Holiday Toy Safety

The holidays are fun but they also are a time for emergency department visits due to injuries from toys. Toys provide children the opportunity to explore the world and develop or refine skills. It is vital every child be given the freedom and encouragement to explore but that does not mean they should be unsupervised. One child in the US is treated in an emergency department every three minutes for toy related injuries. This adds up to over 3 million children receiving treatment from 1990 until 2011 and the number of injuries has increased by 40% since 1990.

The best way to protect your child is by buying toys that are age, interest and skill level appropriate. Read up on the toys you want to purchase before you buy them. Check into the safety record for the toy and make sure there has not been a recall. Make sure all the materials in a toy are labeled non-toxic. This includes lead paint and is especially important when purchasing used toys. Always follow the manufacturer age and restrictions guidelines and never use a toy before you have read all the instructions. This is especially important for all chemistry kit toys that may contain dangerous or toxic chemicals.

Certain types of toys are more risky than others. Toys that must be plugged into a wall outlet are never to be used by a younger child. Electricity can kill your child. Make sure all toys that plug into the wall are UL approved.  Also beware of choking injuries due to objects that are small enough to be swallowed or inhaled and block your child’s airway. Always think big for young children and avoid objects smaller than a ping pong ball. Beware of button batteries, magnets, balloons and plastic tags.  Toys that have a rope, string or ribbon attached can cause strangulation and all riding toys such as a scooter should only be used with supervision and with a properly fitting helmet.

Beware of loud toys that can damage your child’s hearing and be especially careful when using ear buds or head phones.  Always turn on the sound before the ear buds or head phones are placed in or over the ears. Stuffed animals pose the risk of toxic stuffing or stuffing that can be swallowed or aspirated. Loose plastic pellets should never be used for stuffing and beware of toys made of plastic where small pieces can be broken off and choked on. Broken plastic toys often have sharp edges that can cut your child.

Home safety is also important over the holidays. Make sure you properly use safety gates and beware of your child climbing on or falling off of raised surfaces. Electric rockers, exercise machines, recliners and lift chairs can cause entrapment injuries. Extremities and fingers can be caught and crushed. Lastly, be cautious about all furniture and objects that have sharp edges or glass components. These can lead to cuts and blunt trauma injuries.

Most injuries happen when your child is left unattended or unsupervised. Your informed, active and attentive presence is the best protection for your child. Keep all toys organized and in working order. Toys should be cleaned periodically to kill and wash away germs and they should never be used in unintended ways that place your child at risk for injury. Hanging crib toys pose a special risk for choking or strangulation and any toy that shoots objects into the air can cause eye injuries.

A final safety tip is to choose safe places to use a toy. Many toys are safe when used in one location but not in another. Store toys in a location where toys for older children can be kept away from younger children since many toys for older children are very eye catching to young children and can cause injury to a younger child who is not developmentally ready to use that toy.

Follow these guidelines and active play can be safe and a time of discovery and exploration for your child.

How to Protect Your Child From Sexual Abuse

Sexual abuse includes any type of sexual act or behavior with a child including non-contact behaviors such as showing or taking pornographic images of children. The best way for parents to prevent sexual abuse is through knowledge, education and understanding.

Most sex offenders are not strangers to a child. Sexual abuse is most often committed by someone who knows the child. This may be a friend, relative, teacher, coach or neighbor. Someone in a position of authority is commonly the perpetrator and children who are compliant, respectful and obedient are especially susceptible to abuse. In almost all situations the abuser intimidates the child to remain silent and not say anything or tell anyone about the abusive behavior. Often the child assumes a personal responsibility for the actions of another and feels he or she is the cause of the abuse. With time progressive guilt and shame deepen the silence and may actually block out memories for many years or even a lifetime.

Common signs and symptoms of being sexually abused include depression, oppositional or destructive behavior, anxiety, social-withdrawal, new academic difficulties, aggressive behavior, high risk behaviors and self-injurious behaviors. Parents must be aware however, that children who are being abused or who have been abused in the past do not always show signs or symptoms of abuse.

