In Safe Hands

From the time your child is 4 months old until he or she is about 2 years old, an enormous amount of development happens. Your baby is no longer a little bundle, but is learning to sit, crawl, and walk. He or she moves around, tastes, and explores making new discoveries and accom­plishing new tasks each day! It's an exciting and exhausting time for both of you!

When children are moving from one developmental stage to another,the risk of accidents is greatest. Little ones are full of enthusiasm and energy. At the same time, they don't have full control over their move­ments yet, and they're just learning how to judge what's safe and what's dangerous.

PREVENTION IS KEY!

The best way to deal with injuries is to try to prevent them from happening. Of course, accidents can't always be prevented. You should prepare as best you can, and try to

make your home safe and secure. ^On the other hand, it's not healthy to overprotect your child from learning experiences. Letting a child explore — within limits — is good for him or her, and makes your day easier, too.

It's important to Mink prevention in any situ­ation. Look around your home from a "baby's eye view." What hazards are within reach? Are there sharp corners on tables? Open electrical outlets? Chemicals and medicines in unlocked cabinets? There are a lot of things that may not be obvious at first... You may wish to consider taking a course in safety, first aid, and car­diopulmonary resuscitation (CPR) at your local Red Cross, police or fire department, school, or "the Y." Excellent books also exist. Your doctor may be able to recommend some sources, or try the Yellow Pages and bookstores.

Also, remember to keep the phone num­bers for the doctor, hospital, police, fire, and poison control center by each telephone.

FALLS

Infants and children will have their share of falls by the time they're grown. Even the most careful parent — and most cautious child — can't prevent all accidents. However, you can try to stop them. In particular, seri­ous injuries can happen from falls down stairs, out windows, and off furniture.

Head injuries are common, but luckily, few are serious. Preventing damage to the brain is the most important consideration. When a baby falls down, there is usually a moment's silence before the crying starts. If the child stays conscious, calms down after a few minutes, has normal skin color, and does not vomit, it's unlikely that a concus­sion or other brain injury has occurred. If the baby becomes pale and drowsy, starts to vomit, or has a seizure, call the doctor or hos­pital immediately.

The high-chair

No high-chair is tilt-proof. You can buy security straps that are attached to the kitchen table. Your child should also wear a harness while sitting in the high-chair.

Stairs

Stairs are exciting for children as soon as they can crawl. Unfortunately, stairs are also potentially dangerous. You need to install gates at the top and bottom of the stairs,

because children can crawl up or down them. Gates should be at least 27-1/2 to 29-1/2 inches tall, measured from the bottom edge. The space between the bars should be less than 2-3/8 inches, and there should be no cross bar in the middle. The gate must open up or in — not toward the stairs.

Spiral staircases and stairs with open backs are accident traps. Small children can fall through the open spaces or get their head stuck. Close up the open areas as best you can, and be especially careful about keeping the gates secured at all times.

Still, it is wise to teach a baby how to get up and down regular staircases. If somebody for­gets to close a gate one day, your child may be able to avoid a serious fall by knowing how to walk or crawl. You can mount a hand-rail or rope at child's height, for support. Of course, a young child shouldn't be allowed to be on the stairs alone for some time yet!

Windows

Every year, too many children fall out a win­dow and suffer injuries. Children have a large head, compared to the rest of their body. This can make it easy for a child to lose his or her balance and fall over. Install locks at the top of the window. Window bars are also available, if you want to be able to air the room. No win­dow locks are completely secure, but it takes time for small children to open them.

BURNS

Unfortunately, burns are common among infants and toddlers. Scalding accidents occur when a child pulls a pot or pan down from the stove, or manages to turn on the hot water, or touches a hot radiator or oven door. The most common burn injuries are caused by hot water or hot beverages. Turn pot handles away from the front of the stove.

Heat injuries are divided into three categories. With first-degree burns, the injury is superficial; the skin becomes red, but isn't seriously harmed. Second-degree burns develop blisters filled with fluid. Third-degree burns involve tissue deep under the skin; the extent of the damage becomes apparent only after a few days. First-degree burns — and usually second-degree burns — heal without leaving a visible scar.

Immediately after a first-degree or second-degree burn, immerse the wounded area com­pletely in cold running water until it is no longer painful. This stops the burning process. Some experts recommend bathing the area in a mild soap solution with added ice cubes — but don't put ice cubes directly onto the wound. The burn should then be kept dry — either air-dried or covered by dry, sterile bandages. You can put an antibiotic spray or burn ointment on before applying the bandage. Do not cover the area with a raw egg yolk, butter, or oil!

When burns are deep or extensive, contact the doctor or hospital immediately. Burns on

the palm of the hand or near the eyes always require a call, too. While waiting for the ambulance or ride, and on the way to the doctor's office or emergency room, have the child drink plenty of water (if he or she isn't nauseous). People lose a lot of fluids during the first hours after serious burn damage.

