Safety Tip No. 1: Actively supervise

What families can do:
Make sure that you can see and reach your baby at all times when they are moving about. You can use a playpen for short periods of time (15 minutes) when you can’t give your baby your full attention. Your home visitor can talk to you about these Active Supervision strategies:

• Create safe spaces by:
  • Arranging furniture and household items so you can always see your baby
  • Identifying a safe area for him to explore
  • Being aware of a baby’s movements, as infants may roll, crawl, or creep into pathways of unsuspecting adults and older children in the home
  • Making sure that only age-appropriate items are within your baby’s reach, and that all furniture is properly secured or bolted to the wall. It is not safe to put items in a playpen that your baby can use to climb out.
• Stay close by so you can reach your baby quickly if needed.
• Keep a watchful eye. Know where your baby is and what he is doing, as well as what older children and family members are doing in an area where mobile infants are playing.
• Listen. Notice typical as well as unusual noises or silence that could signal distress.
• Anticipate what your baby wants or may try to do.
• Engage and redirect. Even when you are busy, you can stay engaged by talking or singing to your baby about what you are doing. If necessary, intervene quickly before your baby does something that is not safe.

Why it works:
Mobile infants continue to change constantly and demonstrate new interests and abilities. Once they can freely explore their world, any area they can reach must be free of small items that could be choking hazards. Babies may suddenly try to climb over or crawl under furniture, or out of a crib or playpen. Properly securing or bolting furniture to the wall prevents it from tipping over if infants use it to pull up to stand, cruise, or climb. Active Supervision is a way to stay engaged, pay attention, and help mobile infants practice their new skills safely.

Safety Tip No. 2: Use a checklist to create safe environments

What families can do:
Use a home safety checklist¹¹ to identify and regularly inspect household items and infant furniture and equipment to make sure that they are safe. For example, check for splinters, sharp edges, loose pieces, or tears in a playpen that could injure an infant.

Why it works:
Infants need safe places to learn and grow. As children learn new skills, their interaction with the environment changes, leading to new safety risks. Using a home safety checklist, and keeping in mind an infant’s needs and developmental abilities now and in the weeks to come, can help you identify possible hazards so you can remove, repair, and keep your baby away from any objects that could be harmful.

Safety Tip No. 3: Use safety devices

What families can do:
Get and use smoke alarms and carbon monoxide detectors. Properly installed and maintained smoke alarms and carbon monoxide detectors save lives. Follow manufacturer’s recommendations for where to place them. Your home visitor may be able to help you obtain these devices for free or at a reduced cost. Make a schedule to check the batteries routinely to make sure they work and replace them once a year. Have a fire escape plan that describes who will get the children out of the house and where you will meet once outside. Use safety devices such as outlet covers, cabinet locks, and baby gates.

Why it works:
Smoke alarms warn you that there is a fire so you can get your family out of the building quickly. Carbon monoxide (CO) is a deadly, poisonous, odorless, and colorless gas. It may come from home heating and cooking devices. An alarm alerts you to unsafe CO levels in the home. Simple safety devices like outlet covers, cabinet locks, and baby gates prevent injuries and are not expensive. It is always best to plan ahead when child proofing your home so that as a mobile infant develops new skills and abilities, you know that your baby can explore safely.

Safety Tip No. 4: Make sure that windows are safe

What to do:
Keep cribs, furniture, toys, and other objects away from windows and blind cords. Curtains or cordless shades are safer than Roman shades or blinds with cords. Secure the cords and chains from window coverings [PDF, 145KB] so they are up and out of reach. Make sure windows either open from the top or have guards so they can’t open more than 4 inches.

Why it works:
Cords from window blinds are a strangulation hazard. Inexpensive cord safety devices are available from retail stores if you have blinds with cords. Windows can be a source of falls even when they are closed, and can pose a hazard to infants who are developing new motor skills and becoming more active every day. A window screen is not designed to protect a child from falling.

Safety Tip No. 5: Be aware of and keep all poisons out of children’s reach

What families can do:
If you live in a house or apartment built before 1978, it may have lead paint. You can talk to your home visitor as well as your landlord, health care provider, and local health department to find out if you have lead paint in your home, and if so, what to do. Infants learn about their environment by exploring objects using all of their senses. Inspect your home for poisonous materials. Check to make sure indoor and outdoor plants [PDF, 197KB] are not poisonous. Place all cleaning products, chemicals, and toxic materials in locked cabinets. Craft and play materials should say they are "non-toxic." Keep any products that say "keep out of reach of children" and everyday items like toothpaste out of reach. Store medications up and away. Make sure that people who live with or visit you put away their coats, purses, bags, and backpacks so that your baby cannot reach inside for medications [PDF, 455KB] or other unsafe items. Avoid using chemicals near your baby. Post Poison Control information in a central location.