The risk of molestation can be decreased by establishing and supporting an ongoing parent-child relationship focused on open and trusted communication and connection. By spending time with your child and talking about sexuality you will be providing your child information on how to respond if an abuse occurs. Parents who believe their child is not at risk for abuse are hiding behind a mask of ignorance and denial. By talking openly and directly about sex and sexual abuse, using age and developmentally appropriate terms, your child will be able to respond in the right way and at the right time to sexual abuse. There must be no secrets between parents and children.

Children must recognize, understand and respond to the boundaries and limits of sexual behaviors and sexual exploration. Discussions must be open, non-judgmental and shame, fear and guilt must always be avoided.  Your child must understand the meaning of privacy and how certain body parts of his or her body are private and cannot be touched, looked at, talked about or photographed without permission. Children must be taught to allow their own feelings to lead their response. If a child feels scared or uncomfortable he or she must say no and immediately notify a parent about the incident. If a parent is not available then a teacher or guardian should be immediately notified.

When your child is outside of your care special precautions are necessary. Be cautious of adults who take your child on unsupervised outings or special events and make sure your child is adequately supervised during overnight stays away from your home. Verify who is in the away household where your child is staying overnight and talk to those adults directly. Alcohol and drugs must be avoided since both encourage risk taking behaviors by children and adults. If concerned about a location or situation then consider being a chaperone or making an unscheduled visit to check on your child. An open door policy allowing parent visits is always best.

By listening to your child with love and sensitivity you will encourage openness and increase your child’s willingness to share any concerns. This prevents embarrassment and decreases the chance your child will keep the incident or behavior hidden. Never discount your child’s feelings or blame your child for his or her part in an abusive situation. By providing ongoing support, professional counseling and unconditional love to your child healing can begin.

Water Wise

Teaching children about water safety must be on the wish list of every parent.

In the US we take healthy and non-contaminated water for granted. In many parts of the world clean water is not available. Throughout the world, thousands of children die every day due to water-related illness and chemical contamination. Germs, nitrates, man-made chemicals, heavy metals and radioactive particles shorten or end the lives of so many children. Teaching your child the importance of clean water and helping others throughout the world obtain clean water are two of the most important lessons a parent can teach a child.

The ability to be naturally safe around water is another skill parents must model and teach their child from infancy to young adulthood. In the US almost 4,000 people die every year due to drowning. Over half of these deaths occur in children, and children between the ages of 1 and 5 years are at greatest risk. Home swimming pools pose the greatest risk to children under school age, and 80% of those who drown are males. Drowning is the second most common cause of death due to injuries for children under 14 years of age.

Swimming pools must have appropriate fencing that is at least 54 inches tall and have a functioning, self-latching gate that can be locked. Keep all ladders and objects away from the enclosure to prevent children from climbing over the gate or fence.  Choose a swimming pool cover that fits your pool and limits the risk of entrapment. Keep all pool related toys away from the pool when the pool is not in use. Toys attract children and increase the risk for a child inadvertently falling into the pool while trying to retrieve a toy. Make certain the pool your child is swimming in has been treated with the right amount of chemicals, and no matter where your child swims it is a good idea to avoid swallowing the water. Have your child shower with soap and water after swimming in untreated water since many recreational water illnesses including diarrhea and infections of the skin, eyes, ears and respiratory tract are spread in the water in which your child swims.

There should be no diving, pushing or chasing on pool decks. It is too easy to slip and fall on slick surfaces. Children must walk and never run around a pool and should always enter the pool slowly and feet first. If a child is not water-safe, an approved life jacket must be worn. Children under school age must wear a jacket that has a strap between the legs. For all children the life jacket must fit tightly enough so it does not pull up over the shoulders while at the same time does not limit breathing. In 90% of boating deaths a life jacket is not worn.

Every child should learn how to be water-safe. For the toddler and preschooler this means being able to back-float face up before learning how to swim in a face down position with a crawl swim stroke. This face up position decreases fear and panic and allows your young child to breathe and call for help.

Children must also learn about the importance of adult supervision, a buddy system, understanding and following posted regulations, and at all times listening to and following the directions of lifeguards.  Learning how to “read” the water and the weather are also important skills, as is CPR training for the older child.

