Tips for Keeping Infants and Toddlers Safe: A Developmental Guide for Home Visitors

During the first three years, children are constantly growing and acquiring new skills and knowledge. Surveillance systems have shown that injury is the leading threat to the health and well-being of young children. When families understand how children can get hurt and know what to do to protect them, infants and toddlers can learn and grow safely.1

Young children are more likely to be injured in their own home than anywhere else.2 As a home visitor, you can help families to prevent childhood injuries. Whether families bring up concerns or you introduce the topic, safety is an important part of your work with families.

Use this tool to share safety tips with families. Each section includes a review of child development and how it relates to injury prevention strategies. It also includes safety tips organized by families’ daily routines. Some tips apply to all children, while others address the developmental needs of children in a specific age group. When a family has children at different developmental levels, review the safety tips for each.

Home visitors can use this tool to: 

  • Learn safety tips to share with families
  • Explain the reasons for specific safety measures
  • Support families to build safe daily routines for children of all ages and developmental abilities

Using the Tool 

Select the tab that corresponds to a specific developmental stage. Remember that children reach milestones based on their individual pattern of growth and development. Choose a daily routine to see a list of safety tips, including a description for families of what to do and why it works.

Infants depend on their families for food, warmth, and care, and for meeting such basic needs as eating, diapering, sleeping, bonding, and safety. But all babies are unique. Some infants may settle easily and be capable of quickly soothing themselves. Others may cry often or for long periods of time. In order to thrive, infants need nurturing, consistent, and responsive caregivers. Home visitors support family members to develop a responsive relationship with their child and respond positively to the baby's cries, coos, and other communication attempts. Responsive caregiving is at the heart of young children’s development. The architecture of their brain is literally shaped by every single experience they have. Read More about Young Infants 

During the first months of life, a young infant's neck is not strong enough to support the weight of his or her head. Home visitors can demonstrate how to support a baby's early movements by gently holding and positioning the infant's body, head, and neck to prevent injury. They can help families to understand the importance of providing supervised "tummy time" experiences in a safe space for young infants. These experiences give babies a chance to build the muscles they need to hold up their neck, control the movement of their arms and legs, roll over (4–6 months), sit up (7–9 months), and eventually get ready for crawling, cruising, and walking. Young infants also begin to roll over and sometimes move in unexpected ways. Home visitors may talk with families about the need for close supervision at all times to prevent falls, the leading cause of unintentional, nonfatal injury among young children. In addition, as young infants begin to grasp objects, they need to have access to safe materials to avoid choking or suffocating.

Infants' feeding skills evolve as they mature. At first, they only are able to suck and swallow liquids. Over time, they gain more control of their tongue and mouth, which allows them to begin to eat pureed and strained food from a spoon. Home visitors can discuss the importance of observing infants carefully when they are eating so they do not choke. Conversations about food must be respectful of the family's culture and food preferences and support safe and culturally responsive feeding practices.

Young infants are constantly reacting to the world around them. Brightly colored objects, toys that make noises, and soothing music may stimulate or calm babies. Home visitors work with families to observe their child’s reaction to different types and levels of stimulation through sights, sounds, and touch. They also help parents to respond by providing a nurturing and safe environment with enough stimulation to meet each child's needs and interests. "Remember with all babies—timing and match are important! (Your) job...is to recognize (a) baby's natural tendencies, meet her where she is at, and then provide the external support she needs to handle the stimulation that is naturally at the heart of everyday interactions with her caregivers and the world around her."3

1 Gouley, K. K. (n.d.). Stimulation and Development During Infancy: Tuning in to Your Baby's Cues. Retrieved from The Child Study Center of the NYU Langone Medical Center website: Stimulation and Development During Infancy: Tuning in to Your Baby's Cues

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General Safety

Safety Tip No. 1: Actively supervise

What families can do:
Place a young infant on a blanket near you so you can see and reach your baby at all times. Your home visitor can talk to you about these Active Supervision strategies:

  • Create safe spaces by:
  • Stay close by so you can reach your baby quickly if needed.
  • Keep a watchful eye. Know where your baby is and what he is doing.
  • Listen – Notice typical as well as unusual noises or silence that could signal distress.
  • Anticipate what your baby wants or may try to do.
  • Engage and redirect – Even when you are busy, you can stay engaged by talking or singing to your baby about what you are doing. If necessary, intervene quickly before your baby does something that is not safe.

Why it works:
Young infants change constantly, demonstrating new interests and abilities. Using Active Supervision strategies is a way to stay engaged, pay attention, and keep your baby safe. Properly securing or bolting furniture to the wall prevents it from tipping over as infants begin to pull on objects to move around or stand. Setting aside a special area for tummy time that is free of small items that could be choking hazards protects young infants from injury in a busy household.

Safety Tip No. 2: Use a checklist to create safe environments

What families can do:
Use a home safety checklist to identify possible hazards. Regularly inspect household items and infant furniture and equipment [PDF, 604KB] to make sure there are no splinters, sharp edges, or loose pieces that could injure your baby.

Why it works:
As children learn new skills, their interaction with the environment changes. This leads to new safety risks. Using a home safety checklist, and keeping in mind an infant’s needs and developmental abilities now and in the weeks to come, can help you identify possible hazards so you can remove, repair, and keep your baby away from any objects that could be harmful.

Safety Tip No. 3: Use safety devices

What families can do:
Get and use smoke alarms [PDF, 126KB] and carbon monoxide detectors. Properly installed and maintained smoke alarms and carbon monoxide detectors save lives. Follow manufacturer’s recommendations for where to place them. Your home visitor may be able to help you obtain these devices for free or at a reduced cost. Make a schedule to routinely check the batteries to make sure they work and you know when to change them. Have a fire escape plan that describes who will get the children out of the house and where you will meet once outside. Before your baby becomes mobile, begin to use safety devices such as outlet covers, cabinet locks, and baby gates.

Why it works:
Smoke alarms warn you that there is a fire so you can get your family out of the building quickly. Carbon monoxide (CO) is a deadly, poisonous, odorless, and colorless gas. It may come from home heating and cooking devices. An alarm alerts you to unsafe CO levels in the home. Simple safety devices like outlet covers, cabinet locks, and baby gates prevent injuries and are not expensive. It is always best to plan ahead when childproofing your home so as a young infant develops new skills and abilities, you know that your baby can explore safely.

Safety Tip No. 4: Make sure that windows are safe

What families can do:
Keep cribs, furniture, toys, and other objects away from windows and blind cords. Curtains or cordless shades are safer than Roman shades or blinds with cords. Secure the cords and chains from window coverings [PDF, 145KB] so they are up and out of reach. Make sure windows either open from the top or have guards so they can’t open more than four inches.

Why it works:
Cords from window blinds are a strangulation hazard. Inexpensive cord safety devices are available from retail stores if you have blinds with cords. Windows can be a source of falls even when they are closed, and can pose a hazard to young infants who are developing new motor skills and becoming more active every day. A window screen is not designed to protect a child from falling.

Safety Tip No. 5: Be aware of and keep all poisons out of children’s reach

What families can do:
If you live in a house or apartment built before 1978, it may have lead paint. You can talk to your home visitor as well as your landlord, health care provider, and local health department to find out if you have lead paint in your home, and if so, what to do. Young infants learn about their environment by exploring objects using all of their senses. Inspect your home for poisonous materials. Check to make sure indoor and outdoor plants [PDF, 197KB] are not poisonous. Place all cleaning products, chemicals, and toxic materials in locked cabinets. Craft and play materials should say they are "non-toxic." Keep products that say "keep out of reach of children" and everyday items like toothpaste out of reach. Store medications up and away. Make sure that people who live with or visit you put away their coats, purses, bags, and backpacks so that an infant cannot reach medications [PDF, 455KB] or other unsafe items that may be inside. Avoid using chemicals near young infants. Post Poison Control information in a central location.

