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Health, Safety, and Nutrition: Do

Try these practices with infants and toddlers and preschool-aged children. Find out how home visitors can put these practices to work with families.

Infants and Toddlers1,2,3

  • Talk with children during routine care such as diapering/toileting, dressing, mealtime, and naptime. Describe what you and the children are doing and how these routines keep them healthy and safe.
  • As children are able, encourage them to participate in and complete parts of the routine on their own (e.g., infant lifts his arms so you can take his shirt off; toddler gets her "lovey" before lying down on a mat for nap).
  • Establish practices for self-care such as washing hands, brushing teeth, managing sneezes, and safety (e.g., rules for safe play behavior, such as not standing on tables or chairs and not putting small objects in the mouth; using indoor and outdoor play equipment safely; holding an adult's hands or a rope when crossing the street). Use gentle verbal reminders, gestures, physical prompts, and visuals (e.g., photos, illustrations) to help children learn and remember what, why, and how to do it and when it is done.
    • Make sure to follow your program's policies and procedures for promoting good oral health for infants and toddlers. For example, clean an infant's teeth and gums regularly with a clean, damp washcloth or toothbrush with soft bristles and a small head made for infants. Put a smear of fluoride toothpaste on the toothbrush. Brush the child's teeth or help the child brush. Children need help with brushing until their hand coordination is better.
  • Balance keeping toddlers safe with allowing them to take and manage age-appropriate risks as they explore their indoor and outdoor environments. Allowing children to take safe risks in play helps them test their physical limits, develop perceptual motor abilities, and learn to avoid and adjust to environments and activities that may be dangerous.
    • For example, if a child is attempting to walk up a hill that is slippery, say, "This hill is slippery. Let's take our time walking up," instead of, "Be careful, be careful." The first suggestion offers concrete guidance for how to manage a physical challenge; the second does not and may stop the child from exploring the hill and his ability to climb it.
  • Talk with parents of infants about the food their child eats. Coordinate offering new food to infants with when parents do so.
  • Serve all foods, including fruit which is often considered dessert, at the same time. Allow children to eat food in the order or combination they prefer.
  • During mealtimes, encourage children to let you know when they are full. With infants, watch for cues (e.g., turning face away from bottle or spoon). The goal is for children to eat what they need, not to "clean the plate."
  • Provide toddler-sized utensils to encourage self-feeding. Provide small pitchers and help toddlers pour liquid into cups, as needed.

Preschoolers4,5

  • Teach children a song to remind them how to wash their hands. Sing, "Wash, wash, wash my hands. Make them nice and clean. Rub the bottoms and the tops. And fingers in between," twice to the tune of "Row, Row, Row Your Boat."
  • Introduce the idea of invisible germs. Put a tiny dot on a piece of paper and post it on the wall. Have children stand at the opposite side of the room and tell you if they can see the dot. Have them move closer until they can see the dot; explain that the dot is there, but it is so small they could not see it from across the room. Explain that some germs can make people sick, and that is why things like handwashing, especially during flu season, are important to stay healthy.
  • Take a walk in the neighborhood and look for safety signs. Talk with children about what the signs mean and why it is important to follow them.
  • Talk with children about safe indoor and outdoor play practices. Invite them to help you come up with simple rules (e.g., take turns on the slide; wear a helmet when riding a tricycle; stand on the floor, not on the table). Keep the number of rules small. Provide gentle reminders as needed. Acknowledge when you see children follow the rules and use safe practices.
  • Balance keeping children safe with allowing them to take and manage age-appropriate risks as they explore their indoor and outdoor environments. Allowing children to take safe risks in play helps them test their physical limits, develop perceptual motor abilities, and learn to avoid and adjust to environments and activities that may be dangerous.
    • For example, if a child is attempting hang upside down from a bar on the playground climbing structure, say, "I'm going to stand close and spot you so that you can hang upside down safely," instead of, "Don't do that. You're going to fall and get hurt if you do." The first suggestion offers concrete guidance for how to manage a physical challenge; the second does not and may stop the child from exploring her physical and perceptual abilities.
  • Promote language development by helping children learn what to say in an emergency and who to tell (e.g., a police officer, crossing guard). Have each child recite, sing, or sign his or her full name and address, both in English and in the family's home language.
  • Invite guests or provide field trips so children can meet firefighters, police officers, crossing guards, paramedics, street patrols, and other safety helpers.
  • Use cooking activities to combine nutrition with other areas of learning. For example, introduce new vocabulary using large recipe cards. Incorporate math through measuring ingredients and counting the final product. Incorporate science when noting how ingredients change when liquids are added or when cooked.
  • Schedule field trips to gardens, farms, orchards or nearby fruit trees, local produce markets, kitchens, restaurants, grocery stores, or other places where food is grown, sold, or prepared.
  • Help children experience gardening by growing herbs, fruits, or vegetables in pots (indoors or outdoors).
  • Introduce many different foods, taking into consideration any food-related allergies, cultural practices, and physical disabilities. Talk about healthy foods and making good food choices.

