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Sonja Brownlee, MD.
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Last Updated 1/2010
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Safety Concerns: The First Year (0-11 Months Old)
Supervision
- Never leave your baby alone in the house, yard or car.
Jiggling
- Always support your newborn’s head and neck when moving his/her body.
- Don’t play with your infant by throwing her up into the air and catching her.
- Never shake your baby to stop her from crying or as punishment.
Baby Equipment
Changing tables:
- Choose a sturdy, stable changing table with a 2-inch guardrail around all four sides.
- The top should be concave, so that the middle is slightly lower than the sides.
- Don’t depend on a safety strap alone to keep your child secure! Never leave your baby unattended on the changing table.
- Keep powder and other supplies within your reach, so you don’t have to leave your baby’s side to get them. Never let baby play with the powder container. If s/he accidentally opens and shakes it, s/he can inhale particles of powder, which can injure his/her lungs.
Highchairs: falls are the most serious danger
- Select a chair with a wide base, so it can’t be tipped over if someone accidentally bumps against it.
- If the chair folds, be sure the locking device is secure each time you set it up.
- Strap your child in with the safety strap whenever he sits in the chair. Never allow him to stand in the highchair.
- Don’t place the highchair near a counter or table. Your child may be able to push hard enough against these surfaces to tip the chair over.
- Don’t leave a young child unattended in a highchair and don’t allow older children to climb or play on it, as this could tip it over.
- If you use a chair that hooks on to a table:
- Look for one that locks on to the table.
- Be sure the table is heavy enough to support your baby’s weight without tipping.
- If your baby’s feet can touch a table support, s/he can push against it and possibly dislodge the seat.
Infant Seats:
- Never use an infant seat as a substitute for a car seat.
- Always use the strap and harness when your baby is in the seat.
- Choose a seat with an outside frame that allows baby to sit deeply in side. Be sure the base is wide so it is difficult to tip over.
- Check the bottom of the seat to be sure it is covered with a nonskid material.
- Always carry your baby securely strapped into the seat.
- Using the carrying handle with one hand may allow the seat to tip so that baby can fall out – even with the strap on, the weight of baby’s head could pull him/her down and out.
- It is not wise to put the seat above floor level. Even there, an active, squirming baby can tip the seat over, so place the seat on a carpeted area near you and away from sharp-edged furniture.
- Infant seats may tip over when placed on soft surfaces such as beds or upholstered furniture.
- Never place a baby in a car seat on the roof of a car.
Pacifiers:
- Do not use the top and nipple from a baby bottle as a pacifier, even if you tape them together. If the baby sucks hard, the nipple may pop out of the ring and choke him/her.
- Purchase pacifiers that cannot possible come apart. Those molded of one solid piece of plastic are particularly safe.
- The shield between the nipple and the ring should be at least 1 ½ inches across, so baby cannot take the entire pacifier into his/her mouth. Also, the shield should be made of firm plastic with ventilation holes.
- After retrieving your child’s pacifier for the thousandth time, you may think about tying it to his hand or around her neck. Don’t. The danger of strangulation is too great.
- Pacifiers deteriorate over time. Inspect them periodically to see whether the rubber is discolored or torn. If so, replace them.
Playpens:
- Never leave the side of a mesh playpen lowered. A baby who rolls into the pocket created by the slack mesh can become trapped and suffocate.
- Once your baby is able to sit, remove any toys that have been tied across the top of the playpen, so s/he cannot become entangled in them.
- Babies who are teething often bite off chunks of the vinyl or plastic that cover the top rails, so you should check them periodically for tears and holes. If the tears are small, repair them with heavy-duty cloth tape; if they are more extensive, you may need to replace the rails.
- If you use a playpen built before 1974, be sure the mesh is free of tears and that the openings are less than ¾ of an inch across, so that your child cannot get caught in it.
- Slats on wooden playpens should be no more than 2 3/8 inches apart, so your child’s head cannot become trapped between them.
- Circular enclosures made from accordion-style fences are extremely dangerous, because children can get their heads caught in the diamond-shaped openings and the V-shaped border at the top of the gate. Never use such as enclosure, either indoors or out.
Walkers: the American Academy of Pediatrics does not recommend using infant walkers. The AAP recommends that you select a stationary product such as a bouncer or “saucer walker”. Avoid jump seats or swings that fasten in doorways. If you decide to use a walker anyway:
- Use a walker only on a smooth, flat floor where there are not carpets, door thresholds or other obstructions that could cause it to tip over.
