Child safety and injury prevention

You can never completely ‘child-proof’ your home. You can, however, dramatically reduce the risk of injuries by making a few changes to your home and keeping your child under constant supervision. Emergency medical treatment for young children and babies is not always the same as for adults.

If you are a parent or carer, make sure you have current training in child (paediatric) first aid. Plan to do a CPR (cardiopulmonary resuscitation) refresher course once a year, because first aid practices sometimes change and it is easy to forget skills you do not use regularly.

Call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) for an ambulance if your child is severely injured, has collapsed, has stopped breathing, is fitting or is suffering an anaphylactic reaction.

Preventing drowning#

Drowning is one of the leading causes of unintentional injury death for children under five years of age. One- and two-year-olds are most at risk because they are more mobile than infants but are still developing motor skills and cannot judge hazards. Swimming pools, baths, and rivers, creeks and streams are the most common places where toddler drownings occur.

Children can drown quickly and silently in a few centimetres of water. Safety measures include:

• keep children in constant sight and within arm’s reach of an adult at all times in or around water
• when your child is in the bath, stay within arm’s reach with your full attention; have everything you need ready before you start
• empty the bath, buckets and wading pools immediately after use, and close the bathroom door when it is not in use
• fence swimming pools and spas, remove anything that could be used to climb the barrier, and keep the gate closed at all times
• cover fishponds and aquariums with rigid wire mesh
• remember that lifeguards are not babysitters; an adult must stay within arm’s reach of children under five

Water familiarisation and awareness classes are offered for children from six months of age. Learning infant and child CPR is also valuable in case of an emergency.

Preventing falls#

Falling is the most common cause of injury for children of all ages. The seriousness of an injury depends on the height the child falls from, the surface they land on, and what they may hit on the way down. A child who is just learning to stand and toddle has frequent minor falls.

To reduce fall injuries, look at the environment from your child’s level:

• create a clear play area by removing tripping hazards such as toys, rugs and electrical cords
• pad sharp corners of benches and tables, or remove them from the play area
• put bouncinettes and rocker chairs on the floor, never on a table or other high surface, and never carry your baby around in one
• use a change table with sides raised at least 10 cm, keep one hand on your baby at all times, and never leave them unsupervised; consider changing your baby on a towel on the floor instead
• do not use baby walkers, as they let a young child move into danger quickly and unexpectedly
• always use a full-body (five-point) harness in prams, strollers, high chairs and shopping trolleys
• use safety gates at the top and bottom of stairs, and a sensor light for stairs and steps
• put non-skid rubber mats in the bath and shower
• make sure swings, slides and climbing equipment have soft fall material underneath, to a depth of at least 30 cm
• only use bunk beds for children over nine years
• do not let children walk or run while carrying sharp objects such as scissors

Preventing falls from windows#

• keep furniture away from windows so children cannot climb up to them
• install window locks or guards so windows cannot open wide enough for a child to fit through
• remember that insect screens do not prevent children from falling

Preventing burns and scalds#

Install working smoke alarms, test them monthly, change the batteries each year, and replace the alarms every 10 years.

Keep children away from fires, flames, hot surfaces and hot liquids:

• install a fixed guard at least 70 cm high around all heaters, open fires, radiators and stoves
• lock matches, lighters and flammable liquids away out of reach
• keep a fire blanket and a dry powder extinguisher in the kitchen, store the fire blanket at least one metre from the stove, and learn how to use both
• keep the extinguisher near the kitchen entrance, between your exit point and the likely source of a fire
• install a safety switch to help prevent electrocution, and use power boards rather than double adapters
• choose close-fitting nightwear labelled as low fire danger

If you are not confident using the extinguisher or fire blanket during a fire, evacuate immediately, closing the door behind you.

Prepare a home fire escape plan and practise it with the whole family. Make sure there are two ways out of each room where possible, as well as out of the house. Teach your child that if their clothing catches fire they should stop, drop to the floor, cover their face with their hands and roll. Teach them that in a fire they should get down low and crawl through the smoke to the nearest exit, to avoid smoke and poisonous gases.

For burns and scalds, hold the injured area under cool running water for at least 20 minutes. Never use ice, oil, butter or ointments. Seek medical attention if clothing is stuck to the burn, if the burn is on the face, hands, lap or feet, or if it is larger than a small coin.

