Household Safety: Preventing Injuries From Falling, Climbing, and Grabbing

Babies reach, grasp, roll, sit, and eventually crawl, pull up, "cruise" along furniture, and walk. At many stages in the first 2 years or so, they're able to move around, tumble over, and get into things in one way or another. And climbing is something all kids do, but toddlers may not have the coordination to react to certain dangers. They'll pull themselves up using table legs; they'll use bureaus and dressers as jungle gyms; they'll reach for whatever they can see.

So the potential for a dangerous fall or a tumble into a sharp edge can happen in nearly every area of your home at nearly every age. Here are some steps you can take to help prevent your child from getting hurt in your home:

Walkers

• Don't use a walker for your infant. Baby walkers send more than 14,000 children to the hospital every year for falls and other injuries, according to the American Academy of Pediatrics (AAP), which discourages parents from using them. Babies in walkers can fall over objects; roll into hot stoves, pools, and heaters; and roll down stairs. Walkers may give a baby the momentum needed to break through a gate (sometimes with stairs on the other side).
• Instead of a walker, use a stationary activity saucer.

Windows

• Don't rely on window screens to keep children from falling out of windows.
• Open windows from the top or use window guards to prevent your child from falling through screens or open windows (kids can fall from windows opened as little as 5 inches, or 12.7 centimeters). Make sure window guards are childproof but easy for adults to open in case of fire.
• Move chairs, cribs, beds, and other furniture away from windows to prevent children from climbing onto sills.

Stairs

• Never leave a child unattended around stairs - even those that are gated. Babies can climb up the gate at the top of the steps and fall from an even greater height. Properly install a safety gate at the door of your child's room to prevent the baby from ever even reaching the top of the stairs.
• Keep stairways clear of toys, shoes, loose carpeting, etc.
• Place a guard on banisters and railings if your child can fit through the rails.
• Install hardware-mounted safety gates at the top and bottom of every stairway (pressure-mounted gates aren't as secure).
• Avoid accordion gates, which can trap a child's head.
• When you child reaches 10 to 12 months old, teach him or her how to go down stairs backward - your child's only example is you going down forward.

Around Your Home

• Don't keep loose rugs on the floor. Put specially designed pads under rugs to hold them securely to the floor's surface.
• Never put babies in child safety seats, infant seats, or bouncer seats on a countertop or atop furniture. The force of the baby's movements could propel the seat over the side and cause serious injuries.
• Make sure all pieces of furniture a child might climb on - tables, bureaus, cabinets, TV stands, etc. - are sturdy and won't fall over. Be particularly careful of top-heavy pieces like overloaded bookshelves or entertainment centers that can fall on your child. You can also buy "L" brackets to attach furniture to walls to prevent your child from climbing on furniture and having it topple over.
• Attach protective padding or other specially designed covers to corners of coffee tables, furniture, and countertops with sharp edges.
• Clean up any spills around the home immediately.
• Apply nonskid strips to the bottoms of bathtubs.

Cribs, Beds, and Changing Tables

• Never leave a baby unattended on a changing table or bed. If the phone rings while you have your baby on the changing table, bring the baby with you while you answer the call. If you must leave for a moment, put the baby on the floor or in a playpen or crib.
• Don't put a child under age 6 on the top bunk of a bunk bed. Attach guardrails to the side of the top bunk.
• Keep side rails up on cribs.
• Use changing tables with 2-inch (5-centimeter) guardrails.
• Always secure and use safety belts on changing tables, as well as on strollers, carriages, and highchairs. Be sure to strap a small child securely into the seat of a store shopping cart.
• Remove bumpers from cribs once your baby starts to pull up and stand to prevent him or her from using the bumpers to try to climb out of the crib.

Outdoors

• Never allow a child to play on a trampoline, even with adult supervision.
• Be sure outdoor playground equipment is safe, with no loose parts or rust.
• Make sure playground surfaces are soft enough to absorb the shock of falls. Good surface materials include sand and wood chips; avoid playgrounds with concrete and packed dirt.
• Make sure sidewalks and outdoor steps are clear of toys, objects, and anything blocking a clear path. Repair any cracks or missing pieces in walkways.
• If your child has started to ride a bike, make sure he or she wears a helmet and is well-versed in bicycle safety and signals. Head injuries are far too common in this age group, so enforce your helmet rule.

Be Prepared

If you're expecting a baby or you already have a child, it's a good idea to:

• Learn cardiopulmonary resuscitation (CPR) and the Heimlich maneuver.
• Keep the following numbers near the phone (for yourself and caregivers):
  • toll-free poison-control number
  • child's doctor's number
  • parents' work and cell phone numbers
  • neighbor's or nearby relative's number (if you need someone to watch other children in an emergency)
• Make a first-aid kit and keep emergency instructions inside.
• Install smoke detectors and carbon monoxide detectors.

Maintaining a Safe, Kid-Friendly Environment

To check your childproofing efforts, get down on your hands and knees in every room of your home to see things from a child's perspective. Be aware of your child's surroundings and what might be potentially dangerous.

Completely childproofing your home can be difficult. If you can't childproof the entire house, you can shut the doors (and install doorknob covers) to any room a child shouldn't enter to prevent wandering into places that haven't been properly childproofed. For sliding doors, doorknob covers and childproof locks are also great for keeping little ones from leaving your home. Of course, how much or how little you childproof your home is up to you. Supervision is the very best way to help prevent kids from getting injured. However, even the most vigilant parent can't keep a child 100% safe at all times.

Whether you have a baby, toddler, or school-age child, your home should be a haven where your little one can explore safely. After all, touching, holding, climbing, and exploring are the activities that develop your child's body and mind.

Reviewed by: Mary L. Gavin, MD
Date reviewed: November 2007

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