Childproofing and following precautions is very important. But experts explain when parents can finally begin to take a step back.

Advertisement

When you've spent years eyeing the baby monitor, childproofing the house, and following precautions to a T, it can feel as though you'll never be able to stop hovering. But health experts say there comes a time when you can (carefully) ease up on the rules—as long as you understand them.

child surrounded by caution tape-wrapped items
Credit: Priscilla Gragg

Safety Rule #1

Cut up grapes and hot dogs

Small, round, or hard foods pose a significant choking risk to small children, which is why the American Academy of Pediatrics (AAP) recommends slicing them up into smaller bites (aim to get them to about the size of the tip of your pinky) until kids are 5. At that point, most can chew foods with more of a grinding motion.

When you're serving an unsliced item to your kid for the first time, explain that you're giving them a "big kid" food, says Parents advisor Terri McFadden, M.D., professor of pediatrics at Emory University School of Medicine and co–medical director of the Injury Free Coalition for Kids, in Atlanta. This conversation also gives you a chance to share some of the rules that come with this big achievement: Always sit down while eating, avoid distractions, and don't rush your bites.

Be warned, though, that not every 5-year-old may be ready for this all-important step. "Any child who is active and prone to moving, jumping, and talking while eating is not a good candidate for, say, eating whole grapes," cautions pediatrician Laura Jana, M.D., an AAP spokesperson and author of The Toddler Brain.

As for some of the other common foods on the no-fly list? Whole nuts can be served when your child reaches age 4, says Deborah Gilboa, M.D., a family physician in Pittsburgh. Foods with sticky or chewy textures—like caramels, toffees, or marshmallows—are permissible once your kid is 2 1/2, or "they get their back teeth," Dr. Gilboa notes.

Safety Rule #2

Put your baby to sleep on their back

Due to the risk of sudden infant death syndrome (SIDS), babies should be placed on their back at bedtime and naptime for the entirety of their first year. Of course, you've probably received a lecture from a well-meaning grandmother type about how that's not the way she used to do it. But sticking with the plan is worth it: SIDS-related deaths have dropped steadily since the "Safe to Sleep" campaign kicked off in 1994, proving that back sleeping is by far the safest option for infants. At around 4 to 6 months of age, most children will begin to roll over on their own, and that's no cause for alarm. At that point, "you don't have to stay up all night checking on them and flipping them back over," says child-safety expert Debra Holtzman, author of The Safe Baby. But even if your baby is able to sit and roll independently, you should still "always put them to sleep on their back and let them roll over on their own," explains Brenda Anders Pring, M.D., a member of the Parents AAP Panel and a pediatrician at Atrius Health, in Boston. "My own son would try to flip over in midair as I laid him down because he preferred sleeping on his stomach."

Safety Rule #3

Use only a tiny amount of fluoride toothpaste

Ingesting too much fluoride at an early age can cause fluorosis—permanent white spots or streaks on the teeth—and with a large amount, stomach issues like pain, nausea, vomiting, or diarrhea, which is why health experts advise keeping a literal cap on its use. But when your child cuts their first tooth, it's safe to introduce fluoride toothpaste, according to the American Dental Association. Just offer it up in sparing amounts: Stick to a light "smear" of toothpaste on your child's toothbrush, similar in size to a grain of rice, until they reach the age of 3. After that, 3-year-olds can graduate to a pea-size amount, as long as they've mastered the habit of spitting (not swallowing) during brushing.

Safety Rule #4

Keep pillows, blankets, and other bedding out of the crib

Cozy nursery décor is cute, but it isn't safe when it comes to an infant's crib. That's why the AAP recommends that loose bedding and soft items—including bumpers, blankets, pillows, and stuffed animals—be kept out of the crib until your baby is at least 1 year old. "An infant may not be able to move items away from their face, which could lead to suffocation," Dr. Jana says. If you're worried your baby might get chilly without a blanket, especially during the colder months, dress them in no more than one extra layer you yourself would wear, and stick to approved infant sleep clothing, such as a wearable blanket. Be sure to mind the mattress too: Opt for a uniformly firm, flat surface—many models come with a soft and hard side—until your child's first birthday. "A firm mattress is one that does not indent when a baby is lying on it," Dr. Jana explains. Once your baby turns 2, though, you're in the clear to add a small, firm pillow to the mix.

