Health and Safety, Birth to 2 Years

Topic Overview

This topic suggests ways to help prevent illness and accidental injuries in babies and young children. It doesn't cover every risk that a child faces. But it does cover many of the most common hazards and situations that can be dangerous to a child in this age range.

What can you expect from your child at this age?

Watching your child grow is a wonder. But there are concerns in this age range:

• Your child cannot understand and recognize danger. You need to take steps to keep your child safe from everyday hazards, both inside and outside the home.
• Your child's immune system isn't fully developed. This makes it more likely that your child will get bacterial and viral infections.

Remember that no one can watch a child's every move or make a home 100% safe all the time. Try to find a balance among supervising your child, taking safety precautions, and allowing your child to explore. Learn all you can about child growth and development. Doing so can help you learn how to respond to and make a positive impact on how your child behaves.

What can you do to help keep your child safe?

You can:

• Supervise your child both inside and outside the house. For example, always use a car seat, and watch your child closely when he or she interacts with pets.
• Practice healthy habits. Protect your child against illness and infection. For example, wash your hands often, keep toys clean, make sure your child is immunized, and go to all well-child visits. Be sure all visitors are up to date with their vaccinations.
• Take safety measures around the home. For example, use sliding gates in front of stairs, and keep rubber bands and other small objects out of reach. And always place your baby to sleep on his or her back.

What kinds of equipment can be hazardous?

Car seats, cribs, strollers, playpens, and high chairs are all often used by infants and toddlers up to age 2. If any of this equipment is worn or broken, or if you use it incorrectly, it can be dangerous.

If you buy or are given used equipment, make sure it meets current safety standards and has not had any safety recalls. You can check recall information from the U.S. Consumer Product Safety Commission online at www.cpsc.gov or by calling 1-800-638-2772.

How can your stress level affect your child's safety?

Taking care of yourself is a vital part of keeping your child safe. Most injuries to children occur when parents or caregivers are tired, hungry, or emotionally drained or are having relationship problems. Other common causes of family stress include changes in daily routines, moving to a new house, or expecting another child.

If you feel stressed, get help. Talk to your doctor or your child's doctor, or see a counselor. Get together regularly with friends, or join a parenting group.

Call 911 right away if you feel that you are about to hurt yourself or your child.

Frequently Asked Questions

Healthy Habits for Preventing Infection and Illness

The immune systems of babies and young children up to 24 months of age are still developing. This makes them especially prone to getting sick after being exposed to viruses and bacteria. Exposure to common pathogens can occur from person-to-person contact and from improperly prepared food. Good hygiene practices can help you protect your child from exposure to these germs.

Safe food preparation

You can prevent most cases of food poisoning by being careful when you prepare and store food. Wash your hands and working surfaces while preparing food, cook foods to safe temperatures, and refrigerate foods promptly. Be especially careful when cooking or heating perishable foods, such as eggs, meats, poultry, fish, shellfish, milk, and milk products.

To help prevent food poisoning:

• Prepare food safely.
• Shop safely.
• Cook foods safely.
• Store foods safely. Take special care when storing breast milk or formula for bottle-feedings.
• Follow labels on food packaging.
• Choose restaurants wisely. Be sure they handle food safely.

For more information, see the topic Food Poisoning and Safe Food Handling.

Protect against the spread of illness

Colds and flu can occur at any time of year. These upper respiratory infections (URIs) spread easily. Babies and young children have a higher risk for secondary infections from these illnesses. Take extra care to help protect your child against infections.

• Be sure your child gets all needed vaccines (immunizations). These vaccines provide important protection for your child against harmful disease. Be sure all visitors are up to date with their vaccinations. For more information, see the topic Immunizations.
• Avoid germs and people who are sick. Keep your child away from other people who are obviously ill. And avoid exposing your child to a large crowd, especially when an easily spread illness is going around.
• Wash your hands and wash and disinfect surfaces and toys often to help prevent the spread of germs.

Visit the doctor regularly

Go to all well-child visits. During these visits, the doctor:

• Gives your child a general physical exam.
• Gives or schedules immunizations.
• Asks you questions about your child's health and development and whether you have any concerns.