Why it works:
There are many poisons throughout the home. Some are obvious, but others may be harder to identify. According to Safe Kids Worldwide, "every minute of every day, a poison control center answers a call about a young child getting into medicine."4 Indoor and outdoor plants, paint, craft materials, and medications are hazardous if young infants put them in their mouth or spill chemicals on their skin. A small amount of lead is harmful to a child who swallows or breathes in dust that you may not be able to see. Even common, everyday items like makeup and toothpaste can be poisonous if eaten in large quantities. To keep babies safe, store toxic products in locked cabinets and keep personal items out of children's reach.

Safety Tip No. 6: Check the temperature of your hot water

What families can do:
Set the temperature on your hot water heater to 120 degrees Fahrenheit or lower and check the water temperature on the inside of your wrist before bathing your baby.

Why it works:
Young infants have thin skin that burns easily. Babies can’t get out of a bathtub if the water is too hot. To prevent burns from scalding water, make sure that the temperature on your water heater is no higher than 120 degrees.

Safety Tip No. 7: Keep hot foods and liquids out of reach

What families can do:
Don’t hold your baby when you are holding hot food or a hot beverage, cooking, or taking food out of the microwave. Place hot liquids and foods in the center of the counter or a table that is not at your child’s level. Make sure that the microwave and cords from appliances that may contain hot liquid or steam, such as a coffee pot or crock pot, are not in reach. Keep pots on the back burner of the stove with the handles turned inward.

Why it works:
Hot liquids and steam are more likely to burn or scald young infants, as their skin can burn from even brief contact with a hot substance that adults find comfortable. Young infants have a strong grasp and jerky arm movements. If they grab your arm when you are holding hot food or drinks, or pull on a dangling cord or the edge of a tablecloth, hot food or liquid can spill on them. In one study, 90.4 percent of scald injuries to children under age 5 were related to hot cooking or drinking liquids.5

Safety Tip No. 8: Prevent drowning

What families can do:
Always stay hands-on when bathing a young infant and never leave your baby alone. Even before your child becomes mobile, if you live in a house that has a pool, make sure that it has fencing on all sides and has "self-closing and self-latching gates that open outward, with latches that are out of the reach of children."6

Why it works:
Drowning happens quickly and silently. An infant or small child can drown within 30 seconds in as little as two inches of liquid. Infants under 1 year of age are most likely to drown in a bathtub.7 It is important to be actively engaged whenever a child is in or near water.

Safety Tip No. 9: Prepare for emergencies

What families can do:
Post important emergency phone numbers such as poison control, 911, and your child’s doctor in a central location, or program them into your mobile phone. This is especially important if your child has a special health care need. Prepare for common weather-related emergencies. Keep basic first aid and disaster supplies and instructions on hand. You can also talk to your home visitor about opportunities to learn infant cardiopulmonary resuscitation (CPR) and first aid.

Why it works:
Families that prepare for emergencies have a better chance of getting help quickly when needed. Emergency responders and poison control professionals can provide instruction about first aid treatment for different types of injuries.

Safety Tip No. 10: Always use a car seat for your child

What families can do:
Select a car seat based on your child’s age and size, and that fits in your vehicle, and use it every time your child rides in your car or truck. Install the car seat according to the manufacturer’s instructions to ensure that it protects your child. Newborns and infants should ride in the back seat of a car in a rear-facing car seat until age 2 or until they reach the top height or weight limit allowed by the car seat’s manufacturer. Find an inspector who can check your child’s car seat and make sure it is installed correctly.

Why it works:
Motor vehicles are the second leading cause of death among children ages birth to 4.8 The best way to protect your child from injury in a crash is to make sure that he is always seated in the back seat in a car seat that is appropriate for his age and size. Car seat use reduces the risk of death to infants (aged less than 1 year) in passenger vehicles by 71 percent.9 Infants and young children are more likely to be hurt in the front seat. Front air bags are designed to protect adults, not children, and can be dangerous to children seated in front of them.

4 Safe Kids Worldwide (2014). Medicine Safety 2014 Infographic. Retrieved from http://www.safekids.org/infographic/medicine-safety-2014-infographic

5 Lowell, G., Quinlan, K., and Gottlieb L. J. (2008). Pediatrics 122:799-804.

6 Centers for Disease Control and Prevention (2011). Stay Safe In and Around Swimming Pools. Retrieved from http://www.cdc.gov/Features/dsSafeSwimmingPool/

7 Centers for Disease Control and Prevention (2014). National Center for Health Statistics, Unintentional Drowning Deaths in the United States, 1999–2010. Retrieved from http://www.cdc.gov/nchs/data/databriefs/db149.htm

8 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2012). The National Action Plan for Child Injury Prevention. Atlanta, GA: CDC

9 Centers for Disease Control and Prevention, Injury Prevention and Control: Motor Vehicle Safety (2014). Retrieved from http://www.cdc.gov/MotorVehicleSafety/Child_Passenger_Safety/CPS-Factsheet.html

Diapering

Safety Tip No. 1: Stay hands-on and engaged

What families can do:
Have everything you need to change your baby’s diaper before you start. Keep a hand on young infants whenever they are on a changing table or other raised surface. Engaging infants in reciprocal (back and forth) play, such as singing, rhyming, and echoing verbalizations, supports a nurturing relationship between you and your baby and provides opportunities for early learning.

Why it works:
Young infants are constantly exploring what their bodies can do. They may wiggle their arms or legs, thrust them onto the changing pad, attempt to roll over, or scoot forward or backward. It is important to never leave them alone because their movements can be unpredictable. Staying hands-on can prevent your baby from falling off a changing table or other high surface. Providing a positive, engaging activity during diapering creates learning opportunities and helps prevent injuries by focusing a baby’s attention during diapering.

Safety Tip No. 2: Store diapering supplies safely

What families can do:
Keep diaper changing materials, including wipes and ointments, where you can reach them easily but are away from an infant’s grasp. You can give your baby a safe, washable toy to hold while diapering. Wash the diaper changing area [PDF, 351KB] after each use and store the supplies out of an infant’s reach.

Why it works:
Young infants try to grasp objects. As they grow, they are more able to pick up and mouth materials that are within their reach. Providing a safe toy to interest your baby and keeping spray bottles, disinfectant wipes, ointments, medications, and other harmful materials out of reach protects children from injury.

Feeding

Safety Tip No. 1: Check bottle temperatures

What families can do:
If you have chosen to bottle feed rather than breastfeed your baby, Caring for Our Children recommends serving bottles cold from the refrigerator or placing them "under running, warm tap water or in a container of water that is no warmer than 120 degrees" for five minutes to warm them. The American Academy of Pediatrics suggests that the easiest way to test the temperature of the liquid in a bottle is to shake a few drops on the inside of your wrist.

Why it works:
Infants' mouths are sensitive to temperature and may burn if liquids are too hot. Microwaves do not heat liquids evenly and can lead to scalding. Using a bottle warmer or placing a bottle in warm water is safer and more effective.

Safety Tip No. 2: Position children to eat safely

What families can do:
Always hold an infant who is bottle feeding so she can breathe freely through her nose. Supervise closely when she is able to sit up and eat strained food. You can use a feeding chair that is low to the ground with high sides and secure the straps to reduce the risk of injury from a fall. You can also seat your baby in a highchair near you so she can participate in family mealtimes and you can reach her quickly if needed.

Why it works:
Infants breathe through their nose when they eat, so their nasal passages need to be clear to accept a bottle. Securely holding an infant who is bottle feeding supports a baby’s breathing and prevents falls. Supervising carefully ensures quick action if an infant starts to choke on her food. Feeding chairs are low to the ground and an infant is less likely to be injured from a fall. A highchair within easy reach provides an opportunity for your baby to enjoy family meals safely.

Safety Tip No. 3: Choose developmentally appropriate foods and check the temperature

What families can do:
When your baby is ready to eat from a spoon, you can serve foods based on your family’s preferences that are developmentally appropriate, such as strained or pureed fruits and vegetables. Infant food can be served at room temperature and does not need to be heated in the microwave. If you do heat the food, stir it to distribute the heat evenly. You can talk to your baby’s doctor or use the Well-Visit Planner if you have questions about how to introduce solid foods safely.

