Back to Tips for Keeping Children Safe: A Developmental Guide
Infants depend on their caregivers for food, warmth, and care, and for meeting such basic needs as eating, diapering, sleeping, and bonding. But all babies are unique. Some infants may settle easily and be capable of quickly soothing themselves. Others may cry often or for long periods of time. In order to thrive, infants need nurturing, consistent, caring, and responsive caregivers. A caregiver develops a responsive relationship with an infant by responding to the baby's cries, coos, and other communication attempts and providing what the infant needs. Responsive caregiving or relationships is at the heart of young children's development. The architecture of their brain is literally shaped by every single experience they have.
During the first months of life, a young infant's neck is not strong enough to support the weight of his or her head. Infant caregivers support a baby's early movements by gently holding and positioning the infant's body, head, and neck to prevent injury. Caregivers also provide a safe space for young infants to participate in supervised "tummy time." This gives them a chance to build the muscles they need to hold up their neck, control the movement of their arms and legs, roll over (4–6 months), sit up (7–9 months), and eventually get ready for crawling, cruising, and walking. Young infants also begin to roll over and sometimes move in unexpected ways. Caregivers need to supervise them closely to prevent falls, the leading cause of unintentional, nonfatal injury among all children ages birth to 5. In addition, they begin to grasp objects and need to have access to materials that are safe so that there is no risk of choking.
Infants' feeding skills evolve as they mature. At first they are only able to suck and swallow liquids. Over time, they gain more control of their tongue and mouth, which allows them to begin to eat pureed and strained food from a spoon. Caregivers talk with families to determine what foods and feeding styles best meet the needs of their child, and they observe infants carefully when feeding them. Conversations about food are respectful of the family's culture and food traditions, and support safe and culturally responsive feeding practices.
Young infants are constantly reacting to the world around them. Brightly colored objects, toys that make noises, and soothing music may stimulate or calm babies. Caregivers observe their reaction to different types and levels of stimulation—through sights, sounds, and touch—and respond by providing a nurturing and safe environment with enough stimulation to meet each child's needs and interests. "Remember with all babies—timing and match are important! (Your) job . . . is to recognize (a) baby's natural tendencies, meet her where she is at, and then provide the external support she needs to handle the stimulation that is naturally at the heart of everyday interactions with her caregivers and the world around her."1
1Gouley, K. K. (n.d.). Stimulation and development during Infancy: Tuning in to your baby's cues. Retrieved from The Child Study Center of the NYU Langone Medical Center website:
Stimulation and Development During Infancy: Tuning in to Your Baby's Cues
Safety Tip No. 1: Actively supervise
What to do:
Closely observe and supervise young infants so you can see and reach them at all times. Active supervision includes these six strategies:
- Set up the environment
- Position staff
- Scan and count
- Listen
- Anticipate children's behavior
- Engage and redirect
Why it works:
Infants change constantly and continually demonstrate new interests and abilities. Caregivers who use active supervision strategies are able to respond to each infant's individual needs by paying close attention and anticipating and removing potential hazards. Active supervision in classrooms with multi-age groupings is an important strategy to ensure the safety of children at different stages of development.
Safety Tip No. 2: Create safe environments
What to do:
Set up the indoor space with age-appropriate furniture so that young infants are able to explore their environment safely. Arrange furniture so that staff have a clear line of vision and can actively supervise infants at all times. Make sure that furnishings do not have sharp corners or flaking paint, and that there are no dangling cords. Provide a separate area for "tummy time" for young infants, away from play areas for mobile infants.
In outdoor environments, offer soft surfacing, such as a blanket. Use the shade of a tree, stroller canopy, or umbrella to protect young infants from direct sunlight.
Why it works:
Furniture that is waist-high allows caregivers to see and hear everything that is happening in the room, whether they are sitting or standing. All furnishings should be in good condition and properly secured. Setting aside a special area for "tummy time" that is not in the direct path of a mobile infant protects younger infants from injury.