Home Visitors

Home visitors can support parents in identifying, adapting, and trying practices listed above during home visits and group socializations. Here are more ideas.6,7

  • Learn from parents about their values and beliefs related to child health, safety, and nutrition practices. In addition, ask about their expectations for their child's independence around self-care. For example, some parents may feed and dress their preschool-aged child, while others encourage their child to feed himself and do some dressing tasks independently. This will help you be sensitive to and provide appropriate information and guidance when you talk about these topics.
  • Ask parents about their safety rules and maintaining a safe environment for their child (e.g., household cleaners and medications out of reach, electrical sockets covered, appropriate and consistent use of car seats and seat belts, holding hands when crossing the street, gun safety, etc.). Provide recommendations and resources as needed. Know which community resources promote safety and what they can offer parents and families so you can share that information.
  • Describe the importance of adult supervision. Young children can learn scripts (e.g., "Stop, look, and listen" when crossing the street) but have no impulse control (e.g., when a ball rolls into the street, they can't accurately judge how far away cars are or how fast they are going).
  • Talk with parents about healthy nutrition and share strategies for encouraging their child's healthy eating habits.

1Massachusetts Association for the Education of Young Children, Massachusetts Early Learning Guidelines for Infants and Toddlers (Boston, MA: Massachusetts Department of Early Education and Care, 2010), 70–72, 76, 149–152, Physical Health and Wellbeing, http://www.eec.state.ma.us/docs1/Workforce_Dev/Layout.pdf.

2National Center on Early Childhood Health and Wellness (ECHW), Oral Health/How Can You Promote Good Oral Health? (Washington, DC: HHS, ACF, OHS, ECHW, n.d.), https://eclkc.ohs.acf.hhs.gov/sites/default/files/pdf/oral-health-staff-tips.pdf.

3Brussoni, Mariana, Lise L. Olsen, Ian Pike, and David A Sleet, "Risky Play and Children's Safety: Balancing Priorities for Optimal Child Development," International Journal of Environmental Research and Public Health 9, no. 9 (September 2012): 3134–3148, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3499858/.; Chicot, Rebecca, "How to Develop Good Risk Taking Skills in Your Toddler," Essential Parent (n.d.), https://www.essentialparent.com/lesson/how-to-develop-good-risk-taking-skills-in-your-toddler-2210/.

4California Department of Education, California Preschool Curriculum Framework Volume 2 (Sacramento, CA: author, 2011), 234–237, Health Habits, 253–275, Safety and Nutrition, http://www.cde.ca.gov/sp/cd/re/documents/psframeworkvol2.pdf.

5Brussoni, Mariana, Lise L. Olsen, Ian Pike, and David A Sleet, "Risky Play and Children's Safety: Balancing Priorities for Optimal Child Development," International Journal of Environmental Research and Public Health 9, no. 9 (September 2012): 3134–3148, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3499858/.; Wilkinson, Rachel, "Outdoor Risky Play for All," Outdoor Learning in the Early Years (blog), n.d., https://earlyyearsoutdooreducation.wordpress.com/outdoor-risky-play-for-all/.

6Early Head Start National Resource Center (EHS NRC), OpenDoors Home Visitor's Handbook (Washington, DC: HHS, ACF, OHS, EHS NRC, 2014), Chapter 10.3, Physical Development and Health, How To.

7California Department of Education, California Preschool Curriculum Framework Volume 2 (Sacramento, CA: author, 2011), 255–256, Safety, http://www.cde.ca.gov/sp/cd/re/documents/psframeworkvol2.pdf.

Last Updated: August 3, 2018