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Protecting Young Children in the Home

Vol. 2, No. 1, Winter 1997

Wilma S. Hammett, Ph.D., and Sarah D. Kirby, Ph.D.

Children are a source of pride and joy for most parents, but along with the joys of parenthood, there are also some worries -- especially for children's safety. While parents worry about their children's safety when away from home, they often forget about their safety in their own home. The home should be a place where children feel safe and secure. However, the home can also be a place full of hidden hazards that can seriously injure or kill children.

Accidents or "preventable injuries" that take place in and around the home are the leading killers of children. They account for 10,000 deaths each year. Not only are accidents the single largest cause of death in children less than fifteen years of age, but accidents are also the leading cause of permanent or temporary disability in those over the age of one year. In the United States, 12 to 14 million children (one in four children under the age of 15) require medical attention due to accidental injury.

Most, if not all, childhood injury deaths and disabilities are preventable. Most home accidents occur because of childhood curiosity and unsafe physical environments. Parents and caregivers should provide a safe, hazard free environment for children to live and play. Simple child proofing when the child is an infant may not be enough to keep him or her safe throughout the childhood years.

At each stage in a child's life, the parent will have to reevaluate hazards and think about ways to eliminate them. When there is more than one child in a family, parents need to realize that products and/or situations that are not hazardous to an older child may be hazardous to a younger child. Fortunately, children are born with limited mobility so there is time for parents to prepare a safe home for the family.

Injury accidents are made up of three important components. First, there must be a dangerous object ( a boiling pot on the stove). Second, there must be someone who is vulnerable (a toddler). Third, there must be circumstances in the environment conducive to an accident (the pot handle turned outward so the toddler can reach it).

Dangerous Objects. To help determine what sort of dangerous things may be lurking in the house, parents should try to view a room from the child's vantage point. If the child is an infant, the parent should lay on the floor and look all around the room. What looks interesting under furniture? What is at the child's eye level? What can the child reach if he or she pulls up? This may help the parents to better understand the dangers that may look attractive to their children.

Someone Who is Vulnerable. The second component -- someone who is vulnerable -- will change over time. As a child grows from an infant, to a toddler, to a young child, and beyond, parents will constantly have to reevaluate the home environment for safety. Having children of various ages will require a greater level of safety precautions. Children need protection not only from safety hazards they may encounter, but also from hazards caused by an older or younger child. To help keep up with the possible dangers, the American Academy of Pediatrics suggests that parents review the child's developmental capabilities in relationship to his or her living environment by regularly asking themselves: "How far can he move? How high can he reach? What objects attract his attention? What can he do today that he couldn't do yesterday? What will he do tomorrow that he can't do today?".

Environmental Circumstances. Parents can control and monitor environmental circumstances. By eliminating the hazardous conditions that exist in the areas where children live and play, accidents can be greatly reduced if not completely eliminated.

To help determine the kind of hazards that might be in the home environment, it is helpful to review a child's developmental stages in terms of household hazards.

Children Zero to Six months

The environment of very young infants is easier to make safe and to control than that for older children because infants have limited mobility and ability. However, infants do gain new skills quickly, and parents must always be alert to the potential dangers these new skills pose. During this time children may learn to roll over and may sit up. Parents should make certain that the child's crib is safe for sleeping. The mattress should fit snugly in the crib, so the child cannot get his or her face trapped between the mattress and the crib. Soft bedding materials such as pillows and comforters should not be used in the crib.

Children should sleep in flame retardant sleepwear, and parents should follow the manufacturer's instructions when washing sleepwear so as not to deteriorate the flame retardancy. If the child is in an older crib, parents should be certain that the distance between the slats is no more than 2-3/8 inches. There should also be no cutouts on the end panels that can trap heads, arms, and legs. Also, if the crib is older, it should be tested for lead paint. Periodically, side rail slats should be checked to make sure that they are secure. Loose glue joints should be repaired so they do not fall out and leave space for the child to slip out and get caught.

Infant changing tables should have guard rails on the side and a safety strap for securing the infant in place. Even with safety straps, however, it is extremely important never to leave a child unattended on a changing table. Ideally, the middle of the changing table should be slightly lower than the sides.

Finally, the child's bath should be safe, as well as fun. A child should never be unattended in the bathtub -- even in a tub safety ring or infant tub. Bath water temperature is critical to safety. A scald guard on the bathtub plumbing can help prevent burns. If there is no scald guard, the water heater should be set no higher than 105 degrees Fahrenheit. Parents should always check the bath water with their wrist or elbow before putting the child into the bath. The temperature should be checked at several different points in the tub, because the temperature may not be uniform throughout.

Children Six to Twelve Months

During this time of development, children become mobile. In these months children begin creeping, crawling and even walking. Sitting and standing alone are also new abilities. Children of this age typically spend a great deal of time reaching and grabbing for things. They also learn about the world by using their senses of sight, touch, and taste. Almost everything a child touches at this age will go directly into his or her mouth.

As with younger infants, crib safety is still extremely important at this age. By the time the child can crawl on hands and knees, all crib gyms and mobiles should be removed from the crib. By the time the child can sit up, his or her mattress should be lowered to a level where he or she cannot fall out by climbing up and over the crib side or by leaning against the side of the crib. The mattress should be at the lowest level by the time the child learns to stand. Crib bumpers should be removed by the time the child can pull himself or herself up to a standing position.