- Beware of patios that are level with the lawn: they can still tip over at the edge.
- To prevent tipping, a walker should have at least six wheels. The wheel base should be wider and longer than the seat height.
- Be sure stair guards and gates are securely closed before putting a baby in a walker.
- Never leave a baby unattended in a walker.
Burns
- Never hold your baby while smoking, drinking a hot liquid, or cooking by a hot stove or oven.
- Never allow anyone to smoke around your baby.
- Before placing your baby in the bath, always test the water temperature with the inside of your wrist.
- Prevent scalding by reducing the water heater temperature to 120° F max.
- If using a microwave to heat bottles or food, always shake up or stir the contents well after heating and test the temperature of the container as well as the milk or food before feeding your baby.
- Never leave containers of hot liquids or foods near the edges of tables or counters.
- On stoves, turn pot handles inward.
- Do not allow your baby to crawl around hot stoves, floor heaters, or furnace vents.
- Dress baby in flame-retardant clothing.
- Install and maintain smoke detectors in the proper places in your home.
Car Seats
- A rear-facing infant seat in the back seat should be used until your baby is both 20 lbs and 1 year of age.
- Your baby should ride in a properly installed, federally approved car seat every time s/he is in the car.
- A parent's lap is the most dangerous place for a child to ride . Always stop the car to nurse, feed, diaper change, etc, your baby.
- Position the car seat at a slant of less than 45 degrees. Newborns' necks are not strong enough to support their heads well (especially those born 3 or more weeks early). Their heads often fall forward, crimping their airway, when placed in a car seat slanted at more than 45 degrees.
- Most babies can support their heads quite well by 2 months of age. However, their heads often fall forward while sleeping in a car seat slanted at more than 45 degrees, and this can crimp their airway. This is more of a problem when traveling in a car seat longer than 30 minutes.
- By 4 months of age , your baby should be able to travel in a car seat angled at 45 degrees.
- Your baby can overheat in a car seat if traveling in direct sunlight. You may need to use a window shade.
- Cover the car seat when parked to protect it from sunlight and heat . Touch the vinyl and metal buckles before placing your baby in the car seat to avoid burns.
- No matter how short your errand is, never leave an infant alone in a car. S/he might get overheated or too cold and die. Also, any baby alone in a car is a target for abduction.
For more information see Car Safety
Choking
- Don't attach pacifiers, medallions or other objects to your baby's body with a cord.
- Don't place a string or necklace around baby's neck.
- Rattles – probably your baby’s first toy --- should be at least 1 5/8 inches across. An infant’s mouth and throat are very flexible, so one that’s smaller than that could cause choking.
- Check squeeze toys to be sure the squeaker can’t become detached from the toy
- Routinely check all toys for small parts that could be pulled or broken off.
- Look for toys labeled for children three and under, because they must meet federal guidelines requiring that they have no small parts likely to be swallowed or inhaled.
- If you use a crib gym or other suspended toys for the crib, make sure they are fastened securely and tightly so your baby cannot pull them down or entangle him/herself in them.
- Never give a baby any food that could cause choking. All foods should be mashed, ground, or soft enough to swallow without chewing.
- Keeps balloons and plastic bags out of reach.
- Never leave small objects in your baby’s crawling area. Impress upon your older child the importance of picking up all the pieces from toys when s/he’s finished playing with them.
Falls
- Never leave your baby unattended on a bed, couch, table or chair . Even newborns can suddenly extend their body and scoot or flip themselves over the edge.
- Beware of placing baby in an infant seat on a table, chair, or any other surface above floor level . If you do, be sure to buckle baby in. Be sure the seat can’t jiggle or bounce off an edge or be easily bumped off by another child or adult.
- Never leave baby unattended in high places like changing tables or in a crib with sides down.
- Use non-expanding gates at the top and bottom of stairways, and to doors of rooms with furniture or other objects that baby might climb on or that have sharp or hard edges.
- Beware of walkers. See under Baby Equipment .
- Don’t let baby climb on narrow-based ladder-back chairs, or similar types of furniture, that will easily fall over when your baby tries to climb up the back.
- Beware of shopping carts. Babies can easily climb out of the built-in seat. Even when properly secured, an active baby can tip a shopping cart over easily by leaning or shifting their weight. Never leave a baby alone in a shopping cart.
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