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The Safe Nursery: US Consumer Product Safety Commission

Your love and attention are what your baby needs most. That's why you should be sure your home and the things you buy and receive for your baby are safe. Parents and caretakers of babies and young children need to be aware of many potential hazards in the child's environment hazards from incorrect use of products or with products not well designed for their intended purpose. The tips provided here will help you create a safe and sound environment for your baby.

Baby Safety Checklist
> Always put your baby to sleep on his or her back because tummy sleeping increases the risk of Sudden Infant Death Syndrome (SIDS) and suffocation.
> Never allow a gap larger than two fingers between the mattress and sides of the crib to prevent entrapment.
> Cribs that are assembled wrong, have missing, loose or broken hardware or broken slats can result in entrapment or suffocation deaths. Infants can strangle when their head and neck become entrapped in gaps created by missing, loose or broken hardware or broken slats.
> Placing babies to sleep on pillows can result in death by suffocation.
> Children have strangled on inner and outer cords on blinds and window treatments. Keep cribs away from windows and cords of any type.

> Never, ever, leave your child alone or under the supervision of a sibling in bathtub or near any water. Children can drown in only a few inches of water in seconds.
> Keep medicines and cleaning products with child resistant lids locked. Child resistant is not "child proof."

> Do not leave baby alone in a high chair and always use all safety straps. This will prevent injuries and deaths from the baby climbing out or from falling through leg openings.
> Keep matches, lighters, and knives, and cleaning products with child resistant lids, locked and out of reach of children to reduce risk of fire, poisoning, and other injuries.
> Do not place your baby in any child or infant seat, including car seat carriers, infant carriers, bouncers, vibrating seats, or unsecured booster type chairs, on a countertop, table or any elevated surface. The baby's movements can cause the seat to fall, resulting in head or other injuries.

Around the House
> Keep small objects, especially spherical toys such as marbles and objects with rounded ends away from children. These objects present a very high risk of choking.
> Keep toys with magnets away from young children. If two or more magnets are swallowed they can attract through intestinal walls and can cause holes, blockage, and infection which can result in death.
> If swallowed, un-inflated balloons and balloon pieces can lead to death by clinging to the airways.
> Children have died when furniture tipped over on them. Secure furniture with anchors to the wall or floor.
> Install smoke alarms on each level of your home, outside sleeping areas, and inside each bedroom. Install carbon monoxide alarms outside sleeping areas. Return to top >
Cribs & Crib Toys
> To reduce the risk of Sudden Infant Death Syndrome (SIDS) and prevent suffocation, put your baby to sleep on his/her back in a crib on a firm, flat mattress. Make sure there is no soft bedding underneath your baby.
> Temporary beds: Never place your infant to sleep on an adult bed, water bed, or bunk bed. Infants up to 18 months can suffocate in their sleep when their bodies or faces become wedged between the mattress and bed frame or the mattress and wall.
> Never put a crib, child bed, or furniture near window blinds or drapery. Children can strangle on window cords or fall through screens. If local fire codes permit window guards, install them. Make sure all drapery or window blind cords are out of a child's reach. CPSC receives numerous reports of strangulation deaths on window blind cords. To keep cords out of reach of children, use tie-down devices, or take the cord loop and cut it in half to make two separate cords. Consumers can call 800-506-4634 or visit windowcoverings.org/20.html to get free repair kits.
> Never use strings to hang any object, such as a mobile or a toy or a diaper bag, on or near the crib where a child could become caught in it and strangle. Remove crib gyms and mobiles from the immediate crib area when your baby begins to push up on hands and knees so they are completey out of reach. No strings or cords should dangle into the crib. If you have toys with cords or elastic for hanging, cut the strings/cords off.
> To prevent strangulation, NEVER tie pacifiers/teethers around your child's neck. Remove bibs and necklaces whenever you put your baby in crib or playpen.
> Always lock the side rail in its raised position whenever you place your child in the crib. As soon as your child can stand up, adjust the mattress to its lowest position and remove the bumper pads. Also, remove any large toys— an active toddler will use anything for climbing out of the crib.
> When your child reaches 35 inches (890 mm) in height, he/she has outgrown the crib and should sleep in a bed. 8. Never use plastic bags as mattress covers. The plastic film may cause suffocation.
> Check all crib hardware; tighten all nuts, bolts, and screws frequently. After a crib is moved, be sure all mattress support hangers are secure. Check hooks regularly to be sure none are broken or bent. Open hooks may allow the mattress to fall.
> Secure bumper pads around the entire crib and snap or tie in place at least in each corner, in the middle of each long side, and on both the top and the bottom edges. Cut off any excess string length.