Why it works:
There are many poisons throughout the home. Some are obvious, but others may be harder to identify. According to Safe Kids Worldwide, "every minute of every day, a poison control center answers a call about a young child getting into medicine."¹² Indoor and outdoor plants, paint, craft materials, and medications are hazardous when mobile infants put them in their mouths or spill chemicals on their skin. A small amount of lead is harmful to a child who swallows or breathes in dust that you may not even be able to see. Even everyday items like makeup and toothpaste can be poisonous if eaten in large quantities. To keep babies safe, store toxic products in locked cabinets and keep personal items out of children's reach.

Safety Tip No. 6: Check the temperature of your hot water

What families can do:
Set the temperature on your hot water heater to 120 degrees Fahrenheit or lower and check the water temperature on the inside of your wrist before bathing your baby.

Why it works:
Infants have thin skin that burns easily. Babies can’t get out of a bathtub safely by themselves if the water is too hot. To prevent burns from scalding water in the tub or sink, make sure that the temperature on your water heater is not higher than 120 degrees.

Safety Tip No. 7: Keep hot foods and liquids out of reach

What families can do:
Don’t hold your baby when you are holding hot food or a hot beverage, cooking on the stove, or taking food out of the microwave. Place hot liquids and foods in the center of the counter or a table that is not at your child’s level. Make sure that the microwave and cords from appliances that may contain hot liquid, such as a coffee pot or crock pot, are not in reach. Keep pots on the back burner of the stove with the handles turned inward. When using the microwave or stove, it is not safe for a mobile infant to be in the kitchen without supervision.

Why it works:
Hot liquids and steam are more likely to burn or scald infants, as their skin can burn from even brief contact with a hot substance that adults find comfortable. Infants are curious and have a strong grasp. If they grab a dangling cord, tablecloth, or your arm when you are holding hot food or drinks, the food or liquid can spill on them. In one study, 90.4 percent of scald injuries to children under age 5 were related to hot cooking or drinking liquids.¹³ Using a baby gate so your baby can’t go into the kitchen without you when you are cooking can prevent burns to a young child.

Safety Tip No. 8: Prevent drowning

What families can do:
Always stay hands-on when bathing your infant. Never leave an infant alone in the water. Be aware of any body of water around the home such as pools, ponds, or lakes. Children ages 1 to 4 have the highest drowning rates.¹⁴ Most occur in home swimming pools. If you live in a house that has a pool, make sure that it has fencing on all sides and has "self-closing and self-latching gates that open outward, with latches that are out of the reach of children."¹⁵ Keep a phone with you, and learn child cardiopulmonary resuscitation (CPR). Empty buckets and turn them upside down when done. Close the lids to toilets and washing machines. Stay actively engaged whenever a child is in or near water.

Why it works:
Drowning happens quickly and silently. An infant or small child can drown within 30 seconds in as little as 2 inches of liquid, so stay hands-on and actively engaged whenever a child is in or near any water. Mobile infants are curious explorers and can lean inside a bucket or reach for a toy in the pool, but their heads are bigger than their bodies. If they fall in, they are unable to get out and can drown.

Safety Tip No. 9: Prepare for emergencies

What families can do:
Post important emergency phone numbers such as poison control, 911, and your child’s doctor in a central location, and store them in your mobile phone. This is especially important if your child has a special health care need. Prepare for common weather-related emergencies. Keep basic first aid and disaster supplies and instructions on hand. You also can talk to your home visitor about opportunities to learn child CPR and first aid.

Why it works:
Families that prepare for emergencies have a better chance of getting help quickly when needed. Emergency responders and poison control professionals can provide instruction about first aid treatment for different types of injuries.

Safety Tip No. 10: Always use a car seat for your child

What families can do:
Select a car seat based on your child’s age and size, and that fits in your vehicle, and use it every time your child rides in your car or truck. Install the car seat according to the manufacturer’s instructions to ensure that it protects your child. Infants should ride in the back seat in a rear-facing car seat until they reach the top height or weight limit allowed by the car seat’s manufacturer. The safest place for children to sit is the back seat. Find an inspector who can check your child’s car seat and make sure it is installed correctly.

Why it works:
Motor vehicles are the second leading cause of death among children ages birth to 4.¹⁶ The best way to protect your child from injury in a crash is to make sure that they are always seated in the back seat in a car seat that is appropriate for their age and size. Using a car seat reduces the risk of death in passenger vehicles by 71% for infants younger than age 1 and by 54% for toddlers ages 1–4.¹⁷ Infants and young children are more likely to be hurt in the front seat. Front air bags are designed to protect adults, not children, and can be dangerous to children seated in front of them.

