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When Can You Relax on Safety Rules?

I have a friend who still cuts her son's grapes in half, even though he's in kindergarten. Another supervises her daughter in the bath even though the girl knows how to swim. And I'm already wondering when I can take the rails off my 3-year-old's bed. We all know the rules for keeping our children safe. But when is it okay to finally give them a rest? In some cases, it depends on your child's age, but often it hinges more on her individual development and skills. Each kid is different, and what one child is doing at age 1, another might not do until age 2. If you're not sure whether your child is ready for something, don't rush it. There's no downside to being supercautious.

Rule: Put your baby to sleep on her back

To help prevent SIDS, the American Academy of Pediatrics (AAP) recommends putting your child to sleep on her back until she's a year old. If your baby can flip over before that, you don't have to go in her room to turn her onto her back. But you should still wait a year before actually putting her down in her crib on her tummy.

Rule: Support your infant's head

Your baby should gain head control between 3 and 4 months. "You can start taking your hand away once he begins lifting his head when he's lying on his belly," says Parents advisor Ari Brown, MD, author of Baby 411. At first, it's a good idea to "spot" him by keeping your hand just an inch or two behind his head to prevent injuries.

Rule: Avoid blankets and other bedding

You can use a receiving blanket to swaddle your baby right away. But because of the risk of SIDS, you shouldn't use any soft objects or loose bedding while he's sleeping until he's at least a year old. After that, pediatricians have different opinions. Some say you can start using a blanket and a firm pillow. Others recommend that you wait until your child is 2, just to be safe, and use pajamas with feet or a sleep sack on cold nights in the meantime. You want to make sure that your child is able to pull things off of himself if he gets hot or tangled. If he can undress himself, that means he's got this motor skill down. Since toddlers rarely stay under the covers anyway, it's often best to wait and introduce a blanket once your child graduates to a big-kid bed.

Rule: Buy baby laundry detergent

Some children have sensitive skin and need special soaps and detergents for several years, or even forever. But many do fine with adult formulas right away and never need special brands. Start by testing one piece of clothing to see if your baby's skin reacts. However, pediatricians say that even babies with sensitive skin don't necessarily need baby brands. Perfume- and dye-free adult detergents work just as well and let you wash everyone's clothes together.

Rule: Skip peanut butter

If you have no family history of food allergies, some pediatricians say you can let your child try peanut butter between 12 and 18 months. If your family has a history, the American Academy of Allergy, Asthma and Immunology recommends waiting until age 3. "By age 3, the gut has completely formed, making it more difficult for the allergen to be absorbed and trigger cells in the immune system," says Christopher Randolph, MD, a pediatric allergist in Waterbury, Connecticut. However, because kids usually don't outgrow a peanut allergy -- and it can be life-threatening -- some allergists and pediatricians recommend that all kids avoid PB&J until age 3.

Rule: Serve whole milk

Once your child turns 2, it?s time to switch to skim or low-fat milk, because he no longer needs that extra fat for brain development. However, the AAP currently doesn't specify whether you should move right to skim, or to 2 percent or 1 percent milk first. And doctors have different ideas about what's best. The most important thing is to make sure your child drinks skim milk after age 5, says Robert Baker, MD, a pediatrician in Buffalo, who's on one of the AAP's nutrition committees.

Rule: Cut grapes and hot dogs in half

Keep slicing these choking hazards until your child is 4, the AAP recommends. That's the age when most kids can chew with a "grinding motion" -- and also when their airways are large enough to accommodate an accidentally swallowed grape, hot-dog chunk, or piece of popcorn. "But if your older child doesn't chew well, continue cutting!" says Dr. Brown.

Rule: Use bed rails

You can take them down when your child stays in one position for most of the night -- usually around age 3 or 4. Place something soft alongside the bed for the first few weeks. "Definitely take the rails down if your child starts climbing over them, because he'll be more likely to hurt himself that way than if he falls out of bed without the rails," says Karen DeBord, MD, associate professor of child development at North Carolina State University, in Raleigh.

Rule: Use covers on all outlets

If your child can explain why poking something into an outlet could hurt him, it's probably okay to remove the covers. But since they aren't much of an inconvenience, there's no rush -- especially if he loves to experiment. Even some 7-year-olds can't resist an open outlet.

Rule: Don't let your child play with marbles, coins, or other small objects

To be safe, pediatricians recommend, you should keep these choking hazards out of reach until your child is 4 or 5, when his windpipe is larger. If he is over 3 and no longer puts nonfood objects in his mouth, you can let him play with small toys before then -- but you must supervise him carefully and store them where he can't reach them, says Dr. Brown. Be sure to follow the age recommendations on toy packages.

Rule: Put gates at the top and bottom of stairs

There's no consensus about this. Some doctors say you can remove the gates once your child can go up and down stairs without holding on, which usually happens at age 3 or 4. Others say it doesn't hurt to keep gates up longer, particularly at night in case your child sleepwalks -- as long he isn't trying to climb over them.

Rule: Avoid the big swings at the playground

Most doctors say it's best to let your child move from bucket swings to the flat-seat types when she's 5 and her feet are more likely to reach the ground. But she'll probably beg to switch before then. Adult supervision is key to avoiding falls: If you can trust her to hold on tight, you can push her in a big swing when she's 3 or 4. Also make sure the swings are on a soft surface, and that your child knows to wait until the swing has come to a complete stop before getting off.

Rule: Use fluoride-free toothpaste

Because ingesting too much fluoride can cause permanent white spots on your child's teeth called fluorosis, some doctors say it's safest not to use any regular toothpaste until she can spit -- a skill typically mastered at age 3 or 4. But the American Academy of Pediatric Dentistry and the Centers for Disease Control and Prevention recommend that children use a small amount of fluoride toothpaste (no more than the size of a pea) starting at age 2 to prevent cavities -- especially if your local tap water isn't fluoridated. Talk to your dentist and doctor about what's best.

Rule: Supervise bathtime

Never leave your child alone in the tub until he's 5, and then only leave him briefly until he's at least 7. Although drowning can happen at any age, most children who drown in tubs are under age 5, according to the Consumer Products Safety Commission. If your child has learned how to swim, you can feel more confident leaving him alone. Nevertheless, you should never be far away. As your child gets older and wants more privacy, insist that he keep the bathroom door unlocked, says Dr. DeBord.

Copyright © 2007. Used with permission from the October 2007 issue of Parents magazine.

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