Crib Toys
Crib gyms and other toys that stretch across the crib with strings, cords or ribbons can be a hazard for older or more active babies. The Commission knows of cases in which infants strangled or became entangled in crib gyms or other toys stretched across their cribs.
> Make sure that crib gyms are installed securely at both ends so they cannot be pulled down into the crib.
> Make sure that you remove crib gyms and mobiles from the crib when your baby is 5 months old or begins to push up on hands and knees.
> Mobiles and any other toys that hang over a crib or playpen should be out of reach of a child.
> Do not use crib toys with catch points that can hook clothing.
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Bathing Aids
Water presents a real danger: NEVER, even for a moment, leave your child alone or under sibling supervision in the bathtub, even when the child is in a bath ring or seat. Bath rings are intended for use as bath aids, but they are NOT SAFETY DEVICES! Keep children away from buckets, toilets, pools and other containers of water. Young children can drown quickly in small amounts of water. Hot water can scald. To prevent skin burns always check bath water temperature with your wrist or elbow before bathing your baby.

> Never, even for a moment, rely on bath rings or seats to keep baby safe in the bath. Never leave a baby alone in a bath ring or seat in the tub. Never rely on a sibling to supervise a baby in a bath tub. Turning away to get a towel, answer the doorbell or telephone could result in the baby drowning.
> All necessary bathing items (soap, washcloths, towels, etc.) should be placed by the tub before your baby goes in.
> Only fill the tub with enough water to cover the baby's legs. This amount of water is sufficient to bathe the baby. However, be aware that babies can drown in a very small amount of water. All it takes is enough water to cover the nose and mouth.
> Securely attach bath seats and rings to a SMOOTH SURFACE. Suction cups will NOT stick to textured, ridged, appliqued, or factory designed non-skid bathtub surfaces. Suction cups will not stick to scratched, chipped, or repainted tub surfaces.
> Parents and caregivers should be trained in basic CPR techniques. Return to top >
Play Pens
> Always show babysitter/caregiver how to properly set up playpen according to the manufacturer's instructions. Improper setup can cause the playpen to collapse, resulting in injury or death to the child.

> Never leave an infant in a mesh playpen or crib with the drop-side down. Infants can roll into the space between the mattress and loose mesh side and suffocate. Even when a child is not in a playpen, leave the drop-side up. Children may try to climb back into a playpen and cut or pinch their fingers on the unlocked hinge mechanism.
> Remove large toys, bumper pads, or boxes from inside the playpen. They can be used for climbing out.
> Avoid tying any items across the top or corner of the playpen; they can be a strangulation hazard.
> Toys should not be hung from the sides with strings or cords because they could wrap around a child's neck. Use another method for attaching the toys to the playpen.
> Children may use the top rail of the playpen for teething. Check vinyl or fabric-covered rails frequently for holes and tears. A teething child can chew off pieces and choke.
> If staples are used to attach the mesh side to the floor plate, make sure none are loose or missing.
> Examine the mesh and its attachment to the top rail and floor frequently for loose threads. There have been reports of entanglements in threads (stitching) that unraveled.
> Never use a playpen with holes in the mesh sides. These could entrap a child's head and cause strangulation.
> Never use a playpen with a hinge in the center of each of the four top rails that fold if each top rail does not automatically lock when the rail is lifted into the normal use position.
> Never use a pad that does not fit snugly and never add a second pad or mattress. Babies have suffocated when trapped between mattresses or between the playpen side and mattress that was too small. Return to top >
Rattles, Squeeze Toys & Teethers
> Check all rattles, squeeze toys and teethers for small ends that could extend into the back of the baby's mouth. If you feel that the toy may be too small for safety, throw it away.
> Take rattles, squeeze toys, teethers, and other small objects out of the crib or playpen when the baby sleeps.
> Teethers, like pacifiers, should never be fastened around a baby's neck.
> Avoid rattles and squeeze toys with ball-shaped ends.
Return to Top >
Estimates show that more children are injured in baby walkers than with any other nursery product. The accidents happen even when a caregiver is nearby. Almost all of the victims are children under 15 months of age.

> To prevent accidents, always keep your child within view. A walker increases your child's mobility and his/her reach.
> To avoid a fall down stairs or steps, make certain that the door or gate is closed at the top of the stairs every time you use a walker.
> To avoid a tipover, use a walker only on smooth surfaces. Carpet edges, thresholds, and uneven pavement can cause a child in walkers to tip over.
> To avoid a burn injury, keep your child in a walker away from hot surfaces and containers with hot liquids. Beware of dangling appliance cords.
> To avoid a drowning, keep your child in a walker away from swimming pools, toilets, and other sources of water.
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Back Carriers
An infant back carrier can make it easier to go shopping, walking, or hiking with a baby. However, framed back carriers should not be used before a baby is four to five months old. By then the baby's neck is able to withstand jolts and not sustain an injury. Bicycle carriers should not be used before a baby is one year old. Developmentally, children are just learning to sit unsupported around 9 months of age. It is not until this age that infants have developed sufficient bone mass and muscle tone to enable them to sit unsupported with their backs straight.

> A child may stand up or try to climb out of the carrier. If the back carrier has restraining straps, be sure to use the restraining straps at all times.
> Be sure the child's fingers are clear of the frame joints when folding the carrier. Check frames for sharp points, edges or rough surfaces.
> Check the carrier periodically for ripped seams, missing or loose fasteners, frayed seats, or straps. Repair them promptly or discard the carrier.
> If leaning over or stooping, bend from the knees rather than the waist to prevent the baby from falling out of the back carrier. Return to top >
Bassinets & Cradles
The most frequent injury associated with bassinets and cradles involves children falling either when the bottom of the bassinet or cradle breaks or when it tips over or collapses. Suffocation has also been reported in products that are not structurally sound or when pillows or folded quilts were under baby.