Safety Measures Around the Home

From birth to age 2, children depend on parents and other caregivers for their safety. Safety issues change and increase rapidly in number as newborns grow into toddlers.

You can help protect your child from accidents and injuries by taking general safety measures around your home. Think ahead about what potentially dangerous situations will attract your child. Supervise your child, but keep in mind that constant hovering over children can limit their experiences and confidence. Balancing supervision with safety precautions will help prevent accidents and injuries, as well as allow children to explore.

The following are common accidents and injuries that can occur around the house and some suggestions on how to prevent them.

Baby products

In the United States, safety standards for children's equipment, furniture, clothing, and other items are set by the Consumer Product Safety Commission (CPSC). Although most new items you buy will likely meet these standards, older and used items may not. Equipment that has been used before, such as a baby carrier, may not be safe. These items may have wear and tear that affects how they function. The CPSC may also have recalled some items because of reported hazards.

Check that all the products your baby uses meet current standards. The following list provides safety information for items frequently used by children up to age 2:^{footnote 1}

• Cribs should meet all current safety standards, such as having less than 2.4 in. (60 mm) of space between slats. Don't use sleep positioners or bumper pads.
• Baby walkers should not be used, according to the American Academy of Pediatrics. Children can fall down stairs and get hurt. An activity center is a better choice.
• Playpens should have spaces in the mesh material that do not exceed 0.25 in. (0.6 cm) across. Wooden slats should measure less than 2.4 in. (60 mm) apart. Be careful about the toys you put in the playpen. As your children grow, they can get tangled in mobiles or may use larger toys as steps to boost them out of the enclosure.
• High chairs should have a wide, stable base. Always take time to make sure the high chair is locked in the upright position before use. If you need to use a seat that hooks onto a table, make sure it locks onto the table. And make sure your baby can't push against the table support. Use the safety straps, and supervise your child at all times while he or she is in the high chair.
• Changing tables should have a railing on all sides that is 2 in. (5.1 cm) high. A slightly indented changing surface is also recommended. Always use the safety strap, and keep one hand on your child. Have diapers and other items handy, but keep them out of your child's reach.

To help you keep track of important safety features, see the topic Nursery Equipment Safety Checklist.

Safe sleeping and sudden infant death syndrome (SIDS)

Sudden infant death syndrome is one of the most common causes of death for babies 1 month to 12 months old.

Although SIDS cannot be predicted or completely prevented, placing your baby to sleep on his or her back can help prevent this tragedy. For more information, see the topic Sudden Infant Death Syndrome (SIDS).

Falls

You can prevent many falling accidents by using common sense and appropriate equipment that meets all safety standards. Recognize new hazards that your baby may bump into or stumble over as he or she learns to scoot, crawl, and walk. And don't allow your child to walk or run with objects in his or her mouth. Your unsteady toddler could get face and mouth injuries in addition to other injuries from falling.

Choking

• Prevent choking. Your child can choke on things smaller than 1.25 in. (3.2 cm) in diameter and 2.25 in. (5.7 cm) long. These include button batteries and coins. Keep items like these out of your child's reach.
• Learn to recognize signs of choking. For example, a child who is choking can't talk, cry, breathe, or cough.

Strangulation and suffocation

A young child can strangle from a variety of household items. Protect your child by minimizing these hazards:

• Keep cords for blinds and drapes out of your child's reach. Attach cords to mounts that hold them taut, and wrap them around wall brackets.
• Cords with loops should be cut and given safety tassels instead.
• Never use accordion-style gates. A baby or young child may trap his or her head in the gate and may strangle.
• Make sure that furniture does not have cutout portions or other areas that can trap your child's head.

Suffocation is another danger for young children. Teach your child about suffocation and the importance of a safe play area. Pay attention to possible suffocation dangers, such as:

• Trunks of cars. Keep rear fold-down seats closed so children aren't able to climb into the trunk from inside the car. Also, always lock car doors, and keep the keys out of your child's sight and reach.
• Refrigerators and freezers, even those that are not in use. If you are storing an old refrigerator or freezer, remove the door.
• Plastic sacks. Do not let your child play with plastic sacks, and keep them out of his or her reach. Many children like to play with sacks and put them over their heads.
• Be careful with baby slings. Keep your child's chin up, and keep his or her nose and mouth away from the fabric. Make sure you can see your baby's face.