¹¹ See A Home Visitor’s Guide to Safety Conversations in Safety Practices for examples of other home safety checklists. 

¹² Safe Kids Worldwide (2014). Medicine Safety 2014 Infographic. Retrieved from http://www.safekids.org/infographic/medicine-safety-2014-infographic 

¹³ Lowell, G., Quinlan, K., and Gottlieb L. J. (2008). Pediatrics 122:799–804. 

¹⁴ Centers for Disease Control and Prevention (2014). Unintentional Drowning: Get the Facts. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Water-Safety/waterinjuries-factsheet.html 

¹⁶ Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2012). The National Action Plan for Child Injury Prevention. Atlanta, GA: CDC 

¹⁷ Centers for Disease Control and Prevention, Injury Prevention and Control: Motor Vehicle Safety (2014). Retrieved from http://www.cdc.gov/MotorVehicleSafety/Child_Passenger_Safety/CPS-Factsheet.html

Safety Tip No. 1: Stay hands-on and engaged

What families can do:
Have everything you need to change your baby’s diaper before you start. Keep a hand on mobile infants whenever they are on a changing table or other raised surface. Engaging infants in reciprocal (back and forth) play, such as singing, rhyming, and echoing verbalizations, supports a nurturing relationship between you and your baby. It also provides opportunities for early learning.

Why it works:
Mobile infants are constantly testing what their bodies can do. They are able to roll and crawl, and may attempt to scoot forward or backward. It is important to never leave them alone because their movements may be unpredictable. Staying hands-on can prevent an infant from falling off a changing table or other high surface. Providing a positive, engaging activity during diapering creates learning opportunities for your baby and focuses his attention.

Safety Tip No. 2: Store diapering supplies safely

What families can do:
Keep diaper changing materials, including wipes and ointments, where you can reach them easily but are away from an infant’s grasp. You can give your baby a safe, washable toy to hold while diapering. Wash the diaper changing area after each use and store the supplies out of an infant’s reach.

Why it works:
Mobile infants use their hands and mouth to explore their environment. They are able to pick up and mouth materials that are within their reach. Providing a safe toy to interest your baby and keeping spray bottles, disinfectant wipes, ointments, medications, and other harmful materials out of reach protects children from injury.

Safety Tip No. 1: Check bottle temperatures

What families can do:
Caring for Our Children recommends serving bottles cold from the refrigerator or placing them "under running, warm tap water or in a container of water that is no warmer than 120 degrees" for five minutes to warm them. The American Academy of Pediatrics suggests that the easiest way to test the temperature of the liquid in a bottle is to shake a few drops on the inside of your wrist.

Why it works:
Infants' mouths are sensitive to temperature and may scald if liquids are too hot. Microwaves do not heat liquids evenly and can lead to scalding. Using a bottle warmer or placing a bottle in warm water is safer and more effective.

Safety Tip No. 2: Choose developmentally appropriate foods and check the temperature

What families can do:
At this stage, many infants are eating from a spoon. Infant food can be served at room temperature and does not need to be heated in the microwave. If you do heat the food, stir it to distribute the heat evenly. Many babies are also beginning to feed themselves. Serve food that is soft and mashed. Cut food into small pieces (cubes no larger than 1/4 inch) or thin slices that your baby can easily chew and swallow. Avoid high-risk choking foods such as small, slippery foods; dry foods that are hard to chew or sticky; and tough foods.¹⁸ For a list of safe foods, see Foods That Are Choking Hazards. Use the Well-Visit Planner and talk with your baby's health care provider about foods or allergies.

Why it works:
Mobile infants are still learning how to control their tongue, chew, and swallow. As infants grow, they can move food from hand to mouth, and gain more control over their ability to move food around in their mouth, but are still inefficient chewers. Your child's healthcare provider can provide guidance on how to manage allergic reactions.

Safety Tip No. 3: Position children to eat safely

What families can do:
To minimize choking, make a family rule that children and adults must be seated while eating, and teach your baby to sit while eating. Watch to make sure your baby doesn’t put too much food in their mouth at once. Always use the safety straps in a high chair to reduce the risk of injury from a fall. You can also place the high chair near you so your baby can participate in family mealtimes and you can reach them quickly if needed.

Why it works:
Many mobile infants are so interested in moving that they may not want to sit for very long to eat. Sitting while eating and drinking minimizes the risk of children choking or of a dental injury from falling with a cup or utensil in their mouth. Using the safety straps in a high chair reduces the likelihood of an injury from a fall. A high chair within easy reach provides an opportunity for your baby to enjoy family meals safely.

¹⁸ Mayo Clinic. (2011, April). Infant Choking: How to Keep Your Baby Safe. Retrieved from Infant Choking: How to Keep Your Baby Safe.

