Child Safety: Newborns and Young Infants

by Warren P. Silberstein, M.D.
09/01/97

When you first bring your newborn home there are only a few safety concerns. Of course you will want to protect your home against fire for yourself and all your children. The following rules from The Injury Prevention Program (TIPP) of the American Academy of Pediatrics are important for all ages:

• Never leave small children alone in the home, even for a minute. This is especially true for infants who are entirely dependent on adults to remove them to safety.
• Install fire and smoke detectors on every floor and in every bedroom.
• Plan several escape routes from each area of the house and a place to meet immediately after leaving. Rope ladders should be kept on upper floors to permit escape.
• Conduct home fire drills.
• Do not smoke in bed.
• Be careful about disposing of cigarette butts, matches, and ashes.
• Keep matches and lighters out of reach of children.
• Avoid rubbish accumulation, which may cause fire by spontaneous combustion.
• Do not clean clothes with flammable liquids such as kerosene or gasoline
• Teach children to be careful around open flames.
• Do not wear loose-fitting clothing near a stove, fireplace, or open space heater.
• Have your heating system inspected and cleaned annually.
• Check electric appliances and cords regularly for wear or loose connections.
• Use only 15-ampere fuses for lighting circuits; never use a substitute for a fuse.
• Place fire extinguishers in areas of the home where the risk of fire is greatest.
• In the event of a fire get yourself and your children out of the house immediately without stopping to dress, grab valuables, or attempt to put out the fire. Most deaths occur from smoke inhalation rather than burns.

Your newborn will need a safe crib. TIPP provides the following guidelines:

• Buying Recommendations:
  • Cribs should have slats not more than 2-3/8 inches apart.
  • The wood surfaces should be free of splinters and cracks, and have lead-free paint.
  • The end panels should be made of a material which will not splinter.
  • The sides, when lowered, should be 4 inches above the mattress.
  • The sides should be operated with a locking, hand-operated latch which is secure from accidental release.
  • The mattress should be the same size as the crib so there are no gaps to catch arms or legs. The minimum rail height should be 22 inches from top of railing to mattress set at the lowest level.
  • The furniture should meet the standards of the Consumer Product Safety Commission.
• Crib Safety Tips:
  • Read manufacturer's instructions for use.
  • Never leave crib rails down when a baby is in the crib.
  • Bumper pads should be used around the entire crib until the infant begins to stand, then removed.
  • Begin to lower the crib mattress before the baby can sit unassisted. Have it at its lowest point before the baby can stand.
  • No hanging crib toys should be within reach. Do not leave large toys in the crib. The baby may use them as steps to climb out.
  • Use netting or safe extenders on top of cribs for babies who try to climb out.
  • Remove the child from the crib when 35 inches tall.

Your newborn will need a car seat for his first car trip, the trip home from the hospital. It is never safe to hold any baby during a car trip. If an infant requires attention out of the car seat during a trip, the car must be stopped. Newborns and infants less than 20 pounds should be placed in rear facing car seats. The safest place for the car seat is in the back seat of the car even for infants and even when the driver is the only other person in the car. If your car is equipped with passenger side air bags, the car seat must not be placed in the front seat. Airbags can cause serious or even fatal injuries to infants and children sitting in front or rear facing car seats. The car seat must be properly installed so that it can't come loose. The shoulder straps and seat belt must be fastened snugly around the baby for every trip no matter how short the car trip is.

Have everything you need for changing your baby available at the changing table. Most infants don't roll over until 4 months of age, but a crying, flailing newborn could wiggle himself off a changing table. Therefore, it isn't safe to walk away from any baby, even a newborn, leaving him alone on a changing table for even an instant. If you use any type of powder, place a small amount into your hand to rub onto the baby. Don't shake powder from the canister near the baby, especially near his face, because it may create a cloud of powder dust which could be breathed into the lungs.

If you are feeding your baby formula a microwave oven is very fast and convenient for warming middle of the night feedings, but be very careful. Microwaves can superheat some spots leaving other spots cold even in liquids. And microwavable containers don't get hot from microwaving. If you microwave formula to heat it, mix it very well before using it and test the temperature by pouring some onto your wrist, forearm, or the back of your hand.

Once the cord falls off your newborn, which usually occurs by two weeks, you will be able to give him a bath in a tub. Depending on how high your water temperature is set, tap water can be hot enough to scald. To test the temperature of bath water you must immerse your hand or elbow into the water and hold it there. If you just touch the water you may not realize how hot it is. Even if the water is very shallow, never be tempted to leave a newborn or infant in the tub alone for even a second. Only the mouth and nose need to be covered by water for a baby to drown. If there is an emergency, grab your baby out of the tub, wrap him in a towel, and take him with you.

Some pet lovers may not take kindly to my suggestion that you never leave a newborn or infant alone within reach of a pet. Let me assure you that I adore all animals. I'm a firm believer in introducing your pet to your baby and your baby to your pet. But to be fair to your pet, many dogs and cats view small moving objects as playthings, and they respond instinctually to certain movements. Of course your pet would never want to hurt your baby. Animals who must survive in the wild instinctually stay still when they are in danger until their instinct tells them it's time to run. Human babies are totally dependent on adults. Their automatic response to any distress is to scream and move and carry on to attract attention. Such a response could result in an attack by your beloved pet. You owe it to your pet and baby to teach them how to respond to each other.

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