Infant and toddler safety

Infant and toddler safety are those actions and modifications put into place to keep babies and toddlers safe from accidental injury and death. Many accidents, injuries and deaths are preventable.[1]

Infants begin to crawl around six to nine months of age. When they crawl, they are exposed to many dangers. Anticipating the development of the baby and toddler aids caregivers in identifying hazards before they are discovered by the child.[2]

General recommendations

US government agencies recommend that caregivers take the following precautions:

  • Covering all unused electrical sockets with outlet plugs.
  • Keeping cords out of baby's reach. Tack up cords to vertical blinds and move furniture, lamps, or electronics to hide cords.
  • Securing furniture and electronics, such as bookcases and TVs, so they cannot be pulled down on top of the baby.
  • Using protective padding to cover sharp edges and corners, such as from a coffee table or fireplace hearth.
  • Installing safety gates at the bottom and top of stairwells or to block entry to unsafe rooms.
  • Using safety latches on cabinets and doors.
  • Storing all medicines, cleaning products, and other poisons out of the baby's reach.
  • Removing rubber tips from doorstops or replace with one-piece doorstops.
  • Looking for and removing all small objects. Objects that easily can pass through the center of a toilet paper roll might cause choking.
  • Keeping houseplants out of the baby's reach. Some plants can poison or make your babies sick.
  • Setting the water heater temperature to no higher than 125 degrees Fahrenheit. Water that is hotter can cause bad burns.
  • Closely supervising the baby around pets. Even family pets have been known to harm familiar children.[2]

Furniture

Toddlers typically enjoy climbing up things with steps. This includes furniture. Heavy furniture in the home is often not secured to the wall. These pieces of furniture can include bookcases and dressers that can weigh hundreds of pounds. Heavy objects like televisions that are on the furniture can also fall onto the child. If the toddler climbs up the furniture it is likely to fall onto the child. This has resulted in the deaths and injuries of children. Even if the children appears uninjured, it is possible that internal injuries have occurred with serious consequences. Often these injuries are not apparent to caregivers and as a consequence treatment can be delayed. Serious head injuries have also occurred.[1]

Caregivers can prevent accidents related to furniture by securing the furniture to the wall. Placing heavier objects into the lowest drawers. Not placing toys on top of the furniture. Constantly monitoring the activities of the toddler. Putting drawer stops onto the drawers to prevent the toddler from opening the drawer. Mount flat-screen televisions out-of-reach and onto the wall.[1]

Lead poisoning
Further information: Lead poisoning

No safe levels of lead in the body of a child is considered safe and can cause problems for the rest of their life.[3] Children living in low-income families are more likely to have levels of lead in their bodies. Questions regarding the testing procedures have been called into question.[4] Children are at greater risk as they are more likely to put objects in their mouth such as those that contain lead paint and absorb a greater proportion of the lead that they eat.[5] Treatment is available but prevention is better.[6][7][8]

Sleep

Bumper pads installed in cribs have been improved so that an infant cannot get caught between the pad and the bars of the crib.[9]

However, new guidelines advise against them since they pose suffocation hazard.

Infant and toddler food safety
Main article: Infant food safety

Infant food safety is the identification of risky food handling practices and the prevention of illness in infants. The most simple and easiest to implement is handwashing.[10][11] Food for young children, including formula and baby food can contain pathogens that can make the child very ill and even die.[12][13][11]

Sudden infant death syndrome (SIDS)
Main article: Sudden infant death syndrome

Sudden infant death syndrome can cause the death of an infant and often no cause is found. There are some preventative measures that can be taken to reduce the risk of SIDS. These are:

  • Lay the infant on his back for sleeping.[14][15]
  • Breastfeeding[16]
  • Keeping the mattress free of all objects and instead dress the infant warmly.[16][17]
  • Immunizations.[18][19][20][21]
  • Use a pacifier.
  • Using a 'sleep sack' which prevents the infant from turning over and sleeping on her stomach.[22]

