Health and Safety, Ages 2 to 5 Years

Safety Measures Around the Home

Preventing your child from having accidents and injuries is a huge task. Children between the ages of 2 and 5 reason with self-centred (egocentric) perceptions and magical thinking. These thought patterns lead children to overestimate what is in their control, which contributes to their vulnerability. They are often unaware of the consequences of their actions.

You can help protect your child from accidents and injuries by taking general safety measures around your home. Also, think ahead about what potentially dangerous situations will attract your child.

Some parents think that strict safety measures are not needed because their child is closely supervised or has not yet shown an interest in dangerous areas or items. Although responsible supervision is important, it is not realistic to think that you can watch your child's every move or that he or she will never become curious about something off-limits. Also, 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.

Falls

Preventing falls is not always easy. Toddlers and young children often move quickly. Their excitement about their mobility and their lack of experience can make them unaware of dangers, such as stairs or hills. Children between 4 and 5 years of age anticipate many dangers but may not have the physical skills to successfully avoid accidents. You can help prevent young children from falling by putting up stairway barriers, monitoring their play area, and providing stable play equipment. Also, keep walkways, decks, porches, and stairways free of objects.

Choking

Children between the ages of 2 and 5 years can easily choke on everyday objects and food. Your child still needs your supervision, even though he or she may be able to eat independently.

You can help prevent choking by taking basic precautions in how you prepare foods and by teaching your child safe eating habits.

• Establish certain areas for eating, such as the kitchen table or dining room. Help your child learn to sit down while eating and to chew carefully. Do not force a child to eat when he or she is not hungry. These practises also help your child to develop healthy eating habits.
• Learn to recognize signs of choking so you can react quickly. For example, a child who is choking can't talk, cry, breathe, or cough.
• Know how to select and prepare foods. For example, choose soft foods that can be cut up into small pieces, such as cooked carrots. Avoid round, firm foods such as hot dogs, grapes, nuts, and raisins.
• Be aware that young children may choke on small objects. Generally, objects smaller than 3.5 cm (1.5 in.) in diameter and 6 cm (2 in.) long are choking hazards. Examples include coins, buttons, and bottle caps. Keep these items out of reach.
• Do not allow your child to eat while he or she is walking, running, playing, or riding in a car.
• Do not allow your child to chew gum or eat hard candy.
• Do not leave rubber bands or deflated balloons around the house where children can reach them.

Strangulation and suffocation

A variety of household items can strangle a young child. Make sure loose cords, objects, and furniture do not pose strangling risks. The following suggestions can help you reduce potential hazards.^{4, 5}

• Keep cords for blinds and drapes out of reach. Attach cords to mounts that hold them taut and wrap them around wall brackets.
• Cords with loops should be cut and equipped with safety tassels.
• Do not use accordion-style gates. Babies or young children can get their heads trapped in the gate and may strangle.
• Make sure 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 are not able to climb into the trunk from inside the car. Also, always lock car doors and keep the keys out of sight and out of reach of your child.
• Refrigerators and freezers, even those that are not in use. If you are storing an old refrigerator or freezer, be sure to take the door off.
• Plastic sacks. Do not let your child play with plastic sacks, and keep them out of reach. Many children like to put sacks over their head during play, which can lead to suffocation.

Poisoning

To prevent poisoning, identify household cleaners and other chemicals, plants, medicines, makeup, perfumes, and any other products that, when eaten or inhaled, can harm a child. It is critical to properly store these items out of reach of young children. If you have a possible poisoning emergency, call 911 or your local or provincial Poison Control Centre immediately. For more information on poisoning, see the topic Poisoning.

Lead poisoning is another cause for concern in young children who may chew on contaminated paint flakes or painted objects. House paint is no longer made with lead, but older homes (those built before 1978) may still have lead-containing paint on walls and other surfaces. Have your home tested if you are unsure whether it contains any lead-based paint. See the topic Lead Poisoning for more information.

Prevent carbon monoxide poisoning by frequently monitoring levels and taking precautionary measures, such as having your furnace checked each year. Carbon monoxide (CO) is a colourless, odourless, and tasteless gas. It is produced from burning fuels such as natural gas, gasoline, fuel oil, or wood (for example, in indoor heating systems, car engines, cooking appliances, or fires). High carbon monoxide levels quickly affect young children because of their small size. See the topic Carbon Monoxide Poisoning for more information.

Fire hazards

Prevent household fires by having and maintaining smoke detectors, planning and practising escape routes, and teaching your child basic fire safety skills. Children between the ages of 2 and 5 are often curious about fire. Warn your child about the dangers of fire, and explain why only grown-ups are allowed to use it.

Burns

Serious burns are most often caused by heat, electricity, or chemicals. Other types of burns include radiation burns (usually from sun exposure) and friction burns. Prevent burn injuries to your child by identifying dangers in your home and removing them or blocking your child's access to them.

• Most heat burns can be prevented by keeping your child away from fire, steam, hot water and other hot liquids, and hot objects. Consider buying pajamas made of flame-resistant fabric for your child.
• To avoid electrical burns, keep electrical cords out of reach of your child and use safety covers on all outlets. Keep your child indoors and away from windows during electrical storms.
• Prevent chemical burns by keeping all caustic or corrosive products out of reach of children. Acid, such as from batteries, and alkaline products, such as drain cleaners, are especially dangerous.
• Sunburns (radiation burns) can permanently damage a child's skin. Radiation burns are caused by the sun, tanning booths, sunlamps, X-rays, or radiation therapy for cancer treatment. Radiation burns in children usually are caused by sun exposure. Keep children out of the sun or use sun-protection measures when your child is outdoors.
• Friction burns are usually minor injuries, many of which can be prevented by providing proper play equipment and helping children to avoid scrapes.
• Enjoy fireworks from a distance. Almost half of persons injured from fireworks are children 14 years of age and younger.⁶ Children can also get burns from using and being around firecrackers and sparklers. Sparklers have been shown to be most dangerous for children under 5 years of age.⁶

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

Pets are in many households. Children who live in homes without pets likely will encounter animals in other environments. Many injuries can be avoided by teaching children how to properly interact with pets. Also, pet owners who train and keep their animals healthy are less likely to have problems when children are around.

• Teach your child how to interact with pets. Explain that animals can hurt you when they are scared, hurt, eating, or protecting their babies. Teach your child to speak quietly and move slowly around animals and to watch for body language that can alert your child to stay away.
• Train and prepare your pet to behave around children. A well-trained and obedient pet is less likely to harm a young child.

Drowning

Drowning is the second most common cause of accidental death among children ages 1 to 4.⁷ Help prevent a drowning tragedy by following these recommendations:

• 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.
• Control access to water in your home. Keep large bodies of water fenced, such as a pond or pool, and empty all buckets and coolers when not in use. Keep toilet lids down and consider securing them with safety latches.
• Keep pool areas safe. When visiting public or private pools, make sure your children are supervised closely and that they are familiar with pool safety rules. If you have your own pool, make sure to follow all your local regulatory safety codes. These usually are available through your city planning department.
• Teach swimming safety. Make sure your child knows basic rules, such as to always swim with a buddy and to never push another child into the water. Always have your child wear a life jacket when swimming or boating.
• Recognize the dangers of hot tubs and spas. Teach your child that hot tubs and spas are not places to play, and consider making them off limits.
• Keep children away from irrigation canals. Do not let your child play in or near irrigation canals.

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.

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Author:	Debby Golonka, MPH Carrie Henley	Last Updated: February 21, 2007
Medical Review:	Adam Husney, MD - Family Medicine Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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