As you crawl around, check the following items:
• Run your hand along the underside edges of upholstered furniture looking for sharp staples or tacks. As soon as a toy goes under a chair or couch you can expect a little hand to follow it.
• Check for hanging electric cords which are accessible to your baby. Cords we don't see that hang behind tables are still accessible to babies who crawl under those tables. If possible, electric cords that are plugged into outlets at ground level should hang behind solid furniture. Wind electric cords to a length just long enough to reach an outlet so that cords do not hang down from counter tops. Appliances that are rarely used should be left unplugged with their cords wound up out of reach. Electric cords can be pulled resulting in an appliance falling onto a baby. The biggest risk associated with electric cords is that some children bite them. If they bite through the insulation it can result in a nasty electric burn of the mouth. These burns are difficult to treat and can result in significant scarring.
• Look for sharp edges or corners on tables. Consider padding corners on tables in rooms where toddlers play regularly or removing those tables to another room.
• Look for small objects on the floor such as older children's toys. Babies love to explore the world with their mouths. They put everything in their mouths. Small objects are a choking hazard.
• Check for poisons that may be in reach of your baby. That includes plants which babies may chew on.
• Make note of any unprotected heating vents or radiators which are in reach of your baby. Touching these could result in a burn. Once you have noted where these risks are you can make a point of keeping your baby away from them or block access to them.

Once you have finished crawling around, take a well deserved break and consider the following safety tips:
• Keep bathroom doors closed. The bathroom is one of the most dangerous rooms in the house. Ceramic floors and fixtures are one of the hardest surfaces a child can hit his head on. Toilets beg to be climbed making falls even riskier. Curious babies have on occasion drowned in toilets.
• All toxic materials should be kept out of reach and preferably in a locked cabinet. If you store cleaning materials under a sink be sure that the cabinet has a child proof safety latch.
• Keep all toxic materials in the original container. The label has important information that can help you in the event of an accidental ingestion. Without a label you might not even remember what is in a container. Most important: Never put toxic materials into beverage bottles or drinking glasses. A child seeing a familiar container he associates with a drink would assume it's something he could drink if he were thirsty.
• Keep all medicines in the original labeled container, preferably a container with a properly closed child proof cap. Never leave pills out on a table or counter top or in an open container or dish, even if you intend to take the pills shortly after putting them out.
• Even if medications are in a closed childproof container, they should be kept on a high shelf or in a locked cabinet. The medicine cabinet is not a good place to store medicines. Most medicine cabinets don't lock and are placed strategically above the sink which most two year olds can reach by climbing from the toilet to the sink.
• If a child consumes something that may be poisonous, call your local or regional poison control center immediately for advice on management. Syrup of ipecac may be kept on hand to induce vomiting in case that is the treatment recommended by the poison control center, but many poisons should not be vomited. Anything that burns on the way down such as acid or lye will burn on the way up. Vomiting volatile petrochemicals increases the risk of aspiration pneumonia. Since vomiting does not always empty the stomach completely, giving activated charcoal is now often preferred over inducing vomiting for many ingestions. Your poison control center will have the most up to date protocol for treatment. It is always important to have the labeled bottle with you when you call the poison control center or if you go to an emergency room for a poisoning.

About Dr. Warren:

Warren Silberstein is a Board Certified Pediatrician practicing in Lynbrook, NY. He did his undergraduate studies at Rensselaer Polytechnic Institute. He graduated from S.U.N.Y., Downstate Medical College in 1974. He did his Pediatric Residency at Montefiore Hospital in the Bronx.
He is the author of Helping Your Child Grow Slim, Simon & Schuster, 1982.

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