Child abuse
Main article: Child abuse

It is important that caregivers recognize the potential of the abuse of their infant or toddler. An infant or toddler is potentially vulnerable to physical abuse, sexual abuse, psychological abuse and neglect and has inability to verbalize the details of the abuse.[23] Child grooming can be a concern and occurs when a perpetrator wins the trust of caregivers for the purpose of creating an opportunity for them to sexually abuse an infant or toddler.[24][25] Shaken baby syndrome can often result in serious and permanent brain damage to an infant or toddler.[26][27] There are preventative measures that can be taken to reduce the risk of injuring a child this way. Those who care for infants and toddlers may benefit from stress reduction. Becoming educated on normal child development can help someone understand that crying is a normal thing for babies and toddlers, especially if they hungry or need a diaper change. Caregivers can contact another person who is willing to give them a break. Those who are drinking alcohol are more likely to injure the infant or toddler. Carefully choosing someone else to watch the infant or toddler can also reduce the risk of injury.[28]

Car accidents
Further information: Child safety seat

Children under the age of 3 were 43% are less likely to be injured in a car crash if their car seat was placed in the center of the car. The center position is the safest but the least used position.[29]

Hyperthermia and hypothermia
Even a very small icy pond can be hazardous for a toddler

Forgetting that an infant or toddler is in the car and leaving them where they are exposed to high temperatures can result in death.[30]

Toddlers can wander off and fall through ice or be left out in cool or cold weather and experience hypothermia. This low body temperature is often fatal but instances of survival after a near drowning occur. Of all drowning deaths in 2013, 82,000 occurred in children less than five years old.[31]

Drowning

Toddlers have wandered off and drowned in ponds.[32] Toddlers can easily drown in small, shallow ornamental ponds.[33][34]

This five gallon bucket comes with a warning that it can be filled with fluid and an infant can drown.

Animal attacks
Further information: Dog bite prevention

An infant or toddler is more likely than other family members to be injured by an animal because they cannot defend themselves and are lower to the ground. Familiar family pets with no prior history of aggression are more likely to attack the child than unfamiliar pets from other households.

Choking

Toddlers and infants who can hold objects can choke when a small object is inhaled and blocks the trachea.

Falls

High chairs can be hazardous due to the risk of falls.[35]

