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Preventing Common Childhood Injuries

You never know when your baby is going to achieve a milestone: The first time she rolls over might be on the changing table (so keep that safety strap on!). As your baby learns to sit, crawl, stand, and walk, she'll be exposed to new experiences  -- and increased risks. It's essential that knowledge of child development go hand in hand with child safety.

Many injuries occur when parents underestimate their little one's ever-increasing motor abilities and intense curiosity. In fact, a recent analysis of California injury statistics for children under 4 years of age found that at each age, specific developmental milestones influence a child's risk for certain injuries.

One in 10 babies will require emergency care for an injury in the first year of life, and toddlers between 1 and 2 years of age have the highest injury rates in childhood before 15 years of age. The most common injuries are presented below by age group. Of course, all of these injuries could happen at any age, so it's important to take proper precautions no matter how old your child.

Age: 0 to 5 months

Risk: Falls

For infants between 1 month and 1 year of age, only sudden infant death syndrome (SIDS) claims more lives than accidental injury. The California study found that falls from places like furniture, stairs, or playground equipment are the leading cause of injury for babies and young children under 4 years.

Because babies from birth to 5 months have limited mobility, their injuries are usually related to their caretakers' behavior and their environment. Falls  -- such as being accidentally dropped by a caregiver or a young sibling  -- are the leading cause of accidental injury at this young age. As babies begin to roll over at 4 or 5 months and acquire greater mobility, their risk of injury climbs.

How to prevent falls:

• Never turn your back on your baby while he is on a changing table, examining table in a doctor's office, sofa, adult bed, or other furniture.

• Keep the crib sides raised and firmly secured.

• Do not allow siblings to carry a baby unless they are mature enough to do so safely. When supervised, young children can hold the baby while seated in the middle of your bed.

• Install gates at the top and bottom of stairways.

• Place operable window guards on all windows above the ground floor and keep furniture away from windows.

• Do not let your child use an infant walker.

Age: 6 to 8 Months

Risk: Drowning

Submersion injuries and drowning in the bathtub peak at this age, possibly because caretakers mistakenly assume that a baby who is able to sit can be left alone in the tub. Babies have drowned in mere moments in less than 2 inches of water in bathtubs  -- even while using bathtub "supporting ring" devices. They have also drowned in toilets, buckets, pools, ponds, and virtually any body of water.

The rate of accidental injury due to falls from furniture also peaks in this age range, as babies rapidly become more mobile and roll off sofas, chairs, and beds. Falls from stairs also rise as babies start to crawl. The use of walkers has been shown to contribute to falls  -- not only can they tip over or fall down stairs, but they allow a baby to reach locations where he can pull down dangerous objects.

How to prevent drowning:

• Never leave an infant or a young child alone for even an instant in or near a bathtub, bucket of water, toilet, or other body of water.

• Do not leave young children alone in the bathroom or allow them to have unsupervised access to the bathroom.

• Whenever infants and toddlers are in or around water, an adult should be within arm's reach.

• Residential swimming pools and hot tubs should be surrounded by a four-sided fence that's at least four feet high.

• Parents, caretakers, and pool owners should learn CPR and keep a telephone and U.S. Coast GuardÐapproved rescue equipment in the pool area.

Age: 9 to 11 Months

Risk: Choking

Mobile babies this age have increased access to small objects, which they can now pick up with a pincer grasp, and are eager to explore with their mouths, even if something tastes unpleasant. Not surprisingly, choking is the main hazard at this age. Infants can choke on objects they encounter on the floor, such as toy parts. The smaller diameter of the airway and gastrointestinal tract in babies makes them more prone to choking.

Other risks that increase at this age include falls from stairs (since babies are now crawling). Poisoning by medication sharply increases and continues to rise, peaking at 21 to 23 months. Injuries in the pool also become more common, as babies in water-orientation classes associate water with safe play.

How to prevent choking:

• Keep plastic bags, balloons, as well as small objects away from young children.

• Do not give children under the age of 4 years nuts, popcorn, hard candy, grapes, raw vegetables, sliced hot dogs, or other foods that could lodge in the throat. Do not let children run or play while eating.

• Do not put anything around a baby's neck. Remove drawstrings from all children's clothing. Keep cribs away from windows where cords from blinds or draperies could strangle a baby.

• Learn infant CPR and emergency choking procedures.

• Follow age guidelines on toy packaging.

Age: 12 to 14 months

Risk: Burns

Burns from hot liquids and vapor are a leading cause of injury in this age group. Hot tap water from a sink or bathtub tends to cause more severe scalds than do spilled hot liquids. A baby, whose thinner skin burns at a lower temperature and more deeply than an adult's, can suffer third-degree burns in a few seconds when the water temperature is above 140° Fahrenheit.

Car-related injuries (caused by driveway back-overs, falling out of a car, or setting a car in motion) increase markedly with a baby's ability to walk. And falling into a pool or hot tub continues to be a risk as toddlers become able to gain access to these facilities.

How to prevent burns:

• Set the thermostat on your home's hot-water heater to 120°F to prevent scalding.

• Keep children out of the kitchen or secured in a high chair while you're cooking. Turn handles of pots and pans away from the edge of the stove.

• Don't hold your baby while drinking or carrying hot liquids. Do not place hot liquids near the edge of a table, and avoid using tablecloths.

• Install smoke detectors in your home.

• Have working fire extinguishers in your home.

• If you smoke, do not smoke in bed, and properly dispose of butts and ashes.

• Keep electrical appliances and cords out of your child's reach.

• Erect barriers around space heaters, woodstoves, fireplaces, or kerosene heaters.

• Check your heating system at least once a year to prevent malfunctioning, carbon monoxide poisoning, and fires.

• Keep young infants out of direct sunlight. Use shading, sunscreen, and hats when outdoors.

Age: 15 to 17 Months

Risk: Poisoning

Poisoning by such substances as household products, gasoline, and lead-based paint peaks at this age but is still exceeded by poisoning by medication, as active toddlers get into everything, opening drawers and bottles. Babies this age have the highest overall rate of accidental injury  -- almost twice as high as that of babies 3 to 5 months old, who have the lowest rate. A toddler's ability to walk unassisted, insatiable curiosity, and continuing habit of exploring things with the mouth exposes him to more hazards.

Burns from hot liquids and vapor remain a leading cause of injury, since a toddler will grab anything to pull himself up or steady himself. Car-related injuries continue to increase, as toddlers play in driveways and unfenced front yards, where they are able to venture into the street. Falls from furniture also peak, as little ones strive to use chairs and open drawers for climbing.

How to prevent poisoning:

• Put all toxic substances, including medications and household products, out of sight, out of reach, and locked in a childproof cabinet before your child can crawl.

• Keep the national Poison Control Center hotline (800-222-1222) near the telephone. You can also contact them for advice on which poison treatments to keep at home. (Don't administer these products unless instructed to do so by a physician or poison control center personnel.)

• Make sure your medications have child-safety caps.

• Do not store medicine or toxic products in food or drink containers.

• Discard outdated medications.