When supervising children around water, alcohol use and all distractions such as a cell phone must be avoided. Stay at the water’s edge, count the children under your care frequently and briefly focus on each child while you scan back and forth over the area where they are swimming. Keep the swimming area small enough for you to remain “in touch” with each child. If a child’s behavior or play activity is placing other children at risk then have all the children under your care exit the water until you are able to resolve the issue with that child. Once the safety issue has been resolved you may allow the children to return to the water. Accidents often happen when a parent becomes distracted. Don’t allow this to happen to you.

Natural bodies of water such as ponds, creeks and streams carry their own risks. Small bodies of water can be especially dangerous since children are often not afraid to be near or enter them. In addition to the wind, weather, waves, currents, undertow and riptides that we see with lakes and oceans these smaller bodies of water often have many natural and man-made obstacles including currents, rocks, broken glass, entangling vegetation and mud. Fast flowing culverts, creeks and streams are especially dangerous due to the risk of fallen trees and branches that act as strainers that can entrap even the strongest swimmer.  When entering a body of water with waves it is important you enter and exit slowly and always face the waves. If you see a storm or hear or see lightening you must immediately exit the water and seek shelter.

When you teach your child to be water wise you are providing your child with skills they will model for other children and their own children. Water wise is water safe.

Summer Safety Checkup

With the arrival of summer all parents need to perform a safety inspection of the house and all play areas inside and out. It is also the time for vacations, road trips, play dates, sporting events and summer camp. These new opportunities for exploration, experimentation and discovery make the arrival of summer the perfect time for a safety checkup.

A visit to the doctor is often the first step in this process. If your child has not had a yearly checkup, schedule a well-child visit with your pediatrician. Children grow and change so fast that a yearly checkup is essential. Immunizations can be given; vision and hearing screening performed and your child’s growth charts can be reviewed. Healthy lifestyle opportunities can be discussed and dietary, sleep and exercise opportunities can be reviewed.

The next step is to check out all outdoor play equipment. All outdoor playground equipment needs to be inspected and tested. All climbing structures must be inspected for soundness. Make sure rungs, stairs and guardrails are placed appropriately and attached correctly. All openings must be less than 3.5 inches and guardrails must be at least 29 inches tall for preschool children and 38 inches tall for school-aged children. Rope and climbing nets pose a strangulation and entrapment risk and must be inspected. Sliding boards must have at least a 4 inch side and closed slides are preferable.

Make sure all swings are well-attached and are made of soft and flexible materials such as a synthetic rubber or plastic. A full bucket seat is safest for small children and make sure all swings are separated by at least two feet to decrease the risk for collisions. Splinters, loose nuts and bolts and surface padding must all be checked. Having six inches of ground surface padding made out of shredded tires, pea gravel or bark is essential as is making sure the play area is away from trees and other objects that could become a hazard. Having the play area in a clear zone away from brush and trees also decreases the risk for tick bites and contracting Lyme disease.

Summer safety also includes teaching your child about playground safety and learning how to take turns with equipment. Learning how to climb a ladder, use monkey bars, avoid swings and moving away from the bottom of a slide are essential skills to review with your child. Some playground equipment can also become very hot if it is made out of metal and is in direct sunlight. Wooden equipment may also be a source of splinters if it is not well cared for.

During summer the rays of the sun are intense. Skin care is very important. The use of wide brimmed hats, clothing and sunscreen are important, as is making sure your child receives adequate hydration due to increased water intake requirements due to heat and increased activity levels and sweating. Clothing can also be a risk for your child if it can lead to entrapment or strangulation. Avoid drawstrings on all clothing.

Using mouth guards or eye protection while engaging in certain sporting activities is as important as it is to use sport-specific protection such as wrist, knee and elbow guards while rollerblading. For any “wheel” sport including bikes, skateboards and scooters a helmet must be used, and make sure the helmet fits your child correctly. The chin strap must be adjusted to allow only one finger to be placed between the strap and your child’s chin and the helmet must not be able to rock back from your child’s forehead.

Inspect all bicycles and perform yearly maintenance. Take your child’s bike to a bike dealer if you have any concerns about bike safety such as size, fit, brakes or steering. Children are becoming more adventurous with bicycle stunts, ramps and jumps. Discuss these activities with your child. Set boundaries for what is and is not acceptable and consistently enforce the rules you decide upon.

