Sadly, each year one in four toddlers suffers an injury severe enough to require medical attention. Injury is the leading cause of death for toddlers. These injuries and deaths are predictable and can be prevented.
Toddler injuries vary in severity. Scrapes, bruises and cuts are seldom serious. Most severe and dangerous are head and abdominal injuries, mostly due to a toddler’s body shape. Compared to an adult, a small child’s head is very large in relation to the rest of the body. As a result, balance and coordination are awkward. Injuries to the head, abdomen and chest may cause death or permanent disability.
Accidents usually happen at or near home, often when an adult is near. They are most common in the warmer months, in late afternoon or early evening. Boys are hurt more than girls, about half again as often.
Toddlers have not yet mastered motor skills such as walking, climbing and riding. This lack of control means they are not always able to get themselves out of danger. No matter where your child is, you must assess the area and be on guard. Your toddler is not yet old enough to understand the dangers.
Table 1. Vehicle Child Restraints
TYPE OF SEAT
WEIGHT OF CHILD
Use in rear facing position, secured by seatbelt
Birth to 16 kg
Use in forward facing position, secured by seat belt and properly installed with tether strap
|9 to 18 kg
(20 to 40 lbs.)
Can be used forward facing or as a booster seat
Forward facing –
|Over 18 kg (40 lbs.)|
Allows safe transportation of children with conditions such as cerebral palsy, spina bifida, seizure disorders, or those who are quadriplegic or paraplegic
|Up to 36 kg (80 lbs.)|
By law, all toddlers riding in a car must be in a properly installed car seat. Studies have shown that in many cases, child safety seats are not correctly installed. The most common mistake is failing to attach the tether strap to the car body.
Your toddler may rebel against sitting in the car seat. Be firm and encourage your child to stay properly buckled in. Make the ride enjoyable by playing games, chatting, singing songs, and making frequent stops. On longer trips, soft toys, books, activities and music help keep kids happy. Be a good role model and always use your own seat belt. Refuse to drive until your child is in the car seat.
Never leave a toddler alone in the car. A small child can manage to open car doors and windows, and may get out and become lost. If the child releases the brake or puts the transmission into gear, the car will roll. On hot summer days, a car interior can become very hot. Children have become very dehydrated and sick, and even died from such heat.
Drowning is the second leading cause of death for young children. Never leave your young child alone around water.
Toddlers can drown in very little water in a bathtub or wading pool. Always supervise kids in the tub or around pools. Although children enjoy playing in wading pools on hot days, the pool must always be emptied when not in use. All private pools must be fenced and gates should be toddler-proof.
Swimming is lots of fun. Many classes are available for toddlers and parents to enjoy together. During these courses, you and your child can both learn about swimming and water safety.
Although life jackets keep a toddler afloat, they are not a substitute for your supervision.
Playing is an important part of the toddler’s life. Use toys designed for your child’s age. Even if your child seems advanced, always buy toys for the correct age group. Toddlers like to explore with their mouths. They can choke on or swallow small pieces. Many toys, but not all, have a label indicating if they are suitable for young children. Use common sense about which toys you give your child. If you feel a toy is not right for your child’s age group, keep it out of sight until the time is right.
Balloons are dangerous! Children have choked to death on whole balloons or pieces of a broken one. Keep them out of the reach of children.
Even the toy box should be safe. Children have suffocated after becoming trapped inside boxes used to store toys. Falling toy box lids have also injured children. Consider using one without a lid. If your toy box has one, be sure the hinges are stable enough to keep the lid open.
Wagons, tricycles and push toys can all be unstable and a child can fall off. Check these toys for stability before buying them. Since old toys may not meet current standards, think twice before using them.
Toys with button batteries should be avoided. Children have become ill after swallowing these small batteries. Never allow your child to go to bed with a battery-operated toy.
Exploring the outdoors helps a toddler learn about the big, wide world, but this play should always be supervised. A fence around the yard helps keep your child within sight.