Preventing scalds#

Hot liquids cause two out of three burns in small children, and a severe scald can kill a small child, whose skin is far more sensitive than an adult’s:

• keep children’s play areas away from the kitchen, and never hold a child while you have a hot drink
• put hot food and liquids in the centre of the table or to the back of the bench, away from the edges
• do not use a tablecloth, which children can pull; use non-slip placemats instead
• when busy in the kitchen, use a playpen or safety gate to keep your child from underfoot
• when running a bath, run cold water first, add hot water to a safe temperature of about 37-38°C (98.6-100.4°F), then run the cold water last to cool the spout
• limit hot water at bathroom outlets to a maximum of 50°C (122°F); a licensed plumber can check and set this
• keep electrical cords from kettles and other appliances away from the edge and out of reach; use short, curly or cordless options
• turn pot handles inward, use the back hotplates where possible, and consider a stove guard

Microwave safety#

Microwaving heats liquids unevenly, and the temperature keeps rising for a short time after food is removed, so it is easy to misjudge how hot it is. Keep the microwave out of reach of children and take care when heating liquids. If you must warm a baby’s bottle in the microwave, stand it up without a cap and heat briefly (about 30 seconds for a full bottle at full power), replace the cap and teat, shake gently, let it stand for 10 to 20 seconds, then test the temperature. If the liquid feels very warm to you, it is too hot for your baby.

Preventing poisoning#

Young children tend to put objects into their mouths, and children under five, especially those between one and three, are most at risk of poisoning. Household products and medicines are the most common causes, with the most serious poisonings usually involving medicines. Dangerous products include drain and oven cleaners, dishwasher tablets and powders, bleaches, paints, many gardening products and other household chemicals.

Safety suggestions include:

• keep household products and medicines out of the reach and sight of children
• put chemicals and cleaning products away immediately after use
• store medicines and dangerous products in cupboards with a child-resistant lock, at least 1.5 m above the ground
• only remove a medicine from its packaging when you are about to use it, and never leave medicines unattended where a child could reach them
• read warning labels and directions carefully
• leave medicines and chemicals in their original containers; never transfer them into other containers such as drink bottles
• remember that child-resistant caps are not childproof, so products still need to be stored up high in a locked cupboard
• clean out your medicine cupboard regularly, and take unwanted or out-of-date medicines to a pharmacy for proper disposal
• rinse empty containers of liquid medicines and household products with water before throwing them out
• refer to medicines by their proper names, and never call them lollies
• avoid taking medicines in front of children, who tend to imitate adults
• keep visitors’ bags, which may contain medicines, well out of reach
• avoid distractions when giving medicines and double-check before doing so
• if more than one person cares for a child, agree on a checking system to avoid double doses, and note the time and dose given

Be aware that childhood poisoning increases when usual household routines are disrupted, such as moving house, being on holiday or having visitors. Remove or prevent access to poisonous plants in your garden or home, and teach children never to pick up or touch insects such as bees, wasps or spiders.

If you think someone in your care has been poisoned, given the wrong medicine or dose, or bitten or stung by a poisonous creature, try to stay calm and seek advice from your local poisons information service or emergency number. Keep the child with you, along with the container of the suspected substance. If they were bitten or stung, try to capture the creature in a jar for identification, but only if you can do so safely.

Choking and swallowed objects#

To prevent choking:

• be aware of foods children can choke on, such as hard sweets, whole apple and nuts
• do not give a child any object smaller than a small coin; children under three can choke on items this size
• watch for other hazards such as pen tops, hair ties, batteries and coins
• encourage children to sit calmly and not eat too quickly
• check toys regularly for small parts

Button batteries#

Button batteries are found in many household items, including remote controls, calculators, bathroom scales, car keys, toys, watches, talking books and cards, and flameless candles. These coin-sized batteries can cause severe, life-threatening injuries in less than two hours if swallowed. To protect children:

• identify items that contain button batteries
• secure the battery compartments of those items
• keep loose or spare batteries and the items containing them out of reach
• dispose of button batteries and items containing them, including packaging, safely

If you think your child has swallowed a button battery or inserted one into part of their body, take urgent action and seek emergency help immediately. Do not wait for symptoms to appear.

Blind and curtain cords#

Loose or looped cords can wrap around and strangle children who are playing, jumping or climbing nearby, and this can happen very quickly:

• go through every room and check for blinds or curtains with long cords that are loose or looped, including any within reach at floor level or near climbable furniture
• secure loose or looped cords with cleats or tension devices, available from curtain, blind or hardware retailers
• do not put cots, beds, high chairs or playpens near a window where a child can reach the cords
• do not place sofas, chairs, tables, shelves or bookcases near windows with corded blinds, as children often climb up to look out
• always supervise children in any room with reachable cords, and never leave them alone there, even briefly

Key points#

• Emergency medical treatment for young children and babies is not always the same as for adults
• Drowning is one of the leading causes of unintentional injury death for children under five
• Swimming pools, baths, and rivers, creeks and streams are the most common places where toddler drownings occur
• Falling is the most common cause of injury for children of all ages
• Always supervise young children closely and keep hazards out of reach

Where to get help#