Health and Safety, Birth to 2 Years

Safety Measures Around the Home

From birth to age 2, children depend on parents and caregivers for their safety. Safety issues change and increase rapidly in number as newborns grow into toddlers. It is important to consider your child's physical and mental development when evaluating current and future hazards.

Although close supervision is important, it is not realistic to think that you can watch your child's every move. In addition, constantly hovering over your child can limit his or her experiences and confidence. Balancing supervision with safety precautions will help prevent accidents and injuries, as well as allow your child to explore and discover.

Taking the time to research and adopt safe habits can help to prevent common accidents and injuries that can occur around the house.

Use safe baby products

In Canada, safety standards for children's equipment, furniture, clothing, and other items are set by Health Canada's Product Safety Programme (PSP). Although most new items you purchase 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 PSP 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:

• Cribs should meet all current safety standards, such as having less than 6 cm (2.5 in.) of space between slats. Lower the mattress and remove mobiles, large stuffed toys, and bumpers from the crib as your baby grows. Health Canada, the Canadian Paediatric Society (CPS), and other professional organizations do not recommend the use of bumper pads in cribs because of the increased risk of serious injury for infants, including sudden infant death syndrome (SIDS).
• Baby walkers should not be used, according to recommendations from the Canadian Paediatric Society (CPS). It is illegal to advertise, sell, or import baby walkers in Canada because they can cause serious injuries for young children.⁵
• Playpens should have spaces in the mesh material that do not exceed 0.6 cm (0.2 in.) across; wooden slats should measure less than 6 cm (2.5 in.) apart.¹ 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. Do not use booster seats that attach to the table. Always take time to make sure the high chair is locked in the upright position before use. 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 5 cm (2 in.) 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, use the nursery equipment safety checklist(What is a PDF document?).

For more information about equipment standards from the PSP, see the Other Places to Get Help section of this topic.

Safe sleeping and sudden infant death syndrome (SIDS)

Sudden infant death syndrome is one of the most common causes of death for babies between the ages of 1 and 12 months. Most babies who die of SIDS are between 2 and 4 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).

Preventing 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 will encounter as he or she learns to scoot, crawl, and walk.

• As soon as your baby can walk, lock doors to all dangerous areas.
• Use sliding gates at both ends of stairs. Do not use accordion-style gates, because a child's head could get caught. Look for a gate with openings no bigger than 6 cm (2.5 in.).
• Install window guards.
• Do not let children climb on high furniture.
• Do not use baby walkers.
• Be careful when using equipment such as high chairs and changing tables. Always use the safety straps, and keep a close eye on your child.

Choking

Help prevent your child from choking by offering the right kinds of foods and keeping an eye out for choking hazards.

• Learn to recognize the 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.
• Establish certain areas for eating, such as the kitchen table or dining room. Teach your child to sit down while he or she is eating and to chew carefully; do not force a child to eat when he or she is not hungry. These practises will also help your child to develop lifelong healthy eating habits.
• Be aware that young children can choke on small objects. Generally, objects smaller than 3.5 cm (1.5 in.) in diameter and 6 cm (2.5 in.) long are choking hazards. Examples include coins, buttons, and bottle caps. Keep these items out of your child's reach.
• Do not allow your child to eat while he or she is walking, running, playing, or riding in a car.
• Never leave rubber bands or deflated balloons around the house where children can reach them.
• Do not allow young children to chew gum or eat hard candy.

Strangulation and suffocation

A young child can strangle from a variety of household items. Protect your child by minimizing these hazards:¹

• 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 are not 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.

Poisoning

To prevent poisoning, identify household cleaners and other chemicals, plants, medicines, makeup, perfumes, and any other products that can harm a child who eats or inhales them. 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 provincial poison control centre immediately. For more information, 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 may still have it on walls and other surfaces. Have your home tested if you are unsure whether lead-based paint was used. See the topic Lead Poisoning for more information.

Prevent carbon monoxide poisoning by frequently monitoring levels of carbon monoxide in your home and taking precautionary measures, such as having your home's heater checked each year. Carbon monoxide (CO) is a colourless, odourless, and tasteless gas 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. For more information, see the topic Carbon Monoxide Poisoning.

Fire hazards

Prevent household fires by keeping and maintaining smoke detectors and planning and practising escape routes.

Burns

Burns are caused by heat, electricity, chemicals, radiation, or friction. Protect your child from burn injuries by identifying dangers in your home and taking measures to remove or block your child's access to them.

• Heat burns can be prevented by keeping your child away from fire, steam, hot water, and other hot liquids and objects. Do not heat bottled formula or breast milk in the microwave, because hot spots in the liquid can burn a baby's mouth and throat. Consider buying flame-resistant pyjamas for your child.
• Electrical burns can be prevented by keeping electrical cords out of your child's reach and using safety covers on all electrical outlets. During electrical storms, keep your child indoors and away from windows.
• Chemical burns can be prevented by keeping all chemicals out of children's reach. 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. Children younger than 6 months should stay out of the sun entirely. Keep young children out of the sun, or have them use sun-protection measures while they are outdoors.
• Friction burns are usually minor injuries. Rough play or falls may cause these burns in babies or young children.
• Enjoy fireworks from a distance. Almost half of those 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 found in many households. Children who live in homes without pets are likely to 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 animal body language that can help your child know when to stay away.
• Train and prepare your pet to behave around children. A well-trained and obedient pet is less likely to harm a child.

Drowning

Drowning is the second most common cause of accidental death from injury among Canadian children ages 1 to 4 and accounts for more than 1 out of every 5 deaths in this age group.⁷ Never leave your child alone near water, and always follow these water safety recommendations.

• Supervise all baths at all times. Always stay within an arm's reach of your child, and 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, such as a pond or a pool, fenced. Empty all buckets and coolers when they are not in use. Keep toilet lids down, and secure them with safety latches.
• Keep pool areas safe. When visiting public or private pools, keep your child within arm's reach. If you have your own pool, make sure to follow all your local safety codes. These usually are available from your city's planning department.
• 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). It can make the difference between life and death.

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Author:	Douglas Dana Debby Golonka, MPH	Last Updated: May 10, 2007
Medical Review:	Anne C. Poinier, MD - Internal Medicine Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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