Why it works:
A baby's throat is small and easily obstructed. Young infants are learning how to control their tongue, chew, and swallow, but are still not efficient chewers. As they grow, they gain more control over their ability to move food around in their mouths and eat strained and pureed food without choking. The medical home can provide guidance on how to reduce the risk of allergic reactions when introducing solid foods.

Sleeping

Safety Tip No. 1: Use safe cribs

What families can do:
Use a crib that was manufactured on or after June 28, 2011. Cribs made after this date must meet the current safety standard. Drop-side cribs do not meet current safety regulations. More guidance about the standard, including what to do if you cannot use a newer crib, is available from HealthyChildren.org. Talk to your home visitor if you need help finding a safe crib.

Why it works:
As young infants begin to move their bodies, they can get into dangerous positions. While lying on their backs, they may push or wiggle themselves into the side of a crib. They also may slide their arms through the slats in a crib and wedge themselves into positions that could injure them. Using safe cribs protect infants from injury, suffocation, or strangulation.

Safety Tip No. 2: Use safe sleep practices

What families can do:
Use safe sleep practices [PDF, 1.1MB].10 The safest place for your baby to sleep is in the room where you sleep, but not in your bed. Always place young infants on their backs to sleep, without blankets, pillows, and toys that could cover their mouth or nose. Use a firm mattress and a tight-fitting sheet in the crib or bassinet. Do not use bumpers in a crib. Your home visitor can explain why experts say that "bare is best!"

Swaddling can calm very young infants, but make sure that your baby can’t roll over when swaddled. A loose blanket, including a swaddling blanket that comes unwrapped, could cover your baby’s face and increase the risk of suffocation. Try to keep your home cool, or dress your baby in light clothing so he does not get overheated. In addition, to prevent infants from strangling, keep monitor cords at least three feet away from any part of the crib, bassinet, play yard, or other area where young infants are sleeping.

Why it works:
Until young infants are able to control how their muscles move and can regulate their breathing and body temperature, they are at risk for suffocation and sudden infant death syndrome (SIDS). Families can reduce this risk by placing infants on their backs in cribs without toys, pillows, or loose blankets and dressing them lightly to avoid getting overheated. Even a young infant can strangle from a baby monitor cord, so it is not safe to put them in or close to the area where your baby is sleeping.

4 For more information, see SIDS and Other Sleep-Related Infant Deaths: Keeping Your Babies Safe, a webinar from Healthy Child Care American, available at http://www.healthychildcare.org/PDF/Safe%20Sleep%20Webinar.pdf [PDF, 3.9MB]

Playing

Safety Tip No. 1: Use toys, equipment, and materials that have no small parts and are safe for young infants

What families can do:
Only provide toys that are safe for infants. You can also use many everyday household materials [PDF, 134KB] as long as they are sturdy and easy to clean, because babies will put them in their mouth. Make sure that materials and equipment, including dolls and stuffed animals, do not have loose, small parts that could fall off and pose a choking hazard. Keep all objects that are small enough to fit into an infant's mouth out of reach. Any object, such as a button battery [PDF, 1.6MB] or magnet, is dangerous if it can pass through the small-parts cylinder (2.25 inches long by 1.25 inches wide) used for screening choking hazards for children younger than 3 years. For more information, see Which Toy for Which Child: A Consumer's Guide for Selecting Suitable Toys [PDF, 1.2MB].

Select equipment that will not trap a young infant’s head or limbs. Ensure that equipment such as strollers, swings, rockers, and carriers are appropriate for an infant’s height and weight. Always use safety straps and place equipment on the floor so infants cannot fall. Regularly inspect materials and equipment to identify, remove, or repair any objects that may cause injury. Baby walkers are not safe to use, even with an adult close by. To find out if safety concerns have been reported about the toys and equipment you are using, you can search for product safety complaints or report a concern at www.saferproducts.gov. Sign up for free recall notices from the U.S. Consumer Product Safety Commission.

Why it works:
Young infants are becoming more aware of their environment. They use their hands and mouths to explore. As soon as an infant is capable, he may try to grasp an object within reach and bring it to his mouth. Providing toys and materials that contain no small or loose parts eliminates choking hazards. Storing button batteries and magnets out of reach removes hazardous materials.

Age-appropriate equipment prevents injuries from entrapment. Safety straps secure a child in a stroller, swing, rocker, carrier, or other equipment. They also reduce the risk of falls. It is best not to use baby walkers as they can roll down the stairs, or make it easier for infants to reach something that may not be safe for them to have.

Safety Tip No. 2: Provide safe outdoor play environments

What families can do:
Learning about the natural world is fun for families and children of all ages, including young infants. A blanket on the grass provides a soft and clean surface for outdoor play. Use the shade of a tree, stroller canopy, umbrella, or clothing to cover a child’s skin and a wide-brimmed hat to protect them from direct sunlight. Never use sunscreen on an infant under 6 months. Keep infants away from poisonous plants [PDF, 197KB] and any insects that may sting or bite. Dress young children appropriately for the weather, and keep them inside during extreme heat or cold.

Why it works:
Providing safe opportunities to explore the sights and sounds in nature supports children’s development. Because sunscreen is not safe to use on babies younger than 6 months of age, clothing, a hat, and shade are the best ways to protect them from sunburn. Knowing how to recognize plants that are poisonous and making sure that there no insects that sting or bite protects children from injury. Young infants are not able to regulate their body temperature well, so keeping them inside during extreme heat or cold protects them from overheating and frostbite.

Mobile infants have more control of their head, torso, arms, and legs. They also begin to coordinate those movements. At this age, they sleep less and are more active during the day, eager to engage in everything around them. As they learn to stand, crawl, cruise, and walk, they are able to move around more independently and explore their environment. Mobile infants begin to develop their ability to reach for objects – suddenly grabbing, chewing, or trying to climb on objects that were once out of their reach. Home visitors can talk with families about regularly inspecting indoor or outdoor areas, materials, or equipment that could be unsafe.11 Read More about Mobile Infants 

Mobile infants are curious and learn by doing. They use sight, sound, taste, touch, and smell to learn about the objects in their environment. Their brains are developing rapidly as they begin to understand who and what is in their world. They begin to recognize routines, and they are learning that people may leave and return later. As they become aware that objects still exist even when they are hidden, they engage in play to practice this new knowledge. To a mobile infant, cabinets, toy chests, and other items that open and close become more intriguing. They watch where family members place objects and may try to pull up or cruise along the furniture to get them, creating an even greater need for supervision.

Mobile infants are able to swallow semi-solid food and eventually begin to feed themselves solid food. Families choose age-appropriate, culturally responsive foods that do not pose a choking hazard. When preparing food, family members are careful to prevent burns or scalds.

Mobile infants often vocalize more. They begin to respond to simple requests and one-step directions, such as "time to sit" or "get your toy." This sets the stage for learning healthy habits, routines, and safety rules as children grow.

Mobile infants are eager to practice their new skills and learn from the people, places, and things in their environments. Depending on their temperament, some infants are cautious while others are more likely to take risks. To support their child’s development and natural curiosity, families can create safe environments for mobile infants to safely explore their world.