All children need opportunities to play and explore outside as well as inside. Exposure to the sights, sounds, and experiences of their outdoor environment supports child development in all domains.2 However, caregivers working with young infants need to take specific measures to ensure that outdoor experiences are positive and safe. Shade and appropriate clothing are the best sun protection for young infants.
Safety Tip No. 3: Maintain safe environments
What to do:
Before every use of furniture and equipment, conduct safety inspections on indoor and outdoor environments and remove any hazards.
Why it works:
Infants need safe places to learn and grow. When caregivers use a safety checklist to perform environmental safety checks that match a child's level of development, they are able to identify possible hazards and remove or repair any objects that could injure an infant.
Safety Tip No. 4: Store and lock poisonous products
What to do:
Place all cleaning products, other chemicals, medications, and classroom materials that could be harmful to infants in locked cabinets out of their reach. Store staff coats, purses, and bags in closets or outside the classroom.
Why it works:
Young infants learn about their environment by exploring objects using all of their senses. Infants who can reach a cleaning product can put it in their mouth, inhale it, or spill it on their skin. The chemicals can poison or burn them. When caregivers store toxic products in locked cabinets and keep personal items out of children's reach, they cannot pose a threat to young infants.
2Thigpen, B. (2007). Outdoor Play: Combating Sedentary Lifestyles. ZERO TO THREE, 28(1), 19–23.
Safety Tip No. 1: Stay "hands on" and engaged
What to do:
To prevent falls, keep a hand on young infants whenever they are on a changing table or other raised surface. Engaging infants in reciprocal play, such as singing, rhyming, and echoing verbalizations, helps keep them safe and provides opportunities for learning.
Why it works:
Young infants are constantly exploring what their bodies can do. They may wiggle their arms or legs, thrust them onto the changing pad, attempt to roll over, or scoot forward or backward. Because their movements may be unpredictable, staying hands on can prevent an infant from falling off a changing table or other high surface. In addition, providing a positive, engaging activity during diapering fosters a nurturing relationship, creates learning opportunities, and helps prevent injuries by focusing a child's attention during diapering.
Safety Tip No. 2: Store diapering supplies safely
What to do:
Keep topical medications for rashes and skin conditions and diapering ointments within easy reach of the caregiver but away from a child's grasp. Disinfect diapering areas after each use. Wait until children have left the area to prevent exposing them to the chemicals in these products. Follow your state licensing regulations when storing disinfecting solutions. Find more information about diaper changing procedures in Caring for Our Children from the National Resource Center for Health and Safety in Child Care and Early Education (CFOC).3
Why it works:
Diapering areas may contain medications or ointments for diaper rash or other skin conditions in addition to disinfectant supplies. Young infants try to grasp objects. As they grow, they are more able to pick up and mouth any materials that are within their reach. A young infant may try to grab spray bottles, disinfectant wipes, ointments, medications, or other harmful materials that are close to the diaper changing area and put them in his or her mouth. Thoughtful placement of these items is necessary to prevent children from touching them.
3American Academy of Pediatrics, American Public Health Association, & National Resource Center for Health and Safety in Child Care and Early Education. (2011). Caring for our children: National health and safety performance standards guidelines for early care and education programs (3rd ed.). Elk Grove Village, IL: American Academy of Pediatrics. Retrieved from http://nrckids.org
Safety Tip No. 1: Check food temperatures
What to do:
When bottle feeding, CFOC 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. CFOC offers detailed instructions on warming bottles and infant food and on preparing, feeding, and storing human milk.
Why it works:
Infants' mouths are particularly 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.4
Safety Tip No. 2: Position children to eat safely
What to do:
Hold infants who are bottle feeding securely and make sure they are able to breathe freely through their nose. Once an infant is able to sit up and eat strained food, use a feeding chair with secure straps.
Why it works:
Infants breathe through their nose when they eat, so their nasal passages need to be clear to accept a bottle. Hold an infant who is bottle feeding securely. For an infant who is able to sit up and eat strained food, use a chair that is low to the ground with high sides and secure straps to reduce the risk of injury from a fall.