Poisoning

• Prevent poisoning from common household items. Identify any products that could harm your child when eaten or inhaled. Store these products out of your child's reach. If you have a possible poisoning emergency, call 1-800-222-1222. For more information, see the topic Poisoning.
• Prevent lead poisoning. Children may chew on contaminated paint flakes or painted objects. Homes built before 1978 may still have lead paint on walls and other surfaces. For more information about lead, see the topic Lead Poisoning.
• Prevent carbon monoxide (CO) poisoning. Use a carbon monoxide detector, and have your furnace checked each year. High CO levels quickly affect young children because of their small size. For more information, see the topic Carbon Monoxide Poisoning.
• Protect your child from secondhand smoke, mold, and other indoor air pollutants. They can affect health and safety. For more information, see Tips for Reducing Indoor Pollutants in Your Home.

Fire hazards and burns

• Prevent household fires by having and maintaining smoke detectors, planning and practicing escape routes, and teaching your child basic fire safety skills. Young children are often curious about fire. Warn your child about the dangers of fire, and explain why only grown-ups are allowed to use it.
• Prevent burns. Serious burns are most often caused by heat, electricity, or chemicals. Prevent burn injuries to your child by identifying dangers in your home and removing them or blocking your child's access to them. For more information, see the topic Burns and Electric Shock.
• Enjoy fireworks from a distance. Fireworks injure children each summer. Children can also get burns from using and being around firecrackers and sparklers.

Guns and other weapons

Gun and firearm safety measures should be established for all households and especially those where children live or visit. All guns and firearms should be kept in a locked area, unloaded, and out of reach of children. Also store knives (even kitchen knives), swords, and other weapons safely out of reach.

Pets

Teach children how to interact with pets. Teach them to never tease animals or bother them while they are eating. Explain that animals can sometimes hurt you. Also be sure to train your own pets and keep them healthy.

Drowning

Drowning is a leading cause of death in young children. Help prevent drowning by following these tips:

• Supervise all baths at all times. Always stay within arm's reach of your child. Never leave your child alone in the tub-even with an older sibling.
• Deal with water hazards, and teach swimming safety. Teach your child the rules of safe swimming and how to swim. Empty all buckets and coolers when not in use. Keep toilet lids down, and consider securing them with safety latches.
• Keep pools and hot tubs safe. If you have your own pool or pond, keep it fenced. Never leave your child unattended near water.

In addition to these precautions, learn first aid and CPR (cardiopulmonary resuscitation). Knowing these skills can make the difference between life and death in an emergency situation. For more information, see the topic Dealing With Emergencies.

Safety Measures Outside the Home

You cannot protect your child from every danger he or she can possibly encounter outside the home. But you can take reasonable precautions and teach your child basic safety rules. This general training can help prepare your child for many situations he or she may face.

Prevent accidents by using safe equipment, teaching safety awareness, and closely supervising your child.

Basic safety precautions

• Help your child become "street smart." Teach your child basic rules about the dangers of cars and streets.
• Protect your child from too much sun or heat when outdoors. Keep babies younger than 6 months out of the sun. Older babies and children need to stay in the shade or cover up with a hat and clothing when outdoors from 10 a.m. to 4 p.m. Have your child wear UV-blocking sunglasses. And put broad-spectrum sunscreen (SPF 30 or higher) on any exposed skin, even when it's cloudy. Be careful that your child does not develop heat exhaustion from being out in warm temperatures. Small bodies can develop these problems much more quickly than adults. Do not keep your child out in warm weather for long periods, and keep water or other drinks on hand. To learn more, see the topic Heat-Related Illnesses.
• Use insect repellents to prevent bites and stings. Also, take action to lower your child's chances of being stung by an insect by having your child wear socks, closed shoes, and clothes that fully cover his or her body when outdoors. To learn more, see Insect Bites and Stings and Spider Bites.
• Keep your child safe near water. Never leave your child unattended near water.