Do not allow your child to use a trampoline unless it is part of a supervised training program under the direct supervision of a coach or sport specific trainer. Backyard trampolines are dangerous and lead to over 100,000 injuries per year in the US.

Summer can be a time of concussions, broken bones and head and neck injuries. Your attention and preparation can eliminate most of the risk for these injuries and replace these severe injuries with minor sprains, strains, bruises, cuts and scrapes. With a little effort and attention you and your child can be ready for a fun and safe summer.

Keeping Your New Baby Safe

A new infant in the family brings added responsibility to a parent.  The delivery is tiring for both parents and fatigue is often accompanied by poor decision making. Take time before you leave the hospital to rest and catch up on your sleep.  Consider allowing your infant to stay in the nursery while you take a nap and send dad home for a shower and a nap. Post-delivery time is also a good time for parents to discuss a parenting budget and develop a plan to share responsibilities and caretaking so both parents are able to rest. Tired parents are also prone to illness and this is a risk to a newborn.

Breastfeeding is the best way to keep your infant safe. Breast milk is the best nutrient for your infant and breastfeeding is also good for the mother.  By providing support and advice to parents breastfeeding success and duration can be increased.  Make sure you ask for lactation advice both before and after delivery. Avoiding pacifiers and supplemental formula is best. Both of these can be considered after the mother’s milk is in and the infant has become accustomed to breastfeeding.

Babies need to be placed on their backs for sleeping. This “back to sleep” position has been shown to decrease the risk of sudden infant death. Begin this immediately after delivery and continue this positioning after discharge.  Clothing should be in layers and only one thin layer more than you need. A hat should be used if the temperature is below 60 degrees.

Car safety is always important. The infant car seat should be rear facing and a LATCH system should be used. An infant should never be placed in the front seat. Middle rear seat is safest but many cars require back side positioning to use the LATCH system. An appointment should be made with a Child Passenger Safety (CPS) approved technician to inspect your installation if you have concerns. Make sure your car seat straps are at or slightly below shoulder level and the fit is snug. Check the seat angle to make sure your infant’s head and chin do not roll forwards and cause breathing obstruction. Clothing layers should be thin so the straps can fit correctly. Place a blanket over your infant after she is strapped in if the temperature warrants.

Make sure your crib meets the 2011 crib safety guidelines and the mattress is firm and fits properly. There should be no loose objects in the crib and any bumper pads or positioners.

The changing table should be sturdy with guardrails on all four sides. The base should be concave to decrease the risk for your infant rolling off and a safety strap should be used.  Never leave your infant unattended and keep all cleaning materials within easy reach but out of reach of the infant.  Hand washing hygiene is important as is diaper disposal. Baby wipes can save a great deal of time but should be tested on a small area of your infant’s leg first to see if any allergic reaction occurs. Often, wipes do not need to be used for every changing if your child has only urinated. Apply a generous amount of Vaseline to the entire diaper area with every diaper change. This prevents diaper rashes and keeps your infant more comfortable as well as making diaper changing easier.  Bathing time can be challenging. A flat area near the floor is best and be careful about slipping on water. Bathing is often only needed every other day.

When walking around the house with you infant consider using an infant body carrier. With small infants make sure head and neck position do not interfere with breathing. Tripping over pets and other unexpected obstacles that often accompany the arrival of a new baby should also be avoided. Steps are risky and handrails do help. In the kitchen be careful about fumes and hot liquids that could injure your infant.  Proper food preparation and handling and hand washing are always important. Make sure your smoke and carbon monoxide alarms work and are in the right places. Have a practice fire alarm drill so you know who goes where and who gets whom.

For friends and family ask anyone with an illness to stay away. Contact with young should only be with adult supervision and hand washing and hand sanitizer use is essential to prevent the spread of respiratory and gastrointestinal infections.

A new baby in the house is a time for joy.  A safe home and car environment protects both you and your new infant.

Crib and Playpen Safety

Are there any safety tips to follow when selecting a crib?

  • Choose a crib with corner posts less than 5/8 inches height. This will help prevent choking injuries your child may receive from catching a cord or necklace around the post.
  • Avoid bumper pads if there are any safety concerns
  • When throwing away any plastic wrap that the crib mattress came in, be sure to tie it in knots to help prevent any suffocation injuries. Keep all plastic away from your infant.
  • Do not use plastic garbage bags as mattress covers. These are too thin and may cling to your child’s face causing suffocation (inability to breathe).