Safety Tip No. 3: Choose age-appropriate foods
What to do:
When infants are ready to eat food from a spoon, consult with families and introduce age-appropriate, culturally responsive foods. Make sure that all food is strained or pureed. The U.S. Department of Agriculture (USDA) recommends that infants from 4–7 months be offered only strained fruits and vegetables and iron-fortified cereal. USDA guidelines offer important information about meal patterns and infant feeding.
Why it works:
A baby's throat is small and easily obstructed. Young infants are still learning how to control their tongue, chew, and swallow. As infants grow, they gain more control over their ability to move food around in their mouth and are able to eat strained and pureed food without choking. The Sequence of Infant Development and Feeding Skills in Normal, Healthy Full-Term Infants from the USDA's Feeding Infants: A Guide for Use in the Child Nutrition Programs is a helpful chart for understanding foods that are safe for children at different developmental stages.
4Centers for Disease Control and Prevention. (2010). Proper handling and storage of human milk. Retrieved from http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
Safety Tip No. 1: Use safe cribs
What to do:
Use the new U.S. Consumer Product Safety Commission (CPSC) federal safety regulations to protect infants from injury, suffocation, or strangulation in a crib. Drop-side cribs do not meet current safety regulations. Programs are not permitted to use them. In addition, programs must help families locate replacements for drop-side cribs.
Why it works:
As young infants begin to move their bodies, they can put themselves into dangerous positions. While lying on their backs, they may push or wiggle themselves into the side of a crib. They may also slide their arms through the slats in a crib and wedge themselves into positions that could injure them. Using safe cribs prevents injuries to young infants.
Safety Tip No. 2: Use safe sleep practices
What to do:
It is important to employ safe sleep practices. Always place young infants on their backs to sleep, without blankets and toys that could cover a child's mouth or nose. Use a firm mattress and a tight-fitting sheet. Share CPSC recommendations with families that "bare is best" in sleeping arrangements for infants and that it's safer not to use bumpers in a crib.
Why it works:
Young infants develop the ability to flip their heads and bodies as they grow. Until they are able to control how their muscles move, they are at risk for suffocation and sudden infant death syndrome (SIDS). Caregivers can reduce this risk by placing infants on their backs in cribs without toys, pillows, or loose blankets.
Safety Tip No. 1: Use equipment and materials that are safe for infants and have no small parts
What to do:
Select equipment that is appropriate for infants so there is nothing that can trap a child's head or limbs. Ensure that strollers are appropriate for the height and weight of the children. Choose play mats, swings, rockers, carriers and other equipment that accommodate infants' height and weight restrictions. Always use safety straps to secure infants so they cannot fall.
Regularly inspect materials and equipment to identify, remove, or repair any objects that may cause injury. Only provide toys that are safe for infants, and place heavier toys on the bottom shelves. Keep all objects that are small enough to fit into an infant's mouth out of reach. 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. Any object that can pass through the small-parts cylinder (2.25 inches long by 1.25 inches wide) used for screening choking hazards [PDF, 31KB] for children younger than 3 years is too small for infant play.
For more information, see ASTM Toy Test Equipment Small Parts Cylinder and Which Toy for Which Child: A Consumer's Guide for Selecting Suitable Toys [PDF, 1.2MB].
Why it works:
Age-appropriate equipment prevents injuries from entrapment. Safety straps secure a child in a stroller, swing, rocker, carrier, or other equipment and reduce the risk of falls. Routine inspections of materials and equipment eliminate potential hazards. Placing heavier objects on lower shelves reduces the likelihood of injury from a dropped toy.
Young infants are becoming more aware of their environment. They use their hands and mouths to explore. As soon as an infant is capable of grasping objects, a baby may try to grasp an object within reach and bring it to his or her mouth. Providing toys and materials that contain no small or loose parts eliminates choking hazards.
To sign up for recall notices from the U.S. Consumer Product Safety Commission, visit their website at http://www.cpsc.gov/Newsroom/Subscribe/.
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Resource Type: Article
National Centers: Health, Behavioral Health, and Safety
Age Group: Infants and Toddlers
Last Updated: June 6, 2022