Choosing child care

Before your child visits an unfamiliar home, ask the homeowner whether you need to be aware of any dangerous areas, pets, or other safety issues. It is always a good idea to see the household for yourself. Don't be afraid to voice any concerns you have about safety. You are ultimately responsible for protecting your child.

Before enrolling your child in day care, evaluate the environment and talk with care providers. Ask questions about their safety guidelines. Identify any hazards, and ask how they are handled. For more information, see the topic Choosing Child Care.

Going along for the ride: Exercising caution

When you include your child in your activities, be sure to recognize the related safety issues. And focus on your child's comfort and safety.

• Always use a car seat and have your child ride in the back seat of your car. Car accidents are the leading cause of death and injury in young children. Follow basic guidelines established by the American Academy of Pediatrics (AAP). See the AAP website at www.healthychildren.org.
• Never leave your child alone in a car. Heat inside the car and other factors could cause long-lasting injury-or death-in a matter of minutes. Keeping the car windows down won't protect your child in hot or warm weather. Other injuries could also occur from a child getting stuck in the trunk or setting the car in motion.
• Keep your child safe in strollers and carts. Use the safety straps, and follow the printed instructions. It's safest not to put children in shopping carts at all.
• Monitor air pollution when planning to take your child outdoors. Children's lungs are especially sensitive to pollution. You can check your newspaper or local weather station for details about air pollution levels.
• Watch for physical signs that show it's safe to gradually include your child in your activities. When children can run or climb, it's usually a good sign that they are getting stronger and can keep their balance. Before and after these signs appear, use good judgment for your baby's comfort and safety.

Fitness: Staying Active When You Have Young Children

Parent Self-Care

Gaining confidence

Many parents wonder whether they are equipped to handle the responsibility of keeping their child safe. You will likely feel more confident if you are alert, take all the precautions you can, and know how to respond to emergencies.

• Learn first aid and cardiopulmonary resuscitation (CPR). Classes usually are offered through your local hospital or fire department.
• Read and learn about child growth and development. Knowing what to expect can help ease the fear of the unknown.
• Join a support group. Parenting groups can help you learn new skills and help ease emotional issues of having a new child. Groups differ in their focus. Some target specific concerns, such as breastfeeding, while others offer parents a chance to get together with their children for playtime and visiting. Contact a local hospital or religious group, or ask your doctor for resources in your area.

Connection between parent well-being and child safety

Taking care of yourself is a vital part of keeping your child safe. Although accidents can occur at any time, most happen during times of excess stress, such as when:^{footnote 1}

• Parents and children are hungry and tired, especially right after work and before dinner.
• Another baby is expected.
• There is an illness or death in the family.
• Relationship problems develop.
• Major changes in your routine or environment occur. This can happen when your child's caregiver changes, when you move to a new house, or even before you go on a vacation.

Recognize the signs of stress and what situations cause it. Be extra careful during these times, and ask for help when you need it. Also, work on taking care of your personal relationships.

For more information, see the topic Stress Management.

Seeking help

All parents have times when they feel exhausted, frustrated, angry, sad, or overwhelmed. Recognize that this is a normal part of being human and being a parent. But if these feelings become too much for you to handle alone, keep your child safe by getting help.

For example, when your emotions are too much for you to handle alone, you may not have the energy or desire to watch your child as closely as you should. Some parents injure their children when their emotions cause them to shake, hit, or push a child. This can result in injury to the child such as shaken baby syndrome, which can cause lasting brain damage or even death.

Call 911 immediately if you feel you are about to injure yourself or your child.

Places to go for help include:

• A family medicine physician.
• A pediatrician.
• A physician assistant or nurse practitioner.
• A licensed mental health counselor.
• Your local hospital.
• Parenting groups (see the Other Places to Get Help section of this topic).

For more information on physical harm to children, see the topic:

• Shaken Baby Syndrome.
• Child Abuse and Neglect.

For more information on handling difficult emotions, see the topic:

• Depression.
• Anxiety.
• Anger, Hostility, and Violent Behavior.