If I am using an older or second hand crib, what should I look for to make sure it is safe?

Check all the openings in the headboard and rail structure to make sure there are no openings big enough for a child’s head to become caught. Make sure the corner posts are flush with the headboard and footboard.

Are there any mattress safety tips?

Make sure your mattress sits snugly. This will prevent your infant from being wedged between the mattress and the sides of the crib.

Are there any tips on what crib is best to prevent my child from trying to crawl out?

Choose a crib with as large distance as possible between the top of the side rail and the mattress. Adjustable settings are also helpful and allow the mattress height to change as your infant grows.

Are there any tips when painting a crib?

Use only high quality household enamel paint and allow it to dry thoroughly so there are no fumes. Do the painting in a location away from the baby. Do not use old paint since it may have been made before lead paint limitation went into effect in February 1978. Also check the label to make sure the manufacturer does not recommend the paint to be used to paint object such as cribs.

Are there any crib safety tips?

  • If the crib is near a window beware of drapery or venetian blind cords.
  • When your child is old enough to stand or sit up make certain the side rail is always locked in its most raised position. Also make certain the mattress is set down to its lowest position.
  • When your child is climbing out of the crib or reaches about 35 inches in height he should be moved to a bed.
  • Check the crib periodically to see that there are no loose hooks, screws, or bolts.
  • Remember: a crib is not a playpen.

Are there any toys which should not go in a crib?

All toys large enough to be used for climbing should be removed. Use caution with any toys or mobiles with dangling cords. Cords should be less than 10 inches in length and out of reach of the infant.

How can I use my playpen safely?

When a child is able to move around, avoid toys or playpen attachments with strings, ropes or wires attached which could cause your child to become trapped and strangled. Always keep the playpen properly set up unless it is periodically for any loose connections.

Gate and Highchair Safety

Where should gates be used?

Gates should be used at the top and bottom of stairwells and at any place you do not want your child to come in contact with a suspected danger.

What type of gates should I have?

Gates that are V-hatched and collapse together look an accordion should be avoided. They can trap your child’s head, arms, legs, or fingers. A solid mesh screen is the best. It must be high enough that your child cannot climb over it.

How should gates be fastened?

Gates should be securely fastened or bolted to the doorframe. They must be attached in a way that cannot be dislodged unless desired by an adult.

What type of highchair should I buy?

Buy a chair with a solid base. Make sure it can’t be easily tipped over and one that has safety hardness straps around the waist (which prevents standing up in the chair) and between the legs (to prevent slipping under the tray). Follow all instructions for assembling, and check it periodically for any loose connections.

What safety rules should I follow?

  • Never allow your child to stand up in highchair.
  • Always use the safety straps.
  • Do not place highchair close to table, counter-top or wall which could allow your child to kick off the top or knock the chair over.
  • Always supervise your child when he is in a highchair.


Household Safety

Are there any questions I can ask myself to decide if my home is safe?

Yes, think about your home in terms of the danger areas.  Remember, there is no substitute for direct and immediate supervision of your child.

What can I do to make my kitchen safe?

  • Do all harmful products in the cabinets have child resistant caps?  Certain products such as drain cleaners and oven cleaners should have safety packaging and removed from any location where children can find them or reach them.
  • Are all potentially harmful products in their original containers with original labels?
  • Are harmful products stored away from food?
  • Have all potentially harmful products been put up high and out of reach of a child?
  • Are sharp knives or other sharp objects secure from my child’s reach?
  • Do I have child safety latches installed in areas where my child has access to cabinets and drawers?
  • Are chairs and stepstools away from the stove or tabletops where my child could easily get hurt?
  • Are pot handles on the stove top pointing inward out of reach of my child where he night easily get scalded from boiling water?
  • Are electric cords kept out of reach of my child and hidden away?
  • Is there a fire extinguisher for grease fires installed in the kitchen area?

What can I do to make my bathroom safe?