11 Early Head Start National Resource Center. (n.d.). Serving Mobile Infants. Retrieved from Serving Mobile Infants: Sharing Knowledge with Infant—Toddler Teachers and Home Visitors

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General Home Safety

Safety Tip No. 1: Actively supervise

What families can do:
When he is moving about, make sure that you can see and reach your baby at all times. You can use a playpen for short periods of time (15 minutes) when you can’t give your baby your full attention. Your home visitor can talk to you about these Active Supervision strategies:

  • Create safe spaces by:
    • Arranging furniture and household items so you can always see your baby
    • Identifying a safe area for him to explore
    • Being aware of a baby’s movements, as infants may roll, crawl, or creep into pathways of unsuspecting adults and older children in the home
    • Making sure that only age-appropriate items are within your baby’s reach, and that all furniture is properly secured or bolted to the wall. It is not safe to put items in a playpen that your baby can use to climb out.
  • Stay close by so you can reach your baby quickly if needed.
  • Keep a watchful eye. Know where your baby is and what he is doing, as well as what older children and family members are doing in an area where mobile infants are playing.
  • Listen – Notice typical as well as unusual noises or silence that could signal distress.
  • Anticipate what your baby wants or may try to do.
  • Engage and redirect – Even when you are busy, you can stay engaged by talking or singing to your baby about what you are doing. If necessary, intervene quickly before your baby does something that is not safe.

Why it works:
Mobile infants continue to change constantly and demonstrate new interests and abilities. Once they can freely explore their world, any area they can reach must be free of small items that could be choking hazards. Babies may suddenly try to climb over or crawl under furniture, or out of a crib or playpen. Properly securing or bolting furniture to the wall prevents it from tipping over if infants use it to pull up to stand, cruise, or climb. Active Supervision is a way to stay engaged, pay attention, and help mobile infants practice their new skills safely.

Safety Tip No. 2: Use a checklist to create safe environments

What families can do:
Use a home safety checklist to identify and regularly inspect household items and infant furniture and equipment [PDF, 604KB] to make sure that they are safe. For example, check for splinters, sharp edges, loose pieces, or tears in a playpen that could injure an infant.

Why it works:
Infants need safe places to learn and grow. As children learn new skills, their interaction with the environment changes, leading to new safety risks. Using a home safety checklist, and keeping in mind an infant’s needs and developmental abilities now and in the weeks to come, can help you identify possible hazards so you can remove, repair, and keep your baby away from any objects that could be harmful.

Safety Tip No. 3: Use safety devices

What families can do:
Get and use smoke alarms [PDF, 126KB] and carbon monoxide detectors. Properly installed and maintained smoke alarms and carbon monoxide detectors save lives. Follow manufacturer’s recommendations for where to place them. Your home visitor may be able to help you obtain these devices for fzree or at a reduced cost. Make a schedule to routinely check the batteries to make sure they work and so you know when to change them. Have a fire escape plan that describes who will get the children out of the house and where you will meet once outside. Use safety devices such as outlet covers, cabinet locks, and baby gates.

Why it works:
Smoke alarms warn you that there is a fire so you can get your family out of the building quickly. Carbon monoxide (CO) is a deadly, poisonous, odorless, and colorless gas. It may come from home heating and cooking devices. An alarm alerts you to unsafe CO levels in the home. Simple safety devices like outlet covers, cabinet locks, and baby gates prevent injuries and are not expensive. It is always best to plan ahead when child proofing your home so that as a mobile infant develops new skills and abilities, you know that your baby can explore safely.

Safety Tip No. 4: Make sure that windows are safe

What to do:
Keep cribs, furniture, toys, and other objects away from windows and blind cords. Curtains or cordless shades are safer than Roman shades or blinds with cords. Secure the cords and chains from window coverings [PDF, 145KB] so they are up and out of reach. Make sure windows either open from the top or have guards so they can’t open more than four inches.

Why it works:
Cords from window blinds are a strangulation hazard. Inexpensive cord safety devices are available from retail stores if you have blinds with cords. Windows can be a source of falls even when they are closed, and can pose a hazard to infants who are developing new motor skills and becoming more active every day. A window screen is not designed to protect a child from falling.

Safety Tip No. 5: Be aware of and keep all poisons out of children’s reach

What families can do:
If you live in a house or apartment built before 1978, it may have lead paint. You can talk to your home visitor as well as your landlord, health care provider, and local health department to find out if you have lead paint in your home, and if so, what to do. Infants learn about their environment by exploring objects using all of their senses. Inspect your home for poisonous materials. Check to make sure indoor and outdoor plants [PDF, 197KB] are not poisonous. Place all cleaning products, chemicals, and toxic materials in locked cabinets. Craft and play materials should say they are "non-toxic." Keep any products that say "keep out of reach of children" and everyday items like toothpaste out of reach. Store medications up and away. Make sure that people who live with or visit you put away their coats, purses, bags, and backpacks so that your baby cannot reach inside for medications [PDF, 455KB] or other unsafe items. Avoid using chemicals near your baby. Post Poison Control information in a central location.

Why it works:
There are many poisons throughout the home. Some are obvious, but others may be harder to identify. According to Safe Kids Worldwide, "every minute of every day, a poison control center answers a call about a young child getting into medicine."12 Indoor and outdoor plants, paint, craft materials, and medications are hazardous when mobile infants put them in their mouths or spill chemicals on their skin. A small amount of lead is harmful to a child who swallows or breathes in dust that you may not even be able to see. Even everyday items like makeup and toothpaste can be poisonous if eaten in large quantities. To keep babies safe, store toxic products in locked cabinets and keep personal items out of children's reach.

Safety Tip No. 6: Check the temperature of your hot water

What families can do:
Set the temperature on your hot water heater to 120 degrees Fahrenheit or lower and check the water temperature on the inside of your wrist before bathing your baby.

Why it works:
Infants have thin skin that burns easily. Babies can’t get out of a bathtub safely by themselves if the water is too hot. To prevent burns from scalding water in the tub or sink, make sure that the temperature on your water heater is not higher than 120 degrees.

Safety Tip No. 7: Keep hot foods and liquids out of reach

What families can do:
Don’t hold your baby when you are holding hot food or a hot beverage, cooking on the stove, or taking food out of the microwave. Place hot liquids and foods in the center of the counter or a table that is not at your child’s level. Make sure that the microwave and cords from appliances that may contain hot liquid, such as a coffee pot or crock pot, are not in reach. Keep pots on the back burner of the stove with the handles turned inward. When using the microwave or stove, it is not safe for a mobile infant to be in the kitchen without supervision.

Why it works:
Hot liquids and steam are more likely to burn or scald infants, as their skin can burn from even brief contact with a hot substance that adults find comfortable. Infants are curious and have a strong grasp. If they grab a dangling cord, tablecloth, or your arm when you are holding hot food or drinks, the food or liquid can spill on them. In one study, 90.4 percent of scald injuries to children under age 5 were related to hot cooking or drinking liquids.13 Using a baby gate so your baby can’t go into the kitchen without you when you are cooking can prevent burns to a young child.

Safety Tip No. 8: Prevent drowning

What families can do:
Always stay hands-on when bathing your infant. Never leave an infant alone in the water. Be aware of any body of water around the home such as pools, ponds, or lakes. Children ages 1 to 4 have the highest drowning rates.14 Most occur in home swimming pools. If you live in a house that has a pool, make sure that it has fencing on all sides and has "self-closing and self-latching gates that open outward, with latches that are out of the reach of children."15 Keep a phone with you, and learn child cardiopulmonary resuscitation (CPR). Empty buckets and turn them upside down when done. Close the lids to toilets and washing machines. Stay actively engaged whenever a child is in or near water.

Why it works:
Drowning happens quickly and silently. An infant or small child can drown within 30 seconds in as little as two inches of liquid, so stay hands-on and actively engaged whenever a child is in or near any water. Mobile infants are curious explorers and can lean inside a bucket or reach for a toy in the pool, but their heads are bigger than their bodies. If they fall in, they are unable to get out and can drown.

Safety Tip No. 9: Prepare for emergencies

What families can do:
Post important emergency phone numbers such as poison control, 911, and your child’s doctor in a central location, or program them into your mobile phone. This is especially important if your child has a special health care need. Prepare for common weather-related emergencies. Keep basic first aid and disaster supplies and instructions on hand. You also can talk to your home visitor about opportunities to learn child CPR and first aid.

Why it works:
Families that prepare for emergencies have a better chance of getting help quickly when needed. Emergency responders and poison control professionals can provide instruction about first aid treatment for different types of injuries.

