Human Behavior and the Social Environment II: November 2009

Basic Issues (be able to list some of these for the exam) that can be safety hazards for infants and toddlers:

Babies and small children depend on their parents to keep them safe, and, at the same time, to allow them to explore their world and make new discoveries every day. Safety means looking at the environment and matching it up to your own baby's abilities at that time. It means making changes in the environment as your baby moves through each development stage. Anticipating what you'll need to do to keep danger out of your baby's reach is the key part of the safety game. Setting up safe ways and places for your baby to explore works better than planning to watch your baby every second — an impossible task.

The safety rules change with your baby's age, but some general principles of safety apply to every child. Read the following checklist for the best safety rules of thumb. For more age-specific safety information, see our safety-by-age article.

Never shake a baby

Never leave your baby alone

Prevent burns and promote fire safety

Lower the risk of sudden infant death syndrome (SIDS)

Drive safely

Make sure your baby's gear is safe

Baby-proof your home

Check for gas

Prevent choking

Quit smoking

Prevent firearm injury and death

Prevent drowning/promote water safety

Plus more little safety tips

Never shake a baby

Shaking a baby, even playfully, can cause bleeding in her brain and rip nerves and muscles. Shaken Baby Syndrome can result in blindness, brain damage, or death. Taking care of a baby is a tough job, and in the early days it's often difficult to fathom why your baby is crying. Feeling angry and frustrated sometimes is normal. But no matter how frustrated you get, NEVER shake or jiggle your baby violently. If you feel yourself losing control, seek help from your mate, a friend or relative, or a professional. Never shake a baby as part of a game, either. It's just too dangerous.

Never leave your baby alone

Even newborns can occasionally turn over or flip around, so never leave your baby alone in the tub, on a raised surface like a changing table, or on an adult bed. If the phone rings, take the baby with you (or let the answering machine pick up the call). And never leave a baby in a car by herself, even for a minute. Emergencies can happen in an instant, and your child needs an adult with her at all times.

Prevent burns and promote fire safety

Install smoke alarms, especially where your baby sleeps, and check their batteries when you reset your clocks in the spring and the fall. And put fire extinguishers on every floor of your house. Be sure the fire department has directions to your house if you live outside of town.
Use fire-resistant or flame-retardant clothing, bedding, and toys for your child. Check the labels to make sure.
Turn down your hot water heater — 120 degrees F is a good setting for households with small children. You can prevent accidental burns and still get the dishes and the clothes clean.
Replace floor furnaces with another type of heating system, and block radiators.
Move all appliances with cords so that your child can't reach the cords.
Cover all electrical outlets with plugs.
Keep your baby out of direct sunlight and use sunscreen — the sun can hurt a baby's sensitive skin. It's safe to use small amounts of sunscreen on babies under six months of age — apply it for every outing. Use protective clothing (including hats) and eyewear, even for the youngest child, even in winter, and even on cloudy days.

Lower the risk of sudden infant death syndrome (SIDS), or crib death

Put your baby "Back to Sleep." Research has shown that putting babies to sleep on their back lowers their risk of SIDS by as much as 70 percent. But be sure your baby spends wake time on her tummy to discover, explore, and strengthen her shoulders.
Keep your baby's room warm, but not too warm. Maintain an air temperature that is comfortable for you. A young infant has less capability to adjust her temperature than an adult, as she can only sweat around her head. Keep her head uncovered and remove a layer of clothing if her head is damp with sweat. If she's overheated by too many blankets or clothes, she is at greater risk for SIDS.
Keep your baby's head uncovered as she sleeps. Use a sleeper or tuck her in below her neck with a blanket.
Be sure your baby sleeps on a firm mattress. Fluffy, soft surfaces can obstruct her breathing. Do not use thick quilts, comforters, pillows, or sheepskin under or over the baby. Avoid waterbeds. Toys and pillows shouldn't be too big or too plush; infants should not have pillows or large stuffed toys in their cribs at all. Finally, make sure bumper pads are secure. If your infant sleeps in your bed, the same precautions apply. Be sure there isn't any space around the mattress to trap your baby between it and the bed.
No smoking around your baby. Babies exposed to secondhand smoke are at least twice as likely to die of SIDS.
Breastfeed. Breastfed babies have a lower risk of SIDS, so breastfeed as much — and as long — as you can.