Hot drinks and water

When you have a baby on your lap, you'll notice that he or she may suddenly kick and wave the arms and feet. These movements are impossible to predict. Therefore, never hold a baby on your lap when you are drink­ing hot beverages. Friends and relatives should also be taught this rule!

Children's skin is very sensitive and more easily damaged than ours. Did you know that damages from burns can occur even at tem­peratures as low as 104°F? So, the risk of your child being scalded is high. Adjust the ther­mostat of the hot water heater to 110°F, and secure all faucet handles in some way. Most households keep the water unnecessarily hot. A hot bath doesn't need to be more than 100 °F.

FOREIGN OBJECTS

Digestive system

It's incredible what babies put into their mouth and swallow: buttons, coins, needles, glass, and more! Fortunately, the objects usually pass through the stomach and the intestines without causing damage. You should be con­cerned, however, if the swallowed object is sharp, breakable, or poisonous, or if your child shows any signs of pain. In any of those cases, the doctor should be contacted immediately. Otherwise, try to calm down and feed the child. Do not give suppositories unless the doctor tells you to; they can increase the chances of damage. Don't put your finger into your child's mouth, either. Check the baby's stools during the first few days to make sure the object has passed through.

Respiratory system

If your child coughs or chokes after having put an object into his or her mouth, it is very likely that the object has gotten stuck in the airways. This is confirmed when the child can't make any noise or his or her face turns blue. Make the child cough up the object right away, or expel it by holding the child's head down while thumping the upper part of the back fairly forcefully between the shoulder blades. If these actions fail, call the emergency number and rush the child to a hospital.

Nose and ears

Small paper balls, peas, and stones are some of the things young children find "fun" to insert into their nose. This can be dangerous. It's best to try to remove such objects immediately. If you

wait, a foul-smelling, yellow, sometimes bloody material may leak out of the nose. If your child is old enough to cooperate, you may be able to show him or her how to blow forcefully through the nose to dislodge the object. Do not attempt to remove it with tweezers, because great care is needed to not push it farther in. It's generally best to let a doctor remove objects stuck in the nose.

Babies also insert small objects into the ears. These can be easily removed with small tweezers, but be careful not to push the object farther in.Some innocent-looking items

Pacifiers should have a protective shield of 1-1/2 inches. Check frequently that the paci­fier is undamaged and strong. A pacifier with a loose nipple can cause a baby to choke.

Peanuts and hard candies shouldn't be given to children under 4 years old. The lit­tle one can swallow wrong and the peanut can end up in the lungs. And, peanuts con­tain an oil that harms lung tissue. You should also wait to give the child grapes or nuts. Anything smaller than a pencil's eras­er tip can be breathed into the lungs and can get stuck in the throat and choke the child.

POISONING

Remember that all medicines and house­hold cleaning products should be kept beyond the reach of children, preferably in locked cupboards, and not at floor level. Even every­day things like vitamins and dish-washing liq­uid are very dangerous for small children. Keep one ounce of ipecac syrup in the house, but never use it unless a doctor tells you to.

OTHER INJURIES

Graze wounds

Scrapes, rug burns, and other graze wounds should be washed with plenty of clean, cool water and soap, or with a special cleansing remedy from the pharmacy. Let the wound air-dry and apply a dry, sterile bandage. If the wound doesn't become painful or red, and the bandage stays dry, keep a bandage on for 8 to 10 days. If the bandage becomes dirty, change the outer layer, but leave the layer nearest the wound intact.

Cuts

Cuts sometimes bleed profusely for the first few minutes, which gives the impression of a serious injury. Apply pressure to the cut for a few minutes with the cleanest material avail­able — preferably a small sterile bandage —while washing away the blood around the area. Find out how large the wound really is. Often it is enough to apply a bandage straight to the wound while pressing the edges of the

cut slightly together. Apply a strong, sterile bandage. If the wound continues to bleed, or its edges are separated by more than a little bit, contact the doctor or go to the hospital.

If any wound has a lot of dirt or other cont­aminants in it, seek immediate medical help to protect against the risk — even if it is small —for tetanus developing. If the wound is deep, it's important for a doctor to find out whether nerves or tendons have been damaged.

Fractures

The bones of infants and toddlers are flex­ible, like green tree branches. Fractures heal faster in children than in adults. However, you should always seek medical advice if you suspect a broken bone.

IN THE CAR

Never hold an infant or child on your lap in the car. No matter how careful you are, it's impos­sible to protect the child if you're in an accident. All children under age 4 should be secured in an age-appropriate car seat. From age 4 or 40 pounds, seat belts must be worn at all times.

Good car seats can be bought, rented, or borrowed from many stores, including some car repair shops or car rental agencies. Check that the seat is approved by the federal gov­ernment. These seats have been tested and offer good security.