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Week of 19 February 1999

Vol. II, No. 24

Health Matters

Baby safety: rocking those new parent jitters to sleep

As a new parent, I am constantly concerned about keeping my baby safe. What can I do to prevent accidents?

Keeping their children safe is parents' most constant worry -- for good reason. Accidents are the leading cause of death among children in the United States who have passed their first month of life, with causes varying by age. For preschool children, most accidents are caused by burns, falls, and poisoning. For school-age children, most are from drowning and car accidents (both as a pedestrian and as a passenger), and motor vehicle accidents are the major cause of death and serious injury in adolescents.

Howard Bauchner, M.D., director of the division of general pediatrics at Boston Medical Center and a professor of pediatrics and public health at BUSM, says parents can take two primary approaches to keeping children safe -- providing a safe environment and practicing safe living habits.

Most home safety measures, many of which can be taken care of before baby arrives, are fairly simple for parents. Because infants are at risk for scald burns from hot water, parents need to take extra caution when preparing baby's bath. Water heater temperatures should be kept below 120 degrees Fahrenheit, and parents should always check the water themselves before placing the baby in the bathtub. According to Bauchner, research data indicates that parents "do not do a very good job at regulating water temperatures in the home," leading to second-degree and sometimes third-degree burns.

Poisoning is a leading cause of home-based accidents for ages one to three. Poisonous materials, including cleaning fluids and detergents, should be kept in a locked cabinet or out of the reach of children. Bauchner says that parents should keep syrup of ipecac in the house to induce vomiting, but that it should be used only after calling the poison control center (check the local telephone directory for the number in your area).

Many parents are concerned about sudden infant death syndrome, or SIDS, which in the past accounted for nearly 6,000 deaths each year in this country, but Bauchner says that the number has been "phenomenally reduced" in recent years. When putting infants to bed, parents should place them on their backs to avoid smothering. "Parents don't need to hover over their babies to make sure they're sleeping on their backs," he says. "The data are pretty clear that that is unnecessary." He also says that apnea monitors are not helpful unless the infant is at high-risk for SIDS (occurring in about one to every 500 to 1,000 births).

Smoke detectors are also a good safety measure, and in fact, are required in most homes in the United States. Detectors do not need to be placed in your baby's room, but should be located outside the room in a hallway. Check with your local fire department regarding smoke-detector laws in your area and ask for recommendations on the best smoke detectors to use.

When taking baby out, keep safety in mind and buckle up the little one. "Car seats, car seats, car seats," says Bauchner. "I cannot stress enough that parents need to put their babies in appropriate safety seats when riding in the car." The National Highway Traffic Safety Administration estimates that one out of 700 babies in the United States will die in a car accident. Infants up to 20 pounds and one year should ride in rear-facing car seats placed in the backseat of the car. They can be moved to forward-facing seats (still in the backseat) when they pass 20 pounds or their first birthday. Children over 40 pounds should ride in a booster seat until the car's seat belts fit correctly.

Many infant safety tips are common sense, Bauchner says, but parents should not necessarily go it alone in determining appropriate safety measures for their children. Most general child-care books, available in bookstores and libraries, are full of appropriate safety tips for parents.

He cites in particular the most recent edition of Dr. Spock's Baby and Child Care, with an extensive chapter on safety and injury prevention.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on baby safety or other health issues, call 638-6767.