Safety Tip No. 10: Always use a car seat for your child

What families can do:
Select a car seat based on your child’s age and size, and that fits in your vehicle, and use it every time your child rides in your car or truck. Install the car seat according to the manufacturer’s instructions to ensure that it protects your child. Infants should ride in the back seat of a car in a rear-facing car seat until age 2 or until they reach the top height or weight limit allowed by the car seat’s manufacturer. The safest place for children to sit is the back seat. Find an inspector who can check your child’s car seat and make sure it is installed correctly.

Why it works:
Motor vehicles are the second leading cause of death among children ages birth to 4.16 The best way to protect your child from injury in a crash is to make sure that he is always seated in the back seat in a car seat that is appropriate for his age and size. Car seat use reduces the risk of death to infants and young children (aged 1 to 4 years) in passenger vehicles by 54 percent.17 Infants and young children are more likely to be hurt in the front seat. Front air bags are designed to protect adults, not children, and can be dangerous to children seated in front of them.

12 Safe Kids Worldwide (2014). Medicine Safety 2014 Infographic. Retrieved from http://www.safekids.org/infographic/medicine-safety-2014-infographic

13 Lowell, G., Quinlan, K., and Gottlieb L. J. (2008). Pediatrics 122:799-804.

14 Centers for Disease Control and Prevention (2014). Unintentional Drowning: Get the Facts. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Water-Safety/waterinjuries-factsheet.html

15 Centers for Disease Control and Prevention (2011). Stay Safe In and Around Swimming Pools. Retrieved from http://www.cdc.gov/Features/dsSafeSwimmingPool/

16 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2012). The National Action Plan for Child Injury Prevention. Atlanta, GA: CDC

17 Centers for Disease Control and Prevention, Injury Prevention and Control: Motor Vehicle Safety (2014). Retrieved from http://www.cdc.gov/MotorVehicleSafety/Child_Passenger_Safety/CPS-Factsheet.html

Diapering

Safety Tip No. 1: Stay hands-on and engaged

What families can do:
Have everything you need to change your baby’s diaper before you start. Keep a hand on mobile infants whenever they are on a changing table or other raised surface. Engaging infants in reciprocal (back and forth) play, such as singing, rhyming, and echoing verbalizations, supports a nurturing relationship between you and your baby. It also provides opportunities for early learning.

Why it works:
Mobile infants are constantly testing what their bodies can do. They are able to roll and crawl, and may attempt to scoot forward or backward. It is important to never leave them alone because their movements may be unpredictable. Staying hands-on can prevent an infant from falling off a changing table or other high surface. Providing a positive, engaging activity during diapering creates learning opportunities for your baby and focuses his attention.

Safety Tip No. 2: Store diapering supplies safely

What families can do:
Keep diaper changing materials, including wipes and ointments, where you can reach them easily but are away from an infant’s grasp. You can give your baby a safe, washable toy to hold while diapering. Wash the diaper changing area [PDF, 351KB] after each use and store the supplies out of an infant’s reach.

Why it works:
Mobile infants use their hands and mouth to explore their environment. They are able to pick up and mouth materials that are within their reach. Providing a safe toy to interest your baby and keeping spray bottles, disinfectant wipes, ointments, medications, and other harmful materials out of reach protects children from injury.

Feeding and Eating

Safety Tip No. 1: Check bottle temperatures

What families can do:
Caring for Our Children recommends serving bottles cold from the refrigerator or placing them "under running, warm tap water or in a container of water that is no warmer than 120 degrees" for five minutes to warm them. The American Academy of Pediatrics suggests that the easiest way to test the temperature of the liquid in a bottle is to shake a few drops on the inside of your wrist.

Why it works:
Infants' mouths are sensitive to temperature and may scald if liquids are too hot. Microwaves do not heat liquids evenly and can lead to scalding. Using a bottle warmer or placing a bottle in warm water is safer and more effective.

Safety Tip No. 2: Choose developmentally appropriate foods and check the temperature

What families can do:
At this stage, many infants are eating from a spoon. Infant food can be served at room temperature and does not need to be heated in the microwave. If you do heat the food, stir it to distribute the heat evenly. Many babies are also beginning to feed themselves. Serve food that is soft and mashed. Cut food into small pieces (cubes no larger than 1/4 inch) or thin slices that your baby can easily chew and swallow. Avoid high-risk choking foods such as small, slippery foods; dry foods that are hard to chew or sticky; and tough foods.18 For a list of safe foods, see Foods That Are Choking Hazards. You can talk to your baby’s doctor or use the Well-Visit Planner to talk with the medical home about foods or allergies.

Why it works:
Mobile infants are still learning how to control their tongue, chew, and swallow. As infants grow, they can move food from hand to mouth, and gain more control over their ability to move food around in their mouth, but are still inefficient chewers. The medical home can provide guidance on how to manage allergic reactions.

Safety Tip No. 3: Position children to eat safely

What families can do:
To minimize choking, make a family rule that children and adults must be seated while eating, and teach your baby to sit while eating. Watch to make sure she doesn’t put too much food in her mouth at once. You can use a feeding chair that is low to the ground with high sides and secure straps to reduce the risk of injury from a fall. You can also seat your baby in a highchair near you so she can participate in family mealtimes and you can reach her quickly if needed.

Why it works:
Many mobile infants are so interested in moving that they may not want to sit for very long to eat. Sitting while eating and drinking minimizes the risk of children choking or of a dental injury from falling with a cup or utensil in their mouth. Using a feeding chair that is low to the ground prevents an infant from falling. A highchair within easy reach provides an opportunity for your baby to enjoy family meals safely.

18 Mayo Clinic. (2011, April). Infant Choking: How to Keep Your Baby Safe. Retrieved from Infant Choking: How to Keep Your Baby Safe.

Sleeping

Safety Tip No. 1: Use safe cribs

What families can do:
Use a crib that was manufactured on or after June 28, 2011. Cribs made after this date must meet the current safety standard. Drop-side cribs do not meet current safety regulations. More guidance about the standard, including what to do if you cannot use a newer crib, is available from HealthyChildren.org. Talk to your home visitor if you need help finding a safe crib.

Why it works:
As infants begin to move their bodies, they can get into dangerous positions. While lying on their backs, they may push or wiggle themselves into the side of a crib. They also may slide their arms through the slats in a crib and wedge themselves into positions that could injure them. Using safe cribs protects infants from injury, suffocation, or strangulation.

Safety Tip No. 2: Use safe sleep practices

What families can do:
Use safe sleep practices [PDF, 1.1MB].19 The safest place for your baby to sleep is in the room where you sleep, but not in your bed. Although the risk of Sudden Infant Death Syndrome (SIDS) declines for older infants, always place them on their backs to sleep, without blankets and toys that could cover their mouth or nose. Use a firm mattress and a tight-fitting sheet. Do not use bumpers in a crib. Your home visitor can explain why experts say that "bare is best!" Place the mattress at its lowest position, and make sure there is nothing in the crib that your baby can use to try to climb out. To prevent infants from strangling, keep monitor cords at least three feet away from any part of the crib, play yard, or other area where infants are sleeping.

Why it works:
Mobile infants begin to roll around, crawl, and stand in their cribs, often moving around as they sleep. Eliminating toys, pillows, bumper pads, and loose blankets from cribs and sleeping areas can prevent suffocation. Children also may try to get out of the crib. Lowering the crib mattress and making sure there is nothing for your baby to climb on reduces the risk of falls. It is not safe to put monitors in or close to the area where your baby is sleeping.

19 For more information, see SIDS and Other Sleep-Related Infant Deaths: Keeping Your Babies Safe, a webinar from Healthy Child Care American, available at http://www.healthychildcare.org/PDF/Safe%20Sleep%20Webinar.pdf [PDF, 3.9MB]

Playing

Safety Tip No. 1: Use toys, equipment, and materials that have no small parts and are safe for young infants.

