Safety for Children From Birth to Age Three Contents 3 Introduction 4 Baby equipment safety tips 9 Safety: Newborn to 6 months 12 Safety: 7 to 12 months 16 Safety: 1 to 2 years 19 Safety: 2 to 3 years 22 Home safety guidelines 28 Car safety reminders 30 Outdoor safety 34 Preparing for emergencies 37 Helpful emergency resources Reviewed October 2016 by Deborah Borchers, MD. Dr. Borchers is a primary care pediatrician currently practicing at a federally qualified health care center in Ohio. © 1994, 2016 LifeWorks US Inc. Introduction As parents and caregivers, we all care about the safety of Remember, every child (and every home) is different. Use our children. We want to do everything we can to keep the ages in this book only as a guide. All children grow them safe. Adults often worry about violence and crime, at individual rates. Some learn to roll over, sit up, or walk but common injuries like falls, burns, and choking hurt sooner than others. It’s a good idea to read through all of young children more often. Fortunately, many accidents the different sections of the book so you can plan ahead can be prevented with a little caution and planning. to keep your child safe—now and in the future. Remember to take extra care when you are visiting. Your friends and This book will help you take some basic steps to make relatives may not have set up their homes with small chil- your child’s world a safer place to grow, learn, and play. dren in mind. Use this book to plan ahead. Children grow faster during their first three years than at any other time. You’ll find Share this book with babysitters, relatives, and others information on when and why you’ll need to take certain who care for your child. Talk about your concerns and steps to keep your child safe. Some things—like installing expectations. You can be more relaxed and confident if latches or window guards—you’ll only need to do once. you know that everyone understands the rules and guide- Others—like adjusting car seats or lowering the crib lines for your child’s safety. mattress—will need to be done as your child grows and changes. Look at the world through your child’s eyes. One of the best ways to keep children safe as they grow is to watch them. Play with them. Follow them. Get down on the floor with them. What do they see? What might they reach for? What can they grab, pull, bang, climb up, or knock down? What can you do or change to keep them safe? 3 Safety for Children from Birth to Age Three Baby equipment safety tips The following information will help you make informed • Keep the instructions for your car seat and refer to choices when selecting equipment for your newborn, them to make any needed adjustments as your child baby, or toddler. grows older. Car seat • Remember that the safest place for a baby or child age 12 or under is the back seat. • Use the right type of seat for your vehicle and your child’s age and size. Make sure the seat has an FMVSS • Never put a car seat in the front passenger seat of a car (Federal Motor Vehicle Safety Standards) label. If you that has an air bag. And don’t allow children to lean or have questions about whether a seat has been recalled rest against parts of the car where side-impact air bags or doesn’t meet safety standards, call the Vehicle Safety are stored, such as the door, which can increase the risk Hotline at 888-327-4236. Or search for its brand name of injury. For more information, search for “Car Seats: and model on the National Highway Traffic Safety Information for Families at healthychildren.org. Administration website. Your local hospital or health department may be able to help you find a safe car seat. • Once your child outgrows the rear-facing car seat, Need help installing your child’s car seat properly? he or she is ready for a forward-facing car seat, with a Many police officers and firefighters have successfully harness, but always in the back seat. Once they reach completed the National Child Passenger Safety (CPS) the upper weight or height limit of their particular seat certification training course. That program enables (usually around age 4 and 40 pounds), they can switch them to give hands-on help to parents and caregivers to a booster seat in the back seat. who need assistance with installing and fastening car seats. Stop by your nearest police station or firehouse • Adjust the car seat harness so it fits snugly against your and see if a qualified CPS technician can help. child’s shoulders. Be sure to adjust the straps as your child grows. 4 Safety for Children from Birth to Age Three Crib ◦ No decorative cutouts in the headboard or footboard. All new cribs sold in the U.S. must meet federal safety (Cover them so they can’t catch a baby’s head or standards. Drop-side cribs cannot be made or sold, and clothing. A piece of wood that’s sanded and free of immobilizers and repair kits are not allowed. For more splinters will work.) information, see the U.S. Consumer Product Safety ◦ No loose hardware. Check screws and bolts fre- Commission (CPSC) website. quently to make sure they’re all there and tightly fastened. • A safe crib should have: • Keep the crib away from dangling strings such as shade ◦ Rails or slats less than 2-3/8 inches apart. (A baby’s pulls, curtain cords, or wall decorations with ribbons or body can slip through wider rails, leaving the head streamers that might wrap around small necks. Keep the trapped.) Wood rails or slats must be made of strong crib away from lamps and dressers. wood to prevent breakage. • and lower it as ◦ A firm, tight mattress—no more than two fingers Check the mattress height regularly should fit between mattress edge and crib. (A loose- needed as your baby grows. It’s a good idea to put thick fitting mattress can cause suffocation.) Mattress sup- carpeting underneath, just in case your child tries to ports must be durable. climb out. ◦ No crib bumpers. Crib bumpers are not recommended • Never use soft bedding or pillows, or have stuffed due to suffocation risk in younger infants and a climb- animals in an infant’s crib. Take any pillows, plastic wrap ing hazard for older babies. on the mattress, or toys with small parts (such as stuffed animals with button eyes) out of cribs. ◦ Corner posts no higher than 1/16 inch, or no posts at all. (Clothing can get caught on them.) Unscrew or saw • Remove bibs or any other clothing tied around the neck off any corner posts that are too high. before putting a child in a crib. ◦ No splinters. (Sand any rough wood.) 5 Safety for Children from Birth to Age Three • Be particularly careful when buying or borrowing used Changing table equipment. Check the equipment to make sure that it is • If you have a changing table, make sure it’s sturdily in good condition. Make sure that the equipment meets built, with high sides and a safety strap. Keep one hand today’s safety standards—outlined in this book—and on your child at all times when changing diapers. check for product recalls on the CPSC website. • Once a child is moving more, consider using a changing • Mesh-sided cribs and playpens should have mesh less pad or a towel on the floor. than 1/4 inch in size. They should have no tears, holes, or loose threads, which can entangle a baby. Some par- High chair ents prefer to use an easily portable cradle or bassinet • A safe high chair should have a wide base, a tray that instead of a crib for the first few weeks of their infant’s locks securely, and a safety belt with a strap between life. If you choose to do this, the American Academy of the legs to keep your child sitting securely in the chair Pediatrics says, “In general, your baby should move to a (not slipping down or standing up). crib around the end of the first month of life or by the time he weighs 10 pounds.” Bassinets and cradles must • Keep your high chair away from furniture so children meet their own federal safety standards, last updated can’t kick out and push themselves over. in 2013. Be sure to check these standards before using one that you bought for an older sibling or received • Always make sure the safety strap on the high chair is secondhand. You can find these by searching on the securely fastened and the tray is locked in place. website for the CPSC. “Never leave a young child alone in a high chair, and do not allow older children to play on it because this could also tip it over.” —American Academy of Pediatrics 6 Safety for Children from Birth to Age Three Hook-on chair Play yard or playpen • Hook-on chairs are often used as substitutes for high • If you use a play yard or playpen, make sure it has a top chairs. Check any caps or plugs on chair tubing to make rail high enough that your child can’t climb or fall out. sure they’re firmly attached. A chair with a clamp that Only use play yards with firm, cushioned floors.