Drive safely

You and your baby spend a lot of time in the car, so it's important to take the time to make sure the car is safe. Car accidents are THE leading cause of death and injury in children after the first month of life.

Always use a car seat that's appropriate for the age and size of your child. Almost all children badly injured or killed in car accidents were not properly restrained in car seats, or sitting in car seats that were not properly installed. Install the seat according to the manufacturers' instructions, or ask the police department or the car dealer to install it for you. Don't ever give in to a child's desire to ride anywhere but in the car seat.
Always drive with children in the back seat, especially if you have air bags.
Never leave your child alone in the car — not even for a minute! When you're on the road, make sure your child isn't getting too much sun through the car window.
Don't smoke in the car.
Use automatic door and window locks, and keep them set for each ride.
Be a good role model — buckle up every time you're in the car, and drive safely.

Make sure your baby's gear is safe

There are lots of new safety standards for baby and child equipment. Before you purchase anything or take on used baby gear, check to be sure everything meets standards and hasn't been recalled.

Before you buy any baby gear, check for safety information. Everything you buy should pass Consumer Product Safety Commission (CPSC) standards. Call them at 1-800-638-2772 or check their Web site to be sure.
See if your products have the yellow and black certification seal of the Juvenile Product Manufacturers Association.
Click here for an updated list of product recalls.
Items manufactured before 1974 may have lead paint or may have design flaws that make them a safety risk, and they won't appear on recall lists.
Check all of your baby's equipment regularly for loose parts, sharp or rough edges, and peeling paint.

Baby-proof your home

Now, on to baby proofing. First of all, the term "baby proofing" is something of a misnomer, since there is no such thing as a completely baby-proofed house. You will always have to keep a close eye on your baby, and an especially close eye when you're somewhere other than your own home. However, there are some basic steps to make your home as safe as possible:

Take a spin through the house on your hands and knees, looking at it from your baby's perspective. You will quickly notice many looming dangers. Make a list of what you find and take steps to make them safe.
Get as many electrical cords and appliances out of the way as possible. Before you run any appliance, make sure you can see the baby, and that she's far from the action. Make it a habit.
Put locks on all windows so they can be opened no more than six inches. This is particularly important for windows on the second story and above.
Plug up all electrical outlets and put cords out of reach (this is so important it's worth repeating).
Put all cleaning supplies, medicines (prescription and over-the-counter), alcohol, vitamins, and anything else that would harm your baby if ingested up high where she can't reach it. Lock those cupboards.
Be sure all medicines, including visitors', are in safety-capped bottles.
Use cupboard safety latches, even for those containing safe objects.
Block stairs with secure gates, and secure doors and windows with high latches and locks.
Put shade and curtain cords out of reach.
Secure bookshelves and high furniture that could be pulled over. This may mean using wall bolts.
Avoid using tablecloths, scarves, and doilies that your baby can use to pull objects off a table.
Make sure grandparents and care providers adequately baby-proof their homes as well.

Check for gas

Radon, a naturally emitted radioactive gas, is a cancer-causing health hazard that can collect in tightly closed houses, such as those in cold climates. It tends to collect in the lower levels of houses. Babies and toddlers are especially at risk because the gas collects close to the floor. State, county, and city health departments will come out to check your home and show you ways to vent the gas, if necessary.
Carbon monoxide detectors are important if you heat with propane or wood. Keep the batteries current.