What families can do:
Only provide toys that are safe for mobile infants. You can use many everyday household materials [PDF, 134KB] as long as they are sturdy and easy to clean, because babies will put them in their mouths. Make sure that materials and equipment, including dolls and stuffed animals, do not have loose, small parts that could fall off and pose a choking hazard. Keep all objects that are small enough to fit into an infant's mouth out of reach. Any object, such as a button battery [PDF, 1.6MB] or magnet, is dangerous if it can pass through a small-parts cylinder (2.25 inches long by 1.25 inches wide) used for screening choking hazards for children younger than 3 years. For more information, see Which Toy for Which Child: A Consumer's Guide for Selecting Suitable Toys [PDF, 1.2MB]. Place heavier items on lower shelving in a play area.

Select equipment that will not trap an infant’s head or limbs and is appropriate for your baby’s height and weight. Always use safety straps. To find out if safety concerns have been reported about the toys and equipment you are using, you can search for product safety complaints or report a concern at www.saferproducts.gov. Sign up for recall notices from the U.S. Consumer Product Safety Commission.

Why it works:
Mobile infants are learning to transfer objects from hand to hand and hand to mouth. They explore their world through their senses, and often touch and mouth objects. With their greater mobility, they are excited about exploring their physical environment. Most infants do not have a sense of danger or caution and need safe equipment and materials to reduce the risk of injury. Providing toys and materials that contain no small or loose parts eliminates choking hazards. Storing button batteries and magnets out of reach removes hazardous materials. Placing heavier items on lower shelving reduces the risk of injury from a dropped toy. Age-appropriate equipment prevents injuries from entrapment, choking, and strangulation. Safety straps secure a child in a stroller, swing, rocker, or other equipment and reduce the risk of falls.

Safety Tip No. 2: Provide safe outdoor play environments

What families can do:
Learning about the natural world is fun for families and children of all ages, including mobile infants. Supervise children carefully in any outdoor play area. Limit sun exposure between 10 a.m. and 4 p.m. Dress infants appropriately, and keep them inside during extreme heat or cold. In warm weather, dress your baby in light clothing to cover her skin and use a wide-brimmed hat. For infants older than 6 months of age, apply sunscreen to all exposed areas at least 30 minutes before going outside and every two hours afterwards. Bring and encourage drinking water often. Keep your baby away from poisonous plants [PDF, 197KB] and any insects that may sting or bite.

Why it works:
All children need opportunities to play outside as well as inside. Providing opportunities to explore the sights and sounds in nature supports children’s development when these experiences are safe and well-supervised. Using sunscreen and a hat protects an infant from sunburn. Providing fluids frequently prevents dehydration. Knowing how to recognize plants that are poisonous and making sure that there are no insects that sting or bite protects children from injury. Mobile infants are not able to regulate their body temperature well, so keeping them inside during extreme heat or cold protects them from overheating and frostbite.

The toddler years are a time when children are building skills in all areas. They remember what they learn and share it with others. They understand things more deeply, make choices, and engage with others in new ways. The changes in their physical, cognitive, and social-emotional development help them to build new skills that prepare them for school and later learning. Read More about Toddlers 

During the toddler years, children begin to use their large and small muscles in new ways. They practice running, jumping, kicking, and throwing. Although unsteady at first, many children begin to climb stairs by the time they reach age 2. By 2-and-a-half, most toddlers who practice often have generally mastered stairs and are ready to begin climbing more challenging playground equipment. But as their mobility increases, so do the safety hazards. They need close supervision, especially when climbing. Like children of all ages, playground surfacing in areas where children play outside must cushion toddlers’ many falls. Safety gates are an important piece of safety equipment for children in this age group.

Toddlers move from mouthing things within their reach (at 1 year old) to using their fingers and hands to manipulate objects (at 2-and-a-half years and older). They also are learning more about their environment. For example, they continue to learn that a hidden object is not permanently gone, remember things that happened, sort things by characteristics, and use language to describe what they experience. They explore their world using their imaginations and the games they play. Yet, all learning requires some level of risk. Until they understand what is safe, a toddler may take risks that can lead to injury. Families with toddlers need to remove all hazards from the environment and teach children how to explore and engage in active play safely.

Toddlers interact and play with other children, but they are learning to share. They may lack the language skills to easily express their feelings or ask for what they need and want. As a result, they depend on family members to teach them how to play with other children, share and take turns, and model how to interact safely with both children and adults. Consistent routines and clear expectations can reduce the risk of challenging behaviors that may result in injuries to themselves, other children, and adults.

CLOSE

General Safety

Safety Tip No. 1: Actively supervise

What families can do:
Toddlers still want and need to stay close to you. But at this stage, they also want to be independent. Make sure you can see and reach them at all times. Your home visitor can talk to you about these Active Supervision strategies:

  • Create safe spaces by:
  • Stay close by. Be able to see, hear, and reach your child quickly if needed.
  • Keep a watchful eye. Know where your toddler is and what he is doing.
  • Listen – Notice loud noises and plan some soothing activities to change the pace after a period of active play. Check to see what a toddler is doing if you can’t hear him.
  • Anticipate your toddler’s needs. They are learning how to follow safety rules but will learn from your example and the safe behaviors that you model.
  • Engage and redirect – Toddlers can play independently some of the time but need you to stay engaged. Talk to them about their play. Intervene if your child needs some extra support to make safe choices.

Why it works:
Toddlers change constantly and continually demonstrate new interests and abilities. Young toddlers still may put things in their mouths, so any area they use must be free of small items that could be choking hazards. Active Supervision is a way to pay close attention and keep children safe, especially highly active children who are more likely to take risks when it comes to exploring the world around them. Bolting furniture to the wall can help prevent a tip-over tragedy among children in this age group who especially enjoy running, jumping, and climbing or just may be curious about an object that they can’t reach. Explaining what you do to stay safe helps children learn how to judge what is safe for them to do.

Safety Tip No. 2: Use a checklist to create safe environments

What families can do:
Create and maintain safe spaces by using a home safety checklist to identify possible hazards and make sure your home is safe for an active toddler. Regularly inspect toys, furniture, and equipment to look for splinters, sharp edges, and loose pieces to ensure they are safe and working properly.

Why it works:
As toddlers learn new skills, their interaction with the environment changes, leading to new safety risks. To practice their motor skills, they need to be able to climb, walk, run, and jump safely. Inspecting toys, furniture, and equipment protects toddlers from injury. Using a home safety checklist, and keeping in mind your child’s needs and developmental abilities now and in the weeks to come, can help you identify possible hazards so you can remove, repair, and keep you child away from objects that could be harmful.

Safety Tip No. 3: Use safety devices

What families can do:
Get and use smoke alarms [PDF, 126KB] and carbon monoxide detectors. Properly installed and maintained smoke alarms and carbon monoxide detectors save lives. Follow manufacturer’s recommendations for where to place them. Your home visitor may be able to help you obtain these devices for free or at a reduced cost. Make a schedule to routinely check the batteries to make sure they work and you know when to change them. Have a fire escape plan that describes who will get the children out of the house and where you will meet once outside. Use safety devices such as outlet covers, cabinet locks, and baby gates.

Why it works:
Smoke alarms warn you that there is a fire so you can get your family out of the building quickly. Carbon monoxide (CO) is a deadly, poisonous, odorless, and colorless gas. It may come from home heating and cooking devices. An alarm alerts you to unsafe CO levels in the home.

Many toddlers will try to climb or jump over whatever is in their way to get to what they want. You can support your toddler’s growing independence and curiosity by using inexpensive safety devices. This restricts access to objects and areas of the house that are not safe for toddlers to explore without supervision. For example, some toddlers may be able to open a door to get into a basement, run into the street, or even open a door in a moving car; you may need to use door knob covers, install a latch that was not necessary previously, and use child safety locks in the car.

Safety Tip No. 4: Make sure that windows are safe

What families can do:
Keep furniture and toys away from windows and blind cords. Curtains or cordless shades are safer than Roman shades or blinds with cords. Secure the cords and chains from window coverings [PDF, 145KB] so they are up and out of reach. Make sure windows either open from the top or have guards so they can’t open more than four inches.

