campaign for Worksafe. But perhaps karma does exist after all. Five days later, he drew Rekindling out of the hat in our neighbourhood Melbourne Cup sweep, and won $80. Now that is a lot of money for a four year old, and the sensible parenting decision would be to spend a small amount, then deposit the rest in his bank account. Instead we went to Toys R Us and blew the lot on Lego and a PJ Masks Geckomobile. It was the best day of his life.