Prevent choking

In the United States, choking is the fourth leading cause of accidental death among children under 5. Fortunately, choking can be prevented. Follow these guidelines:

Avoid foods that pose the greatest choking hazard. This includes hot dogs, whole grapes, peanuts, hard candy, and raw carrots.
Always feed your baby sitting up, in your lap, or in an infant chair. Make sure your toddler sits at the table and doesn't walk or run with food in her mouth.
Make sure your child's toys are safe. Soft toys should be washable, stuffed with fire-safe material, and have no loose pieces such as eyes, buttons, or latches. If toys break down into pieces, no piece should be smaller than 1.75 inches. (They should be too big to fit through a paper towel tube.) Pieces smaller than that pose a choking hazard. Don't use any toys that have strings, fasteners, buttons, or chipping paint. And avoid latex balloons and small balls, and check all of your baby's toys regularly for rough edges, loose parts, or peeling paint.
Only dress your baby in safe clothing. Check clothes inside and out for loose strings or ribbons or anything that could wrap around your baby's neck, small fingers, or toes. Avoid drawstrings on clothes that can get caught in doors, cribs, or toy equipment such as bicycle wheels. Remember, children can always pull off buttons that you think are securely attached.

Quit smoking

A smoke-free house is healthy for everyone who lives there, especially your baby. No one should smoke around a baby, including baby sitters or relatives. People unwilling to quit smoking should abstain from smoking in a baby's house. If you or someone in your house smokes, you have many reasons to quit — if not for your sake, then for your baby's.

Babies in smoking households are at least twice as likely to die from SIDS.
Children in smoking households get more chest colds, ear infections, sore throats, asthma, pneumonia, burns, and other health problems compared with children in non-smoking households.
Smokers' houses are at greater risk for fire and fire-related injuries.

Prevent firearm injury and death

Today and every day, 10 children in the United States will die from handgun accidents, murder, and suicide. Even more are wounded. In gun-owning households, the natural curiosity and playfulness of children can quickly turn deadly.

The best way to keep your baby safe is:
Remove all guns from your home, period.

If you do have guns:

Lock them up. Make sure your guns are locked away, with all ammunition locked up separately. Make sure only adults know where the guns and ammunition are kept and that the key stays with an adult.
When a gun isn't locked up, never leave it unattended. Whenever you handle your gun, including when you clean it, don't let it out of your sight, even for an instant. Most firearm accidents involving children happen because the children weren't supervised.
Use trigger locks and other safety devices.
Never refer to a gun as a toy.
No child under 8 can be relied upon to remember rules for handling a gun, no matter how well they are taught.

Prevent drowning/promote water safety

Drowning is the second most deadly type of accident for children in the United States. Young children are especially at risk, not only because they don't know how to swim, but also because they can drown in a very small amount of water.

Never let your child out of your sight near any pool of water, including toilets, scrub buckets, fountains, swimming pools, wading pools, lakes, ponds, or the ocean.
Children of any age need to be directly supervised around any swimming pool or body of water. All monitors should have no other tasks than to watch children when they're around water.
Keep the bathroom off-limits for infants and toddlers, except for when they are directly supervised.
If you have a pool, enclose it with a fence taller than 4 feet that has a locked gate. If you live near a community pool, get it up to these standards.
Bathtub rings do not protect a child. If you use one, you must still supervise your child constantly.
Swimming lessons aren't recommended for children until after their fourth birthday. They give parents a false sense of security. You must always supervise your children when they're in the water, even if they've had swimming lessons. Young children may swallow too much water while swimming, leading to serious or even fatal salt imbalance.
If you have a boat, make sure you follow all U.S. Coast Guard safety regulations. Have a regulation life preserver, sized appropriately, for each person on board, and teach your older children safety rules and boat etiquette.
Arm "wings," plastic rings, and other devices do not ensure safety for young children in the water. Watch your children directly at all times. If your child is under 2 years old, you should be in the water with her at all times.

Other little safety tips

Don't put pacifiers or necklaces around your young infant's neck. A cord or necklace can too easily get caught and strangle her.
If you use a pacifier, be sure it's molded in a single piece.
Any space or opening bigger than 2 3/8 inches wide can accommodate a baby's head at an angle, so keep an eye out for potential traps.
Never refer to medicine as candy.
Put all visitors' handbags and luggage out of your child's reach.
Make sure carrying devices such as packs and strollers fit your child's age and stage of development.