> Check screws and bolts periodically to see if they are tight.
> If the product has legs that fold for storage, make sure that effective locks are provided to ensure that the legs do not accidentally fold while in use.
> Mattresses and padding should fit snugly and be firm and smooth. Never use pillows.
> Decorative bows and ribbons should be trimmed short and stitched securely to prevent strangulation.
> Swinging cradles should have a way to keep them from swinging once a baby is asleep. Return to top >
Carrier Seats
Most injuries associated with carrier seats result from falls: infants falling out of carrier seats, or the carrier seat falling with the infant still sitting in it. The movements of an active infant can cause the carrier seat to move or tip over. Deaths have occurred when carrier seats or bouncers were placed on beds, sofas, or other soft surfaces and then tipped over.

> The carrier should have a wide, sturdy base for stability.
> Stay within arm's reach of the baby when the carrier seat is on tables, counters, or other furniture. Never turn your back. Carrier seats slide more easily on slippery surfaces such as glass table tops.
> If the carrier seat does not already have non-skid feet, attach rough surfaced adhesive strips to the underside.
> Always use the safety belts and keep them snug.
> If the carrier seat contains wire supporting devices which snap on the back, check for security. These can pop out causing the carrier seat to collapse.
> Never place a carrier seat on soft surfaces such as beds or sofasƒthe carrier seat may tip over and the baby may strangle or suffocate.
> REMEMBER—A carrier seat is not always an infant car seat, and should never be used in an automobile unless it is labeled for that purpose. Return to top >
Hook-on Chairs
Hook-on chairs are used as substitutes for high chairs and are attached to the edge of a table. The Commission has reports of children either falling out of these chairs or dislodging the chair from the table.

> Do not place the chair where the child's feet can reach table supports, benches, or chairs, to push off from and dislodge the chair from the table.
> The restraining straps should be easy to use and always fastened around the child when in the chair.
> After clamping the chair to the table, check its security by pulling backwards on the chair.
> Don't leave a child unattended.
> Never use hook-on chairs on glass top, single pedestal or unstable tables.
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Changing Tables
Most injuries associated with changing tables occur when children fall from the changing table to the floor.

> Look for a table with safety straps and always use them. In the instant it takes to turn for diapers and pins, an active baby can roll over and fall. Remember, just because you are using the safety straps it does not mean that you can leave your child unattended. Return to top >
In 1977, the Commission issued a regulation for the safety of pacifiers. Among other requirements, the regulation says that:

> Pacifiers must be strong enough to not separate into small pieces on which a baby could choke or suffocate.
> Pacifier guards or shields must be large enough and firm enough to prevent the pacifier from being drawn entirely into a baby's mouth.
> Pacifier guards or shields must have ventilation holes.
> Pacifiers cannot be sold with a ribbon, string, cord, or yarn attached, and must be labeled with the statement: "Warning—Do Not Tie Pacifier Around Child's Neck as it Presents a Strangulation Danger."
Although the regulation has helped to reduce the number of accidents involving pacifiers, the Commission still receives reports of infants strangling on pacifier cords or ribbons tied around their necks. Children have caught pacifier cords on crib corner posts, crib toys and gyms, pieces of furniture, and even doorknobs.
> Pacifiers may deteriorate with age, exposure to food, sunlight, etc. Inspect them frequently and discard immediately if you notice a change in texture, tears, holes or weakening. Return to top >
Strollers & Carriages
Deaths have resulted when infants were left to sleep in strollers with the backrest reclined to the carriage position. The infants moved (wriggled) feet first towards the front of the stroller and, when their bodies passed through the opening between the handrest (grab bar) and front edge of the seat, they became trapped by the head and strangled.

> Close the opening between handrest (grab bar) and seat when using a stroller in the reclined carriage position.
> When folding or unfolding a stroller, keep your child away from it. Children's fingers have been amputated in parts of the folding mechanism.
> Always secure the seat belt.
> Never leave a child unattended in a stroller, especially when the baby is asleep.
> A stroller is not a toy. Never allow children to use one as a plaything.
> Never use a pillow, folded quilt, or blanket as a mattress in a stroller or carriage. Return to top >
The Consumer Product Safety Commission hopes this information, with its selected safety hints, will be your ABC primer helping you buy nursery products, using them, keeping them in good repair, and properly disposing of a product if it becomes a hazard.

A is for Awareness . . . of parents and caretakers about potential hazards in the child's environment, including nursery products.
B is for Baby.
C is for Caution . . . in selecting and maintaining products for the child's environment, including nursery products.
S is for Safety . . . the sum of the A B C's.

The Commission has several ways to keep you informed. The Commission publishes Safety Alerts and recall notices, has a Hotline service (1-800-638-2772, TTY: 1-800-638-8270) and has a Website (www.cpsc.gov). CPSC can also send you information for hosting a Baby Safety Shower, a great way to inform new parents how to protect their babies from harm in their own homes.
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