References
  1. Lee, Lois (6 July 2017). "How a Hole in the Wall Can Save a Child's Life". American Academy of Pediatrics. Retrieved 27 July 2017.
  2. "Making Your Home Safe For Baby". Office on Women’s Health, U.S. Department of Health and Human Services. 1 February 2017. Retrieved 17 July 2017. This article incorporates text from this source, which is in the public domain.
  3. "Advisory Committee On Childhood Lead Poisoning Prevention (ACCLPP)". CDC. May 2012. Retrieved 18 May 2012.
  4. "Study: Improvement Needed to Accurately Detect Precise Levels of Lead in Blood".
  5. "Lead poisoning and health". WHO. September 2016. Retrieved 14 October 2016.
  6. "What Do Parents Need to Know to Protect Their Children?". CDC. 30 October 2012. Retrieved 14 October 2016.
  7. Gracia, RC; Snodgrass, WR (1 January 2007). "Lead toxicity and chelation therapy". American Journal of Health-System Pharmacy. 64 (1): 45–53. doi:10.2146/ajhp060175. PMID 17189579.
  8. Dapul, H; Laraque, D (August 2014). "Lead poisoning in children". Advances in Pediatrics. 61 (1): 313–33. doi:10.1016/j.yapd.2014.04.004. PMC 2060893. PMID 25037135.subscription required
  9. "Baby bumper pad".
  10. Foodsafety.gov. "Baby Food and Infant Formula". www.foodsafety.gov. Retrieved 26 July 2017. This article incorporates text from this source, which is in the public domain.
  11. Nutrition, Center for Food Safety and Applied. "Health Educators - Food Safety for Moms to Be: Once Baby Arrives". www.fda.gov. Retrieved 25 July 2017. This article incorporates text from this source, which is in the public domain.
  12. "Learn About Cronobacter". 2017-04-10. Retrieved 26 July 2017. This article incorporates text from this source, which is in the public domain.
  13. http://apps.who.int/iris/bitstream/10665/43547/1/9241563311_eng.pdf?ua=1 page xv
  14. Pease, AS; Fleming, PJ; Hauck, FR; Moon, RY; Horne, RS; L'Hoir, MP; Ponsonby, AL; Blair, PS (June 2016). "Swaddling and the Risk of Sudden Infant Death Syndrome: A Meta-analysis". Pediatrics. 137 (6): e20153275. doi:10.1542/peds.2015-3275. PMID 27244847. Limited evidence suggested swaddling risk increased with infant age and was associated with a twofold risk for infants aged >6 months.
  15. Mitchell EA (November 2009). "SIDS: past, present and future". Acta Paediatrica. 98 (11): 1712–9. doi:10.1111/j.1651-2227.2009.01503.x. PMID 19807704. S2CID 1566087.
  16. "What Can Be Done?". American SIDS Institute. Archived from the original on 2003-06-21.
  17. "The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk". American Academy of Pediatrics. Archived from the original on 2008-12-03. Retrieved 2008-11-06.
  18. Müller-Nordhorn, Jacqueline; Hettler-Chen, Chih-Mei; Keil, Thomas; Muckelbauer, Rebecca (28 January 2015). "Association between sudden infant death syndrome and diphtheria-tetanus-pertussis immunisation: an ecological study". BMC Pediatrics. 15 (1): 1. doi:10.1186/s12887-015-0318-7. PMC 4326294. PMID 25626628.
  19. Mitchell, E A; Stewart, A W; Clements, M (1 December 1995). "Immunisation and the sudden infant death syndrome. New Zealand Cot Death Study Group". Archives of Disease in Childhood. 73 (6): 498–501. doi:10.1136/adc.73.6.498. PMC 1511439. PMID 8546503.
  20. Fleming, P. J (7 April 2001). "The UK accelerated immunisation programme and sudden unexpected death in infancy: case-control study". BMJ. 322 (7290): 822. doi:10.1136/bmj.322.7290.822. PMC 30557. PMID 11290634.
  21. Vennemann, M.M.T.; Höffgen, M.; Bajanowski, T.; Hense, H.-W.; Mitchell, E.A. (2007). "Do immunisations reduce the risk for SIDS? A meta-analysis". Vaccine. 25 (26): 4875–9. doi:10.1016/j.vaccine.2007.02.077. PMID 17400342.
  22. L'Hoir MP, Engelberts AC, van Well GT, McClelland S, Westers P, Dandachli T, Mellenbergh GJ, Wolters WH, Huber J (1998). "Risk and preventive factors for cot death in The Netherlands, a low-incidence country". Eur. J. Pediatr. 157 (8): 681–8. doi:10.1007/s004310050911. PMID 9727856. S2CID 21642651.
  23. "What is Child Abuse and Neglect?". Australian Institute of Family Studies. September 2015.
  24. "Child Sexual Abuse and the "Grooming" Process". Archived from the original on 2015-12-18. Retrieved 2017-07-27.
  25. Christiane Sanderson (2006). Counselling Adult Survivors of Child Sexual Abuse. Jessica Kingsley Publishers. p. 30. ISBN 978-1843103356. Retrieved April 6, 2016.
  26. Advanced Pediatric Assessment, Second Edition (2 ed.). Springer Publishing Company. 2014. p. 484. ISBN 9780826161765.
  27. "Shaken Baby Syndrome". Journal of Forensic Nursing. Retrieved 2011-04-27.
  28. "Abusive Head Trauma: How to Protect Your Baby".
  29. Lecture by Levitt at TED Retrieved June 2011
  30. "The Last Word: Forgotten Baby Syndrome". The Week. March 26, 2009.
  31. GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
  32. "2-year-old drowns in pond inside SC community".
  33. "Toddler dies after being found in Pa. Pond, authorities say".
  34. "Babysitter of Toddler Found in Koi Pond to be Arraigned". 2017-07-05.
  35. "Rise in U.S. High Chair Injuries Stuns Experts".
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