Safety Tip No. 1: Use safe cribs

What families can do:
Use a crib that was manufactured on or after June 28, 2011. Cribs made after this date must meet the current safety standard. Drop-side cribs do not meet current safety regulations. More guidance about the standard, including what to do if you cannot use a newer crib, is available from HealthyChildren.org. Talk to your home visitor if you need help finding a safe crib.

Why it works:
As infants become more active, they can get into dangerous positions. While lying on their backs, they may push or wiggle themselves into the side of a crib. They also may slide their arms through the slats in a crib and wedge themselves into positions that could injure them. Using safe cribs protects infants from injury, suffocation, or strangulation.

Safety Tip No. 2: Use safe sleep practices

What families can do:
Use safe sleep practices. The safest place for your baby to sleep is in the room where you sleep, but not in your bed. Although the risk of Sudden Infant Death Syndrome (SIDS) declines for older infants, always place them on their backs to sleep, without blankets and toys that could cover their mouth or nose. Use a firm mattress and a tight-fitting sheet. Do not use bumpers in a crib. Your home visitor can explain why experts say that "bare is best!" Place the mattress at its lowest position, and make sure there is nothing in the crib that your baby can use to try to climb out. To prevent infants from strangling, keep monitor cords at least three feet away from any part of the crib, play yard, or other area where infants are sleeping.

Why it works:
Mobile infants begin to roll around, crawl, and stand in their cribs, often moving around as they sleep. Eliminating toys, pillows, bumper pads, and loose blankets from cribs and sleeping areas can prevent suffocation. Children also may try to get out of the crib. Lowering the crib mattress and making sure there is nothing for your baby to climb on reduces the risk of falls. To prevent infants from strangling, keep monitor cords at least three feet away from any part of the crib, play yard, or other area where infants are sleeping.

Safety Tip No. 1: Use toys, equipment, and materials that have no small parts and are safe for young infants.

What families can do:
Only provide toys that are safe for mobile infants. Use materials that are sturdy and easy to clean, because babies will put them in their mouths. Make sure that materials and equipment, including dolls and stuffed animals, do not have loose, small parts that could fall off and pose a choking hazard. Keep all objects that are small enough to fit into an infant's mouth out of reach. Any object is dangerous if it can pass through a small-parts cylinder (2.25 inches long by 1.25 inches wide) used for screening choking hazards for children younger than 3 years. For more information, see Which Toy for Which Child: A Consumer's Guide for Selecting Suitable Toys [PDF, 1.2MB]. Make sure that there are no button batteries or magnets within reach that an infant could swallow. 

Select equipment that will not trap an infant’s head or limbs and is appropriate for your baby’s height and weight. Always use safety straps. To find out if safety concerns have been reported about the toys and equipment you are using, you can search for product safety complaints or report a concern at www.saferproducts.gov. Sign up for recall notices from the U.S. Consumer Product Safety Commission.

Why it works:
Mobile infants are learning to transfer objects from hand to hand and hand to mouth. They explore their world through their senses, and often touch and mouth objects. With their greater mobility, they are excited about exploring their physical environment. Most infants do not have a sense of danger or caution and need safe equipment and materials to reduce the risk of injury. Providing toys and materials that contain no small or loose parts eliminates choking hazards. Storing button batteries and magnets out of reach removes hazardous materials. Placing heavier items on lower shelving reduces the risk of injury from a dropped toy. Age-appropriate equipment prevents injuries from entrapment, choking, and strangulation. Safety straps secure a child in a stroller, swing, rocker, or other equipment and reduce the risk of falls.

Safety Tip No. 2: Provide safe outdoor play environments

What families can do:
Learning about the natural world is fun for families and children of all ages, including mobile infants. Supervise children carefully in any outdoor play area. Limit sun exposure between 10 a.m. and 4 p.m. Dress infants appropriately, and keep them inside during extreme heat or cold. In warm weather, dress your baby in light clothing to cover her skin and use a wide-brimmed hat. For infants older than 6 months of age, apply sunscreen to all exposed areas at least 30 minutes before going outside and every two hours afterwards. Bring and encourage drinking water often. Keep your baby away from poisonous plants [PDF, 197KB] and any insects that may sting or bite.

Why it works:
All children need opportunities to play outside as well as inside. Providing opportunities to explore the sights and sounds in nature supports children’s development when these experiences are safe and well-supervised. Using sunscreen and a hat protects an infant from sunburn. Providing fluids frequently prevents dehydration. Knowing how to recognize plants that are poisonous and making sure that there are no insects that sting or bite protects children from injury. Mobile infants are not able to regulate their body temperature well, so keeping them inside during extreme heat or cold protects them from overheating and frostbite.