4.11: Safety
- Page ID
- 233843
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Infants and toddlers are curious, but they lack the judgement to recognize the dangers of their actions, so childproofing the home and providing adult supervision are essential for this developmental age group.[2
Fatal injury (death) and nonfatal injury risks for infants and toddlers:
- suffocation and choking
- injury by fire or other burns
- falls
- accidental poisoning
- drowning (the leading cause of injury or death under age 4)
- motor vehicle accidents
Choking
Toddlers are at a high risk for choking. As they begin to be mobile and to eat solid foods, this risk increases. At mealtimes items like hot dogs could potentially get stuck in a throat when sliced and served in rounds, so it should be cut horizontally to help prevent choking. Whole grapes are another round food that has the potential to get stuck in a toddler’s throat, so slice them vertically in half or quarters so that the pieces are easy to chew. Small items like Legos, beads, buttons, pen caps, batteries, magnets, and coins should be placed out of the reach of a child under age 3.
A caregiver must provide proper supervision and make sure the environment is child proofed. Using a choking tube or choke tester to see if an item is choke proof is one means of monitoring choking hazards in the home. If an object fits completely in the tube, it is a great risk for causing choking.
Fig. 4.11. Choking tube or choke tester.
Image source: Anti-Choking Hazard Device for Kids. Amazon.com
Car Seat Safety
Fig. 4.11.1. Infant in rear-facing car seat.
Image source: Children's Hospital Colorado
The most dangerous thing that U.S. children do as part of daily life is ride in a car. Car crashes are a leading cause of death for children 4 years and older.
Infants are especially vulnerable during a car crash because their skeletons are less mature, their heads are heavy, and their necks are fragile. Their ligaments are also stretchy. When a baby is riding in a rear-facing car seat, their whole body - neck, head, and torso - is cradled within the back of the safety seat which protects them from the impacts of a crash. A rear-facing car seat protects the baby better in other types of crashes, particularly side impact crashes.
The American Academy of Pediatrics advises parents and caregivers to keep use rear-facing car seats for children as long as possible, up to the weight or height limits of their car seat. Many convertible rear-facing car seats can accommodate a child up to 40-50 pounds which includes most children 4 and under. Rear-facing car seats should be used ONLY in the back seat of a car with an active airbag.
A 2- to 4-year-old child in a car seat should be restrained with a five-point harness system - two shoulder straps, two hip straps and a buckle strap. A five-point harness system has more places to distribute crash forces and offers better protection than a lap and shoulder belt.
When a child has grown enough they can use a front-facing car seat which can accommodate children up to 65 pounds. Always use the top tether strap (the long piece of webbing with a clip on the end located on the top back of a forward-facing car seat) according to the vehicle owner's manual and child restraint manufacturer's instructions.
Boppy Safety
Fig. 4.11.2 Dad feeding baby supported by boppy.
Image Source: Boppy Original Support Nursing Pillow - Spice Woodland. Natural Resources.com
Boppy pillows are sold to support children while nursing, they are not designed for sleep and are not safe for sleep. However, many families and care providers allow babies to sleep on these nursing pillows. While propping your baby up on a nursing pillow can make feedings easier and more comfortable for both parties involved, letting your baby sleep on a nursing pillow could be a fatal mistake. Infants are unable to pull themselves off if they slide down into the curve and their head starts pushing back on the curve of the pillow and then goes forward. In addition, deaths occur when children are left unattended or sleeping on or near these pillows, and the baby rolls over, rolls off, or falls asleep face down or their heads may fall in such a way that can block their airway and lead to suffocation.
Safe Sleep Advice
- Bare is Best --- This means an empty crib - no blankets, pillows, padded bumpers, or other items to the baby’s sleep environment.
- Back to Sleep --- Always place infants to sleep on their backs on a firm, flat surface.
Sources
- Car Seat Safety Laws: Tips and Guidance for Kids of All Ages. Just Ask Children's. Parenting Articles. Children's Hospital Colorado. November 11, 2024.
- Lally, Martha and Suzanne Valentine-French.