Safety Rule #5

Place covers on electrical outlets

While this is a wise rule when there are little kids about, it doesn't have to be one you follow forever. "In general, consider keeping outlets covered until children are 6 or 7," Dr. Pring says. By that age, kids are less impulsive and can clearly let you know that they understand the danger of sticking anything into the holes. Until then, if your younger child figures out how to wiggle those little plastic safety disks out of the wall, stay the course and keep popping them back in. Better yet: Install the sliding-panel protectors, which are more effective (and attractive) than the traditional plastic inserts. "Be firm, use simple language like 'danger' to try to keep your child away, and continue covering up the outlets," Dr. Pring says. "If that approach still doesn't work, slide some furniture in front of the problem outlet."

teddy bear wrapped in caution tape
Credit: Priscilla Gragg

Safety Rule #6

Always engage the child lock on car windows and doors

It's a good idea to teach your children not to play with window switches and door handles in the vehicle, advises Tammy Franks, senior program manager for mobility safety at the National Safety Council (NSC). Of course, the age at which little ones will grasp the importance of keeping their hands to themselves varies from kid to kid. So for the time being, you'll likely need to enable your car's childproof locks. Once your child is more mature, you can evaluate whether you're comfortable dispensing with such measures.

Safety Rule #7

Set choking hazards out of reach

"Toddlers have a tendency to put lots of things in their mouth, and before the age of 3 they haven't really started to develop executive function skills, which means they don't have the ability to control their impulses and consider consequences," Dr. Jana says. "This makes for a potentially dangerous combination and indicates that all small and/or dangerous items, including toys with small parts, coins, marbles, and latex balloons, should be kept away from them." But if your 3-year-old is no longer putting objects in their mouth, you can gradually begin to give them smaller objects—provided that your kid is still being carefully supervised and the objects are stored up and away from them when playtime is over. Regardless of your kid's age, continue keeping these items away from them if they still like putting stuff in their mouth, Dr. Gilboa says.

Safety Rule #8

Keep hardware-mounted gates at the top (and bottom) of stairs

"Safety gates are designed for children ages 6 to 24 months," says Colleen Driscoll, executive director of the International Association for Child Safety, so feel free to ditch them once your toddler turns 2. But if you happen to have a particularly tall—or agile—child who is able to scale the gates before that point, it may in fact be safer to take them down: Climbing a safety gate (especially one located at the top of a stairwell) poses a greater injury risk to your child than falling down the stairs. If you have a younger child in the mix who still needs the gate, choose one with vertical slats rather than horizontal ones, and make sure the slats are no more than 2 3/8 inches apart, Holtzman says. (Even better, choose a gate made from fine mesh or plexiglass, she says.) It's essential to use a hardware-mounted or screw-fit gate at the top and bottom of stairs to ensure they stay put; never put a pressure-fit gate (the kind held in place by springs on either side, which press outward against walls and banisters) at the top of the stairs, as they can come loose if your child pushes on them, causing them (and your child) to fall. Use pressure-fit gates only for separating rooms on the same floor and in hallways.

Safety Rule #9

Never leave bathtime unattended

Drowning is one of the leading causes of child mortality, according to the NSC. Babies and young toddlers should not be left solo in the tub for even an instant, since they lack the core stability to stay upright. (Bath seats and similar stabilizers are too prone to tipping to be a reliable substitute for supervision.) After kids reach age 3, the experts' opinions vary: Some recommend waiting until a child has learned how to swim to leave them solo at bathtime, while others acknowledge that stepping away briefly may be fine once your child is verbally mature enough to maintain constant communication with you. If you're going to leave your preschooler alone for a moment, have them tell you a story or sing a loud song. "That way, you'll know they're doing well and you can get back to them immediately if they suddenly go quiet," Dr. Gilboa says. But don't stay away any longer than necessary.

For kids who are old enough, switching to showers is another safety-boosting option. "They're much less risky for drowning, and teaching kids to shower is easier than teaching them how to swim," Dr. Gilboa says. (Just make sure the water in your tub is draining properly—standing water of any depth is potentially dangerous.) "I began to let my kids bathe alone at around the age of 6, once they could swim independently, but they had been showering alone since around age 4 or 5, when I knew they had the maturity and impulse control to avoid slipping," Dr. Pring says.

Always Follow These Rules

Some safety measures have no expiration date. Here are three to keep in place for the long haul.

Place corner guards on sharp surfaces like tables, hearths, and counters

"Parents remove them when kids are stable walkers and not constantly pulling themselves up on furniture," child-safety advocate Colleen Driscoll says. "But the risk of injury exists after that point—a young child could still fall and get hurt on a sharp corner or a raised hearth."

Set your water heater to 120°F or below to prevent burns

"This is a worthwhile rule to follow from birth throughout life," says pediatrician Laura Jana, M.D. "There's no downside. The time it takes to be burned by water at 140°F is only about six seconds, while it takes several minutes at 120°."

Use furniture anchors

Large, heavy items such as televisions, bookcases, dressers, and major appliances can easily tip over and potentially fall on a young child if they push or climb on them. Secure furniture in place with an anchor kit, which can be found online or at a hardware store.

This article originally appeared in Parents magazine's November 2021 issue as "Revisiting the Safety Limits." Want more from the magazine? Sign up for a monthly print subscription here

Parents magazine