Playground equipment is not always safe for toddlers. Make sure the equipment is not broken and the surface underneath is soft. Always stay beside your child as support and to prevent falls. Scarves, drawstrings, loose clothing and necklaces are all hazards that can become caught in equipment and strangle a child.
It is never too early to teach your toddler about pedestrian safety. Talk about how to cross the street and show your child how to do it properly. Be a good role model.
Toddlers are small and not easily seen by drivers, especially if a car is backing up. Young children do not understand the dangers of moving cars. Teach your child to stay with you and to watch out for vehicles.
Automatic garage doors have seriously crushed and even killed toddlers trapped beneath them. Always keep the garage door in sight when you close it.
The curious toddler wants to know how things taste. Toxic materials like household cleaners and medications can be swallowed. Lock away dangerous materials where your child cannot reach them. Never treat pills as though they were candy. Keep all chemicals in their original containers – never put them in pop, juice or beer containers.
Some children even eat houseplants. Some very common household plants, including dieffenbachia, philodendron and some types of ivy and fern, are poisonous. Provincial poison centres or local greenhouses can advise which plants are unsafe.
A toddler is still learning how to eat solid food. Cut food into bite-sized pieces and encourage your child to chew it properly. Toddlers choke easily on foods such as nuts, grapes, popcorn, candies and hot dogs. Avoid solid foods that are small and could stick in the throat.
Mealtimes should be relaxing, quiet, and unhurried. Expect your child to sit properly at the table and avoid laughing and talking with a full mouth. Never leave a child alone while eating.
Toddlers can suffocate on a plastic bag, often when a small piece is placed in the mouth and blocks the airway. After unwrapping something, make sure all the bits of packaging are properly discarded out of your child’s reach.
Painful burns often result when toddlers pull hot liquids onto themselves from above. Keep pot handles and containers of hot liquids away from your child. Use placemats instead of tablecloths.
Set your water heater temperature no higher than 54 C (130 F). Always check the temperature of bath water before putting your child in.
Children are fascinated by fire. They must be supervised around fires and fireplaces. Keep lighters and matches out of reach, as toddlers will try to use them if they find them. Smoke detectors are also important in warning your family if there is a fire. Make sure they are working properly.
Electric cords and outlets also pose a danger. Biting or mouthing an extension cord joint can cause serious electrical burns and facial scarring.
A child first learning to walk is quite clumsy and likely to fall. Gates prevent falls down stairs. Cover sharp corners on coffee tables and fireplace hearths. Children falling against them have suffered face and head injuries, or ruptured livers and spleens.
Secure windows and doors that are high off the ground with safety latches. Keep the balcony door locked, and never leave small children alone on a balcony. Be sure the gates and latches you buy meet safety guidelines.
Public Health Agency of Canada, Injury Prevention
(Safe, Healthy Environments)
consumer products safety
Canadian Paediatric Society
(Children’s Health Topics)
Injuries are expensive, not just in terms of health care dollars, but also in emotional costs. An injury can hurt a child psychologically, leaving fear and bad dreams.
Developmental skills such as toilet training may be lost. If an injury is severe, taking unpaid time off work may be necessary. Stress and worry take a toll. When injury results in a permanent handicap, long-term grief can affect the entire family.
The key to safely surviving the toddler days is adequately supervising your child. It is not enough just to be in the same area – you must be constantly watching. In a large group, make sure at least one adult is supervising the kids. Be aware of dangers and take appropriate precautions.
Only a few of the dangers in a toddler’s world have been discussed here. Federal and provincial government departments have detailed information about all aspects of child safety, including current standards for toys and furniture. Agencies such as provincial automobile associations, the Red Cross and St. John Ambulance also have educational materials.
Taking a first aid (CPR) course is an essential way to learn about keeping your child safe. You can ask your doctor or community nurse for guidance on specific topics. Your toddler naturally wants to explore and learn about limits. There is no reason that this cannot be done safely.