Why it works:
Cords from window blinds are a strangulation hazard. Inexpensive cord safety devices are available from retail stores if you have blinds with cords. Windows can be a source of falls even when they are closed, and can pose a hazard to toddlers who are interested in what is happening outside and are becoming more active every day. A window screen is not designed to protect a child from falling.

Safety Tip No. 5: Be aware of and keep all poisons out of children’s reach

What families can do:
If you live in a house or apartment built before 1978, it may have lead paint. You can talk to your home visitor as well as your landlord, health care provider, and local health department to find out if you have lead paint in your home, and if so, what to do. Toddlers learn about their environment by exploring objects using all of their senses. Inspect your home for poisonous materials. Check to make sure indoor and outdoor plants [PDF, 197KB] are not poisonous. Place all cleaning products, chemicals, and toxic materials in locked cabinets. Craft and play materials should say they are "non-toxic." Store any products that say "keep out of reach of children" and everyday items like toothpaste out of reach. Store medications up and away. Make sure that people who live with or visit you put away their coats, purses, bags, and backpacks so that a toddler cannot reach inside for medications [PDF, 455KB] or other unsafe items. Avoid using chemicals near toddlers. Post Poison Control information in a central location.

Why it works:
There are many poisons throughout the home. Some are obvious, but others may be harder to identify. According to Safe Kids Worldwide, "every minute of every day, a poison control center answers a call about a young child getting into medicine."20 Indoor and outdoor plants, paint, craft materials, and medications are hazardous if toddlers put them in their mouth or spill chemicals on their skin. A small amount of lead is harmful to a child who swallows or breathes in dust that you may not even be able to see. Even everyday items like makeup and toothpaste can be poisonous if eaten in large quantities. To keep toddlers safe, store toxic products in locked cabinets and keep personal items out of children's reach.

Safety Tip No. 6: Check the temperature of your hot water

What families can do:
Set the temperature on your hot water heater to 120 degrees Fahrenheit or lower and check the water temperature on the inside of your wrist before bathing your child.

Why it works:
Toddlers have thin skin that burns easily. To prevent burns from scalding water in the tub or faucet, make sure that the temperature on your water heater is not higher than 120 degrees.

Safety Tip No. 7: Keep hot foods and liquids out of reach

What families can do:
Don’t hold your child when you are holding hot food or a hot beverage, cooking on the stove, or taking food out of the microwave. Place hot liquids and foods in the center of the counter or a table that is not at your child’s level. Make sure that the microwave and cords from appliances that may contain hot liquids, such as a coffee pot or crock pot, are not in reach. Keep pots on the back burner of the stove with the handles turned inward. Teach toddlers that it is not safe to climb onto a counter and turn the water on themselves. Help them use their growing independence to try to play at a comfortable distance when you are cooking. When using the microwave or stove, it is not safe for toddlers to be in the kitchen without supervision.

Why it works:
Hot liquids and steam are more likely to burn a young child’s skin from even brief contact with a hot substance that adults find comfortable. Some kitchen items contain hot liquid, such as a coffee pot or crock pot. Be sure appliances and their cords are not within reach. If young children grab your arm when you are holding hot food or drinks, or pull on a dangling cord or the edge of a tablecloth, hot food or liquid can spill on them. In one study, 90.4 percent of scald injuries to children under age 5 were related to hot cooking or drinking liquids.21 Using a baby gate so your toddler can’t go into the kitchen without you when you are cooking can prevent burns to a young child.

Safety Tip No. 8: Prevent drowning

What families can do:
Be aware of any body of water around the home, such as pools, ponds, or lakes. Always stay hands-on when bathing your toddler. Never leave a toddler alone in any type of water. Children ages 1 to 4 have the highest drowning rates, mostly in swimming pools.22 If you live in a house that has a pool, make sure that it has fencing on all sides and has "self-closing and self-latching gates that open outward, with latches that are out of the reach of children."23 Keep a phone with you, and consider learning child cardiopulmonary resuscitation (CPR). Empty buckets [PDF, 56KB] and turn them upside down when done. Close the lids to washing machines. Use door knob covers on bathroom doors, locks on the toilets, or keep bathroom doors closed, and make it a family rule that children only go into the bathroom with an adult.

Why it works:
Drowning happens quickly and silently. A toddler or small child can drown within 30 seconds in as little as two inches of liquid, so be actively engaged whenever a child is in or near any water. Young children can be taught to swim, but even if you think your child is comfortable in the water, never leave a child unsupervised in or near any body of water. Curious toddlers can pull themselves up and lean inside a bucket or reach for a toy in the pool, but their heads are bigger than their bodies. If they fall in, they are unable to get out and can drown.

Safety Tip No. 9: Prepare for emergencies

What families can do:
Post important emergency phone numbers such as poison control, 911, and your child’s doctor in a central location, or program them into your mobile phone. This is especially important if your child has a special health care need. Prepare for common weather-related emergencies. Keep basic first aid and disaster supplies on hand. You also can talk to your home visitor about opportunities to learn child CPR and first aid.

Why it works:
Families that prepare for emergencies have a better chance of getting help quickly when needed. Emergency responders and poison control professionals can provide instruction about first aid treatment for different types of injuries.

Safety Tip No. 10: Always use a car seat for your child

What families can do:
Select a car seat based on your child’s age and size, and that fits in your vehicle, and use it every time your child rides in your car or truck. Install the car seat according to the manufacturer’s instructions to ensure that it protects your child. When children outgrow their rear-facing seats, use a forward-facing car seat until they reach the upper weight or height limit of their particular seat. Find an inspector who can check your child’s car seat and make sure it is installed correctly.

Why it works:
Motor vehicles are the second leading cause of death among children ages birth to 4.24 The best way to protect your child from injury in a crash is to make sure that he is always seated in the back seat in a car seat that is appropriate for his age and size. Car seat use reduces the risk of death to infants and young children (aged 1 to 4 years) in passenger vehicles by 54 percent.25 Young children are more likely to be hurt in the front seat. Front air bags are designed to protect adults, not children, and can be dangerous to children seated in front of them.

20 Safe Kids Worldwide (2014). Medicine Safety 2014 Infographic. Retrieved from http://www.safekids.org/infographic/medicine-safety-2014-infographic

21 Lowell, G., Quinlan, K., and Gottlieb L. J. (2008). Pediatrics 122:799-804.

22 Centers for Disease Control and Prevention (2014). Unintentional Drowning: Get the Facts. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Water-Safety/waterinjuries-factsheet.html

23 Centers for Disease Control and Prevention (2011). Stay Safe In and Around Swimming Pools. Retrieved from http://www.cdc.gov/Features/dsSafeSwimmingPool/

24 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2012). The National Action Plan for Child Injury Prevention. Atlanta, GA: CDC

25 Centers for Disease Control and Prevention, Injury Prevention and Control: Motor Vehicle Safety (2014). Retrieved from http://www.cdc.gov/MotorVehicleSafety/Child_Passenger_Safety/CPS-Factsheet.html

Diapering and Toileting

Safety Tip No. 1: Stay hands-on and engaged

What families can do:
For toddlers that are not yet toilet training, provide safe ways for them to climb onto or off of changing tables. Help toddlers that are toilet training to climb onto or off the toilet safely if they are no longer using a "potty chair." To prevent falls, keep a hand on toddlers at all times while changing diapers if you are using a changing table or other high surface rather than the floor. Engage active toddlers in reciprocal (back and forth) play such as singing and rhyming. In addition, toddlers can participate in diapering activities by handing you a diaper.

Why it works:
During diapering, toddlers may move around, so staying hands on prevents injuries. Teaching toddlers how to safely climb onto or off of a changing table or the toilet if they are not using a potty chair supports their independence. Encouraging your toddler’s active participation reinforces the importance of safe daily routines.