  • Do medicines and other potential harmful products have child resistant closures?
  • Have you discarded all out-of-date prescriptions?
  • Is all medicine in their original containers with original labels?
  • Are all medicines stored out of reach of my child?
  • Are safety latched installed on cabinet doors?
  • Have I installed a non-skid bathmat on the floor and in the bathtub?
  • Is the hot water temperature lowered to 125 degrees to prevent potential scalding injuries?
  • Are curling irons, electric razor, razor blades, and hairdryers kept out of reach of my child, when in use and out of use?

What can I do to make my garage or storage area safe?

  • Did you know that many things in your garage or storage area that can be swallowed are terrible poisons?
  • Do all of these poisons have child resistant caps?
  • Are potential poisons stored in their original containers with original labels?
  • Are original labels on the container?
  • Have you made sure no poisons are stored in drinking glasses, pop bottles or other “drinkable” container?
  • Are potential poisons in locked cabinets or safely out of reach?

What can I do to make my stairwells safe?

  • Are stairs carpeted to prevent head injuries in case of falls?
  • Do stairwells have gates or door locks installed?

What can I do to make my windows safe?

  • Does your child have easy access to windows to crawl through and fall?
  • Are window locks installed on windows and screens?
  • Is there peeling or chipped paint on window sills that my child could easily ingest or swallow?

What can I do to make my other living areas safe?

  • Do all electrical outlets not in use have outlet covers installed?
  • Have all furniture with sharp edges been removed from the room or have corners protected with covers?
  • Are electrical cords well hidden out of view of children?
  • Have matches and lighter been placed out of reach of children?
  • Are small objects out of reach that your child may choke on, for example, candy, gum, toys plastic bag or coins?
  • Has access to fireplaces or space heaters been prevented by some type of barrier?
  • Are drapery cords out of reach of children to prevent accidental choking or strangulation?

What can I do to make my bedroom safe?

  • Are safety pins out of reach of my child?
  • Do I avoid baby powders that my child could easily inhale or swallow?
  • Does my changing table have safety straps and high side boards to prevent falls?  (Never leave your child alone on a changing table).
  • Have smoke alarms been installed in the bedroom hallways and checked at regular monthly intervals for battery charge?

Infant Walkers, Swings or Bouncy Seats

Are there any potential dangers in using infant walkers?

A potential danger of infant walkers is that developmentally, infants are not able to properly control them.  Infants are unaccustomed to the speed to which they can be propelled. They are also unable to protect themselves if the walker is tipped over.

Potential hazards include:

  • Entrapment of arms, legs, hands, or feet.
  • Head and other injuries from tipping over the walker, running into objects, or falling down stairwells.
  • Damage to feet and/or ankles from the walker running over the infant feet.

Are there any benefits in using an infant walker?

Children do not learn to walk any faster by using infant walkers.  It may actually delay walking by interfering with your child’s own motivation to walk.  Although your child may be more stimulated by being positioned upright and able to “bounce,” infant walkers should never be used unless under close supervision.

Other infants propelled toys may expose your child to similar dangers. They should also be used only with strict supervision.

Are bouncy seats and swings safe?

Yes they can be. Use them in moderation and make sure there are no safety issues. Use them when your child is developmentally ready to use them safely. They need to be assembled correctly and must have adequate support. Make sure there is not risk for an arm or leg being entrapped and as always be cautious about choking risk.



What should I do if my child ingests a poison substance?

Prevention is the best treatment, but be prepared in case an ingestion occurs.  The best preparation is to have a Poison Control Center telephone number and your doctor’s telephone number written down close to your telephone.

Who should I call first in case of poisoning?

You should always call you Poison Control Center immediately without delay.  Do not call your physician or the hospital emergency room until after you have contacted the Poison Control Center.

What information should I have available when I call?

  • An accurate description of the product swallows (read the label).
  • An estimate of how much of the poison was ingested or how many pills were swallowed
  • Your child’s age or size in pounds or kilograms.
  • An estimate of how long it has been since the ingestion.
  • Current medicines your child had taken in the past 48 hours.
  • Current illness or chronic medical problems present.
  • Describe any reactions or symptoms suffered from the ingestion (i. e., choking, gagging, vomiting, sleepiness, seizures, unconscious, etc.)

Remember: If any poison is spilled on the skin or in the eyes, rinse thoroughly with luke warm water. Call your Poison Control Center immediately thereafter.