Environments for young children can appear to adults to be delightful, healthy and safe, yet many harbor hidden dangers for children. Evaluating the total environment for safety is critical, yet many times hazards are overlooked, even by the most diligent caregiver. Hazards may include equipment and facilities, toys and supplies, personal items, clothing and accessories worn by adults, and even clothing and accessories worn by children.

Sometimes furnishings and equipment can cause safety concerns. For example, rocking chairs frequently are found in childcare programs for young children and can contribute to positive interactions between caregivers and children as they rock together. However, in infant and toddler settings, young children can have fingers smashed under the rockers or fall as they try to crawl up onto the rocking chair. An alternative is a well-anchored hammock with a solid cloth material, or a glider, which has fewer safety issues than a rocking chair. These also allow adults to sit with two children more comfortably than does a rocking chair.

Infant walkers sometimes are used in childcare programs even though the dangers of young children using the walkers are becoming more well known. More children are injured with baby walkers than with any other nursery product. In 1995, the American Academy of Pediatrics (AAP) recommended a ban on the manufacture and sale of infant walkers because the risks have been found to be high and the benefits unproven.

Some childcare programs have a small refrigerator for storing milk and other baby food. A refrigerator in the room may eliminate the need for caregivers to leave to retrieve milk, thus ensuring better supervision and proper adult-to-child ratio. However, the refrigerator should not be placed on the floor where children can open the refrigerator and have access to the contents. Possible entrapment is another concern. Small refrigerators should be locked at all times or secured on a very sturdy cabinet, high out of children's reach children. The cord also should be out of the children's reach to avoid strangulations and electrical shock.

There are numerous safety concerns regarding the use of microwaves for heating baby bottles. It is difficult to truly determine the temperature of the milk, so the use of a microwave may increase the chance of burning a baby's mouth and throat. Some cases of nipples exploding off the bottle and scalding the adult or infant also have been reported. Changes in the milk during microwave heating may result in a decrease in the vitamins it provides. Some foods, like jelly donuts, heat unevenly and are extremely hot inside, although they do not feel it outside. Therefore, microwaves should be avoided for heating drinks or food for young children.

Some experts have questioned the developmental appropriateness of television for young children, but a more serious issue is the potential safety hazard of TVs or other heavy equipment. If televisions, stereos, boom boxes, aquariums, refrigerators, and other equipment are in a childcare setting, they should be well secured to ensure that they cannot be pulled over by climbing children. Tall shelving and furniture also should be safely secured to the wall.

Trash is another often overlooked safety issue with young children. Small trash cans are just the right size to grab the attention of children, and their hands can move into the trash quickly. Trash cans both inside and outside may contain dirty diapers, sharp can lids that can cut, or many small items that pose choking hazards. Paying close attention to the location of trash cans, using covers, and being aware of what is in the trash cans may help ensure that young children will not be harmed by trash.

Choking hazards and poisoning are two of the most significant hazards for infants and toddlers, so extreme care should be given to safety in these areas. Because young children spend a great deal of time on the floor, the carpet should be inspected frequently to ensure that it is free from small pieces of toys or caregiver supplies such as rubber bands or paperclips. Although multi-age grouping has many developmental and social benefits, choking hazards may increase in these settings because older children need toys and supplies with smaller parts than younger ones.

In addition to ensuring that small parts are not left on the floor, also check for the security of all materials with small parts on tables and shelves, as well as hanging mobiles. Childcare settings are likely to contain button batteries, cleaning supplies, bleach, medications, glues and other caregiver supplies, which all can be toxic and should be stored accordingly. Plants, which can enhance the atmosphere of the space, should be nontoxic. Check with the regional poison center for guidance on poisonous plants and other toxic substances. (The April-May 2001 issue of Healthy Childcare included an article on plants in the childcare setting.)

Purses, diaper bags, coat pockets, and other containers may contain vitamins, medicine, cosmetics, and even items like guns, knives, or pepper spray. Therefore, policies to ensure that all containers are kept in a secure place away from children are an important contribution to safety. Visitor purses and containers also may pose a safety concern, so policies should include visitors.

Clothing and accessories worn by adults may impact the safety of children, especially those with allergies. Fragrances worn by caregivers can sometimes be a safety issue for young children, especially infants. Adults who are holding or hugging children close to them should be aware of how their clothes and hair feel and smell. Because children's faces may come in direct contact with the adult's hair and clothes, they are inhaling these odors. Hair spray, shampoo, perfume, detergent, fabric softener, and similar products intended to add a pleasant smell may be too strong for direct contact with children's skin and result in allergic reactions or worse. Dyes in some clothes also may contain smells and unsafe chemicals. Adults who smoke or are exposed to smoke have smoke odors in their clothes. Some programs provide staff with smocks or aprons washed with unscented detergent to minimize potential problems.

Accessories worn by caregivers can create safety hazards for themselves and for the children. Earrings or rings can scratch children or cause eye injuries while caregivers hold and hug them. Earrings capture the attention of young children, who may reach and pull them, thus causing pain or injury for the caregiver. Accessories worn by young children also can be hazardous. Necklaces, bracelets, rings, and earrings may catch on equipment, causing strangulation. Rings, pins, buttons, hair beads, small barrettes, and other accessories are additional choking hazards for young children. In addition, remember that long fingernails may also interfere with safe contact with children.

Increased awareness of safety can result in a more pleasant and secure environment for adults and children. Looking for potential safety concerns where they are least expected is important and may make a major difference in the health and well-being of young children.

By Connie Jo Smith, Ed. D.
Amy S. Hood, MA

Resources

American Academy of Pediatrics, PO Box 927, Elk Grove Village, IL 60009;
800-433-9016; www.aap.org

American Association of Poison Control Centers; 3201 New Mexico Ave., Ste. 310; Washington, DC 20016; 202-362-7217; www.aapcc.org

National Resource Center for Health and Safety in Child Care, UCHSC at Fitzsimons, Campus Mail Stop F541, PO Box 6508, Aurora, CO 80045-0508; 800-598-KIDS; nrc.uchsc.edu

National Safe Kids Campaign, 1301 Pennsylvania Ave, NW, Suite 1000, Washington, DC 20004-1707; 202-662-0600; www.safekids.org

U.S. Consumer Product Safety Commission, 5401 Westbard Ave., Bethesda, MD 20207; 800-638-2772 ; www.cpsc.gov