By Jennifer Gruen, MD
By the age of six months you need to think very seriously about protecting your children from the world around them, before they become mobile explorers.
The best approach to childproofing is to think in terms of multiple barriers.
The first barrier between a child and any danger is generally you, always watching out of the corner of your eye. But that doesn’t always work- particularly with the distractions of ordinary life such as phones, computers, and other children.
Unfortunately, we cannot avoid such distractions, but we can create additional barriers. For example, a second barrier is to keep the door to a dangerous room closed at all times, and maybe locked.
But sometimes that might be left open. So, a third barrier is to keep the dangerous stuff high in a cabinet. But sometimes an older child will be visiting and might climb up there and offer that forbidden substance to your child. So, a fourth barrier is to keep it locked.
Most protective measures you will be able to figure out for yourselves with a trip to the childproofing section of ToysRUs, Target, or children’s store. Here are a few tips to get you thinking:
1. Get down on your hands and knees and crawl thru your home- you will get a child’s eye view of what is easy to access.
2. Use the “toilet paper roll rule”- if it fits thru the tube, it can be choked on.
3. Put all dangerous items (medicines, cleaning agents, knives, small choking hazards) up high- and preferably in a locked cabinet (remember your child will one day climb!)
4. Beware of where you put what you are drinking. Coffee cups belong far out of reach of toddlers. Pots on the stove should have their handles turned inward. If you have a party, don’t leave your drinks around afterwards .
5. DO NOT USE WALKERS-they allow children to access dangerous areas such as stairs.
6. Sharp objects, especially little ones such as toothpicks, are dangerous. Keep them well hidden, preferably locked and at a height.
7. Electrical outlet covers are essential- I prefer the kind that require you to insert a plug in partway, then turn to access the holes of the outlet. Plastic plug-in protectors are often easily removed by an adept toddler.
8. Keep electrical appliances such as blow dryers and toasters unplugged when not in use.
9. Never leave a child unattended in a bath, even for a minute.
10. All children should learn to swim by the age of five to seven; we also have brochures for a terrific water safety program for children as young as infants in the office. The more barriers between a pool and your child the better- think safety covers, pool alarms, and multiple fences at least 5 feet high.
11.Turn down your water heater, if you can, to a maximum temperature of 120 to 130 degrees. At these temperatures accidental water burns will be much less severe.
12.All stairs need two sets of gates- at the top and bottom. Gates at the top of stairs must be bolted to the wall, and have vertical slats so that a child cannot easily climb them.
13. Cut window-blind cords, or use safety tassels and inner cord stops so children can’t get entangled.
14. Lock stove knobs- keep kids from igniting stove burners by using protective appliance knob covers.
15. Hide all cords (electrical, computer, phone.)
16. Don’t use bumpers in the crib, nor have blankets or toys in there. Once a child can sit up, lower the mattress down to the lowest level. Once a child can climb out of the crib, take the side off to create a toddler bed, or put a mattress on the floor. Put a gate in the doorway to prevent wandering toddlers at night.
17. Secure furniture (bookcases, chest of drawers) that can topple to the wall.
18.Avoid choking foods for infants and toddlers, and never let your child wander while eating. Worst offenders: hot dogs, whole grapes, popcorn, dried fruits such as raisins, small candies.
19. Help older children store small items and toys in labeled bins that are put out of reach of toddler siblings- if they have their own room, allow them to gate it off from their younger sibs.
20.Put stickers with the poison control # on all phones: 1-800-532-2222. If you fear your child has ingested a poison, or taken too much of a medication, call poison control rather than the pediatrician- PC is much better equipped to calculate whether there is a need to seek medical help. Never give a child ipecac or any other liquid after an ingestion without calling poison control first. If your child appears to be in distress (difficulty breathing, choking, trouble swallowing, drooling) FIRST CALL 911, then poison control.
21. LEARN CPR. We can arrange for individual classes with our certified CPR instructor, or help you find a class.
With all these necessary precautions, we still have to strike a balance and leave our children room to wander. One of the best places to do this is in a controlled area- try to make one central room a safe place to explore, and a location where you can safely deposit your child should you need to run to the bathroom, or answer a call.
Fill your bottom kitchen cabinets with pots, pans, Tupperware and other items that your child can discover and play with. Let your child have adequate floortime to explore in a safe environment (walkers and exer-saucers actually delay a child’s walking !)
Dr. Gruen opened her practice, Village Pediatrics, in 2009, but prefers spending time creating fantastic kids birthday parties.
Survivor: Pediatrics 
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