Safety Tip No. 2: Store diapering supplies safely

What families can do:
Keep diaper changing materials, including wipes and ointments, where you can reach them easily but are away from a toddler’s grasp. Wash the diaper changing area [PDF, 351KB] after each use, and store the supplies out of your child’s reach. Wait until your child has left the area to prevent exposing your toddler to the chemicals in these products.

Why it works:
Toddlers will want to touch any materials that are within their grasp. Diapering supplies, such as medications and ointments for skin conditions and disinfectant supplies, can be harmful to young children. Many of the items close to the diaper-changing area—spray bottles, disinfectant wipes, medications, ointments, or other materials containing toxic ingredients—can burn or poison a child who has contact with them.

Eating

Safety Tip No. 1: Choose age-appropriate foods

What families can do:
Choose age-appropriate foods that your family prefers and cut them into small pieces (cubes no larger than ½ inch in size) to prevent choking. Avoid all high-risk foods. These include small, slippery foods, dry foods that are hard to chew or sticky, and tough foods.

Why it works:
Toddlers are still learning how to coordinate their mouths to fully chew and swallow food. They also grow teeth at varying rates and may not be able to chew or break down certain foods. Therefore, it is safest to feed toddlers foods that they can easily break apart and swallow whole.

Safety Tip No. 2: Position children to eat safely

What families can do:
Toddlers can sit in chairs at tables that are appropriate for their age and size. If they are still using a low feeding chair, be sure it is appropriate for your child’s size and weight. Your child can sit in a booster chair or seat at the table for family style eating as long as you use the safety straps. Make a family rule that children and adults must be seated while eating. Teach toddlers how to feed themselves safely using a child-sized fork, spoon, and cup.

Why it works:
Toddlers may try to climb while eating. Furniture that is low to the ground minimizes the risk of injury from falls. Safety straps secure a child in a booster seat or chair so your child doesn’t fall out. Sitting while eating and drinking minimizes the risk of children choking or of a dental injury from falling with a cup or utensil in their mouth. Toddlers are becoming more independent and can feed themselves using child-sized cups, spoons, and forks with blunt points. For more information regarding safe self-feeding, you may want to read Encouraging Self-Feeding by Older Infants and Toddlers.

Sleeping

Safety Tip No. 1: Use safe cribs (for younger toddlers)

What families can do:
Use a crib that was manufactured on or after June 28, 2011. Cribs made after this date must meet the current safety standard. Drop-side cribs do not meet current safety regulations.Your home visitor can help you find a safe crib. If young toddlers are trying to climb from the crib, consider using a bed that is low to the ground.

Why it works:
Toddlers may reach their arms through the slats in a crib or put their fingers into places that can pinch or cut them. Toddlers are more likely to try to climb from a crib, particularly as they get closer to age 2. Cribs are only safe to use if a toddler is not able to climb out.

Safety Tip No. 2: Offer child appropriate sleeping furniture (for older toddlers)

What families can do:
Select an age-appropriate toddler bed and side rail. Do not place the bed close to the window, and use window guards or locks to prevent falls. You may need to help your child learn how to stay in his bed to fall asleep.

Why it works:
When toddlers begin sleeping on a cot or bed, they may get up or fall out of their bed. They may need some time to develop a nightly routine and get used to the freedom of not being in a crib. Keeping the bed away from the window and installing window guards or locks prevents falls.

Playing

Safety Tip No. 1: Use toys, equipment, and materials that are safe for toddlers and have no small parts

What families can do:
Only provide toys that are safe for toddlers. You can use many everyday household materials [PDF, 134KB] as long as they are sturdy and easy to clean because toddlers will put them in their mouth. Place heavier items on lower shelving in a play area. Place any object that is small enough to fit into a toddler's mouth out of reach. Make sure that materials and equipment, including dolls and stuffed animals, do not have loose, small parts that could fall off and pose a choking hazard. This includes small toys such as marbles, balloons, small balls, and coins, as well as parts of toys that may break off, like buttons on a teddy bear.12 Any object, such as a button battery [PDF, 1.6MB] or magnet, is dangerous if it can pass through the small-parts cylinder (2.25 inches long by 1.25 inches wide) used for screening choking hazards for children younger than 3 years. For more information, see Which Toy for Which Child: A Consumer's Guide for Selecting Suitable Toys [PDF, 1.1MB].

Select equipment that will not trap a toddler’s head or limbs. Ensure that equipment is appropriate for a toddler’s height and weight. Safety straps secure a child in a stroller, swing, or other equipment and reduce the risk of falls. To find out if safety concerns have been reported about the toys and equipment you are using, you can search for product safety complaints or report a concern at www.saferproducts.gov. Sign up for recall notices from the U.S. Consumer Product Safety Commission.

Why it works:
Providing toys and materials that contain no small or loose parts eliminates choking hazards. Storing button batteries and magnets out of reach removes hazardous materials. Placing heavier items on lower shelving reduces the risk of injury from a dropped toy. Following the manufacturer’s instructions regarding height and weight restrictions on equipment protects toddlers from injury.

Safety Tip No. 2: Teach toddlers how to use materials and equipment safely

What families can do:
Teach toddlers how to use materials and equipment appropriately. Examples include, "crayons are for coloring" and "paint brushes are for painting." Creating routines helps maintain a safe environment. This includes teaching toddlers to clean up and put items away when they are finished using them. Teach toddlers how to use outdoor equipment like balls and scooters safely. This includes using helmets when riding tricycles, scooters, big wheels, and other riding toys.

Why it works:
Toddlers begin to use equipment and materials for projects while they play. They learn by watching and will copy the behavior of other children and family members. By demonstrating clear expectations and how to use materials and equipment properly, you can help your child learn basic safety rules and routines.

Safety Tip No. 3: Provide safe outdoor play environments

What families can do:
Learning about the natural world is fun for families and children of all ages, including toddlers. Supervise children carefully in any outdoor play area. In the warm months, be aware of temperature, humidity, and direct sun. Check play equipment and surfaces that may get hot in the sun. Consider your child’s age and where you live when choosing and using a sunscreen product. Follow the label instructions for proper application. A wide-brim hat and loose fitting clothing also provide some protection. Bring and encourage drinking water often. Keep toddlers away from poisonous plants [PDF, 197KB] and any insects that may sting or bite. During cold months, be aware of temperatures and wind chill. Dress children appropriately and ensure their heads, fingers, and feet are covered. Limit children’s outdoor play in extreme heat or cold.

Why it works:
Providing opportunities to explore the sights and sounds in nature supports children’s development when these experiences are safe and well supervised. Knowing how to recognize plants that are poisonous and making sure that there no insects that sting or bite protects children from injury. Surfaces such as pavement, sidewalks, slides, and swings absorb the heat of the sun and can burn a toddler’s sensitive skin. Sunburns are painful and can increase a child’s risk of skin cancer. Frostbite may require medical treatment. Toddlers do not regulate their body temperature well. Providing fluids frequently prevents dehydration. Keeping toddlers inside during extreme heat or cold protects them from overheating and frostbite.

Safety Tip No. 4: Teach toddlers about pedestrian safety

What families can do:
Toddlers need close supervision when they play outside. Teach your child to watch for cars and trucks, and never to run into the street to chase a ball. You also can begin to teach toddlers about traffic lights, holding hands with an adult, and following directions when crossing the street. Find additional tips, lessons, and teaching strategies at Safe Kids Worldwide.

Why it works:
Toddlers are beginning to explore the world outside their homes. They have opportunities to walk to the neighborhood park, school, or other community locations with a family member. It may be hard for drivers and cyclists to see them, so toddlers need to understand pedestrian safety and learn how to follow safety rules outside the home.

1 Morrongiello, B., & Corbett, M. (2008). Elaborating a Conceptual Model of Young Children's Risk of Unintentional Injury and Implications for Prevention Strategies. Health Psychology Review, 2(2).

2 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2014, August). Retrieved from http://www.cdc.gov/injury/overview/leading_cod.html

Additional Resources

Last Reviewed: September 2015

Last Updated: September 29, 2015