(Pampers.com)

The very first test given to a newborn, the Apgar score occurs right after your baby's birth in the delivery or birthing room. The test was designed to quickly evaluate a newborn's physical condition after delivery and to determine any immediate need for extra medical or emergency care.

Although the Apgar score was developed in 1952 by an anesthesiologist named Virginia Apgar, you may have also heard it referred to as an acronym for: Activity, Pulse, Grimace, Appearance, and Respiration.

The Apgar test is usually given to your baby twice: once at 1 minute after birth, and again at 5 minutes after birth. Rarely, if there are concerns about the baby's condition and the first two scores are low, the test may be scored for a third time at 10 minutes after birth.

Five factors are used to evaluate the baby's condition and each factor is scored on a scale of 0 to 2, with 2 being the best score:

activity and muscle tone
pulse (heart rate)
grimace response (medically known as "reflex irritability")
appearance (skin coloration)
respiration (breathing rate and effort)
Doctors, midwives, or nurses add these five factors together to calculate the Apgar score. Scores obtainable are between 10 and 0, with 10 being the highest possible score.

he very first test given to your newborn, the Apgar score occurs right after your baby's birth in the delivery or birthing room. The test was designed to quickly evaluate a newborn's physical condition after delivery and to determine any immediate need for extra medical or emergency care.

Although the Apgar score was developed in 1952 by an anesthesiologist named Virginia Apgar, you may have also heard it referred to as an acronym for: Activity, Pulse, Grimace, Appearance, and Respiration.

The Apgar test is usually given to your baby twice: once at 1 minute after birth, and again at 5 minutes after birth. Rarely, if there are concerns about the baby's condition and the first two scores are low, the test may be scored for a third time at 10 minutes after birth.

Five factors are used to evaluate the baby's condition and each factor is scored on a scale of 0 to 2, with 2 being the best score:

activity and muscle tone
pulse (heart rate)
grimace response (medically known as "reflex irritability")
appearance (skin coloration)
respiration (breathing rate and effort)
Doctors, midwives, or nurses add these five factors together to calculate the Apgar score. Scores obtainable are between 10 and 0, with 10 being the highest possible score.

A baby who scores a 7 or above on the test at 1 minute after birth is generally considered in good health. However, a lower score doesn't necessarily mean that your baby is unhealthy or abnormal. But it may mean that your baby simply needs some special immediate care, such as suctioning of the airways or oxygen to help him or her breathe, after which your baby may improve.

At 5 minutes after birth, the Apgar score is recalculated, and if your baby's score hasn't improved to 7 or greater, or there are other concerns, the doctors and nurses may continue any necessary medical care and will closely monitor your baby. Some babies are born with heart or lung conditions or other problems that require extra medical care; others just take a little longer than usual to adjust to life outside the womb. Most newborns with initial Apgar scores of less than 7 will eventually do just fine.

It's important for new parents to keep their baby's Apgar score in perspective. The test was designed to help health care providers assess a newborn's overall physical condition so that they could quickly determine whether the baby needed immediate medical care. It was not designed to predict a baby's long-term health, behavior, intellectual status, or outcome. Few babies score a perfect 10, and perfectly healthy babies sometimes have a lower-than-usual score, especially in the first few minutes after birth.

Keep in mind that a slightly low Apgar score (especially at 1 minute) is normal for some newborns, especially those born after a high-risk pregnancy, cesarean section, or a complicated labor and delivery. Lower Apgar scores are also seen in premature babies, who usually have less muscle tone than full-term newborns and who, in many cases, will require extra monitoring and breathing assistance because of their immature lungs.

If your doctor or midwife is concerned about your baby's score, he or she will let you know and will explain how your baby is doing, what might be causing problems,

if any, and what care is being given. For the most part, though, most babies do very well, so relax and enjoy the moment!

http://kidshealth.org/parent/pregnancy_newborn/pregnancy/apgar.html

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