Infants depend on their families for food, warmth, and care, and for meeting such basic needs as eating, diapering, sleeping, bonding, and safety. 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, and responsive caregivers. Home visitors support family members to develop a responsive relationship with their child and respond positively to the baby's cries, coos, and other communication attempts. Responsive caregiving 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 their head. Home visitors can demonstrate how to support a baby's early movements by gently holding and positioning the infant's body, head, and neck to prevent injury. They can help families to understand the importance of providing supervised "tummy time" experiences in a safe space for young infants. These experiences give babies 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. Home visitors may talk with families about the need for close supervision at all times to prevent falls, the leading cause of unintentional, nonfatal injury among young children. In addition, as young infants begin to grasp objects, they need to have access to safe materials to avoid choking or suffocating.
Infants' feeding skills evolve as they mature. At first, they only are 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. Home visitors can discuss the importance of observing infants carefully when they are eating so they do not choke. Conversations about food must be respectful of the family's culture and food preferences 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. Home visitors work with families to observe their child’s reaction to different types and levels of stimulation through sights, sounds, and touch. They also help parents to 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
1 Gouley, Kathleen Kiely, "Stimulation and Development during Infancy: Tuning In to Your Baby's Cues," n.d., New York University Child Study Center, http://thelifehabit.com/formative-years/512-stimulation-and-development-during-infancy-tuning-in-to-your-baby-s-cues
Safety Tip No. 1: Actively supervise
What families can do:
Place a young infant on a blanket near you so you can see and reach your baby at all times. 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
- Creating a separate area for tummy time away from walkways and areas where older children may be playing
- 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
- 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.
- 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:
Young infants change constantly, demonstrating new interests and abilities. Using Active Supervision strategies is a way to stay engaged, pay attention, and keep your baby safe. Properly securing or bolting furniture to the wall prevents it from tipping over as infants begin to pull on objects to move around or stand. Setting aside a special area for tummy time that is free of small items that could be choking hazards protects young infants from injury in a busy household.
Safety Tip No. 2: Use a checklist to create safe environments
What families can do:
Use a home safety checklist to identify possible hazards. Regularly inspect household items and infant furniture and equipment to make sure there are no splinters, sharp edges, or loose pieces that could injure your baby.
Why it works:
As children learn new skills, their interaction with the environment changes. This leads 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 routinely check the batteries to make sure they work and you know when to change them. Have a fire escape plan that describes who will get the children out of the house and where you will meet once outside. Before your baby becomes mobile, begin to 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 childproofing your home so as a young 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 families can 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 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 young 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. Young 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 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 an infant cannot reach medications [PDF, 455KB] or other unsafe items that may be inside. Avoid using chemicals near young infants. 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."4 Indoor and outdoor plants, paint, craft materials, and medications are hazardous if young infants put them in their mouth 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 be able to see. Even common, 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:
Young infants have thin skin that burns easily. Babies can’t get out of a bathtub if the water is too hot. To prevent burns from scalding water, make sure that the temperature on your water heater is no 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, 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 or steam, 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.
Why it works:
Hot liquids and steam are more likely to burn or scald young infants, as their skin can burn from even brief contact with a hot substance that adults find comfortable. Young infants have a strong grasp and jerky arm movements. If they grab your arm when you are holding hot food or drinks, or pull on a dangling cord or the edge of a tablecloth, hot 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.5
Safety Tip No. 8: Prevent drowning
What families can do:
Always stay hands-on when bathing a young infant and never leave your baby alone. Even before your child becomes mobile, 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."3
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. Infants under 1 year of age are most likely to drown in a bathtub.7 It is important to be actively engaged whenever a child is in or near water.
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 can also talk to your home visitor about opportunities to learn infant cardiopulmonary resuscitation (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 that is right for your child’s age, height and weight, and developmental needs. Make sure it 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. Newborns and infants should always 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. Find an inspector who can check your child’s car seat and make sure it is installed correctly.
Why it works:
Motor vehicles crashes are a leading cause of death among infants and young children.6 The best way to protect your child from injury is to make sure that they always ride in a car seat that is appropriate for their age and size. Using a car seat in passenger vehicles reduces the risk of death to infants younger than age 1 by 71 percent.7 The back seat is the safest place for children to sit. 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 a child sitting in front of them.
2 Safe Kids Worldwide (2014). Medicine Safety 2014 Infographic. Retrieved from http://www.safekids.org/infographic/medicine-safety-2014-infographic
3 Lowell, G., Quinlan, K., and Gottlieb L. J. (2008). Pediatrics 122:799-804.
5 Centers for Disease Control and Prevention (2014). National Center for Health Statistics, Unintentional Drowning Deaths in the United States, 1999–2010. Retrieved from http://www.cdc.gov/nchs/data/databriefs/db149.htm
6 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
7 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 young 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 and provides opportunities for early 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. It is important to never leave them alone because their movements can be unpredictable. Staying hands-on can prevent your baby from falling off a changing table or other high surface. Providing a positive, engaging activity during diapering creates learning opportunities and helps prevent injuries by focusing a baby’s attention during diapering.