Children of this age will use various items to pull up on. Be aware of cleaning buckets. Always empty cleaning buckets of liquid after using because young children have been known to drown after falling into buckets holding only two inches of water.

Child safety gates can and should be used into the toddler years to keep children away from stairs. Parents should not allow children to climb stairs alone until they can safely negotiate steps. This usually occurs around the age of two, but may be later for some children. Child safety straps will not always keep babies from falling out of baby furniture and play items. Never leave babies unattended in highchairs, swings or other baby equipment.

The Toddler Years (ages 1-3)

Children of this age enjoy running, climbing, mimicking parents, and exploring all kinds of things. During this time their physical abilities are increasing rapidly. However, their ability to understand the consequences of their actions is not developed.

Burns are a serious concern for children of this age. Keep young children away from appliances such as irons, curling irons, blowdryers, heaters, and toasters to prevent burns. Turn handles on pots and pans away from the front of the stove so that young children cannot reach them and pull them over. Whenever possible, use the back burner on the stove.

Many children find themselves in serious trouble by climbing on things. An anti-tip device installed on the stove will prevent it from toppling when a child climbs on it. Children have been killed when crushed by kitchen stoves. Other furnishings, such as bookshelves, Grandfather clocks, a chest of drawers, or a china cabinet, can be secured to the wall to prevent them from toppling on a child. Toy chests should have a safety latch to prevent the lid from falling on a child. Falling lids can kill or seriously injure children.

Like older infants, toddlers will put anything in their mouths. Parents can protect children from the hazard of choking by keeping small items, such as coins, marbles, safety pins, tacks, etc., out of their reach. If the item is smaller than a quarter, it is too small for a young child.

To prevent the possibility of electrical shock, safety plugs should be in all electrical outlets. Children should not be allowed to plug in appliances or to turn appliances on or off.

The Young Child (ages 3-5)

Children of this age have much improved physical coordination. They also have a great desire to do things independently of parents or caregivers. Coupled with this independence is an active imagination. The combination of skills, independence, and fantasy can be dangerous, because although they can practice some self control, their physical abilities are still ahead of their judgment.

Children of this age should not be allowed to play with matches or lighters. These devices should always be stored out of reach of children. Additionally, children should never be left unattended to play near fireplaces, grills, or any type of open flame.

Like fire, water is fascinating to children of all ages. Backyard pools, children's wading pools, creeks, ponds, streams, etc. can be very dangerous for the young child. Children should be well supervised whenever they are around any body of water. Wading pools should be emptied when not in use. Backyard pools should be protected by a locked fence, at least 4 feet high.

Other Concerns for Children of All Ages

The cords on window treatments can be dangerous for young children. Cords from blinds and draperies have been known to strangle children under the age of five. To prevent this, parents can install cord wraps. Cord wraps are devices that mount on the window frame. The cord of the window treatment is wrapped around the device and out of reach of children. Infant cribs should not be placed near a window because children under the age of 18 months have become entangled in cords for window coverings.

Windows should be kept closed in areas where children sleep and play to prevent young children from falling out. If a window must be opened, it should be opened no more than two inches. Window screens will keep bugs and debris from entering a home, but they cannot support the weight of a child and should not be relied upon to prevent children from falling out of open windows. All windows should have locks to prevent children from opening them. When arranging rooms, furniture that can be climbed on, such as beds, chairs, and desks, should not be placed near the window.

Children under the age of five are the most frequent victims of poisoning. There are many things parents can do to prevent childhood poisonings. All potentially hazardous materials, including medicines, cleaners and pesticides, should be kept in a locked cabinet. Because children like to mimic adults, parents should never take medications in front of them and should never refer to medicine as candy. Parents should take extra precautions to make certain that all child resistant and child proof closures should be in place. When thinking about potentially poisonous household items, parents should not overlook household plants. Common plants such as the philodendron and diffenbachia, contain a substance that can irritate the mouth and throat causing swelling that impairs breathing. Wild mushrooms have been known to cause death in young children. Even garden plants such as the tomato and potato have toxic parts. The best thing parents can do is to become familiar with toxic plants and keep children away from them.

Sources

Aherin, R.A. & Todd, C.M. (1989). Developmental stages of children and accident risk potential. 1989 International Winter Meeting of the American Society of Agricultural Engineers.

Barsley-Marra, B.L. (1993). Understanding and encouraging your young child's large motor development. University of Missouri-Columbia.

berg, A., Murkoff, H.E., & Hathaway, S.E. (1994). What to expect, the toddler years. New York: Workman Publishing.

Hammett, W.S. & Mock J.E. (1996). Safety on the farmstead. Unpublished manuscript. North Carolina State University.

Shelov, S. P. & Hannemann, R.E. (Eds.). (1993). Caring for your baby and young child, birth to age 5. New York: Bantam Books.

United States Consumer Product Safety Commission. (1985). Prevent your grandchildren from being poisoned: Safety alert. ( #5041). Washington, DC: U.S. Consumer Product Safety Commission.

Authors

Wilma S. Hammett, Ph.D., Extension Specialist, Interior Design
Sarah D. Kirby, Ph.D., Extension Specialist, Housing, Family and Consumer Sciences, North Carolina Cooperative Extension Service, North Carolina State University.

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