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:
Young infants try to grasp objects. As they grow, they are more 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:
If you have chosen to bottle feed rather than breastfeed your baby, 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 burn 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: Position children to eat safely
What families can do:
Always hold infants who are bottle feeding so they can breathe freely through their nose.
Supervise closely when they are able to sit up and eat strained food. 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:
Infants breathe through their nose when they eat, so their nasal passages need to be clear to accept a bottle. Securely holding an infant who is bottle feeding supports a baby’s breathing and prevents falls. Supervising carefully ensures quick action if an infant starts to choke on their food. Using the safety straps in a high chair reduces the likelihood of an injury from a fall. A highchair within easy reach provides an opportunity for your baby to enjoy family meals safely.
Safety Tip No. 3: Choose developmentally appropriate foods and check the temperature
What families can do:
When your baby is ready to eat from a spoon, you can serve foods based on your family’s preferences that are developmentally appropriate, such as strained or pureed fruits and vegetables. 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. You can talk to your baby’s health care provider or use the Well-Visit Planner if you have questions about how to introduce solid foods safely.
Why it works:
A baby's throat is small and easily obstructed. Young infants are learning how to control their tongue, chew, and swallow, but are still not efficient chewers. As they grow, they gain more control over their ability to move food around in their mouths and eat strained and pureed food without choking. Your child's health care provider can provide guidance on how to reduce the risk of allergic reactions when introducing solid foods.
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 is available from HealthyChildren.org. Talk to your home visitor if you need help finding a safe crib.
Why it works:
As young infants begin to move their bodies, 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 protect infants from injury, suffocation, or strangulation.
Safety Tip No. 2: Use safe sleep practices
What families can do:
Use safe sleep practices [PDF, 1.1MB].8 The safest place for your baby to sleep is in the room where you sleep, but not in your bed. Always place young infants on their backs to sleep, without blankets, pillows, and toys that could cover their mouth or nose. Use a firm mattress and a tight-fitting sheet in the crib or bassinet. Do not use bumpers in a crib. Your home visitor can explain why experts say, "bare is best!"
Swaddling can calm very young infants, but make sure that your baby can’t roll over when swaddled. A loose blanket, including a swaddling blanket that comes unwrapped, could cover your baby’s face and increase the risk of suffocation. Try to keep your home cool, or dress your baby in light clothing so your child does not get overheated. To prevent infants from strangling, keep monitor cords at least three feet away from any part of the crib, bassinet, play yard, or other area where young infants are sleeping.
Why it works:
Until young infants are able to control how their muscles move and can regulate their breathing and body temperature, they are at risk for suffocation and sudden infant death syndrome (SIDS). Families can reduce this risk by placing infants on their backs in cribs without toys, pillows, or loose blankets and dressing them lightly to avoid getting overheated. Even a young infant can strangle from a baby monitor cord, so it is not safe to put them in or close to the area where your baby is sleeping.
8 For more information, see Help Your Baby Sleep Safely So You Can Sleep Soundly from the American Academy of Pediatrics: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Sleep-Soundly-While-Baby-Sleeps-Safe.aspx
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 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 the 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 a young infant’s head or limbs. Ensure that equipment such as strollers, swings, rockers, and carriers are appropriate for an infant’s height and weight. Always use safety straps and place equipment on the floor so infants cannot fall. Regularly inspect materials and equipment to identify, remove, or repair any objects that may cause injury. Baby walkers are not safe to use, even with an adult close by. You can search for product safety complaints about the toys and equipment you are using or report a concern at www.saferproducts.gov. Sign up for free recall notices from the U.S. Consumer Product Safety Commission.
Why it works:
Young infants are becoming more aware of their environment. They use their hands and mouths to explore. An infant may try to grasp an object within reach and bring it to their mouth. 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. Safety straps secure a child in a stroller, swing, rocker, carrier, or other equipment. They also reduce the risk of falls. It is best not to use baby walkers as they can roll down the stairs, or make it easier for infants to reach something that may not be safe for them to have.
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 young infants. A blanket on the grass provides a soft and clean surface for outdoor play. Use the shade of a tree, stroller canopy, umbrella, or clothing to cover an infant's skin and a wide-brimmed hat to protect them from direct sunlight. If protective clothing and shade are not available, only use sunscreen on small areas of the body, such as a baby's face. Keep infants away from poisonous plants [PDF, 197KB] and any insects that may sting or bite. Dress young children appropriately for the weather, and keep them inside during extreme heat or cold.
Why it works:
Providing safe opportunities to explore the sights and sounds in nature supports children’s development. Protecting babies younger than 6 months of age from sunburn with clothing, a hat, and shade is the best way to protect them from sunburn. Knowing how to recognize poisonous plants and insects that sting or bite protects children from injury. Young 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.
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Read more:
Resource Type: Article
National Centers: Health, Behavioral Health, and Safety
Age Group: Infants and Toddlers
Audience: Home Visitors
Last Updated: November 6, 2024