For every age of patient who comes to see me for well-child visits, I have a set of things I talk about. When parents bring in a newborn, I tell them about why you put the baby on her back to sleep, what to do if there’s a fever, and how to handle post-partum depression. Kids approaching adolescence get a brief discussion about confidentiality. I tailor it a bit from patient to patient. For those playing a higher-risk sport, I talk about concussions, for example. But by and large I go over the same things for every developmental stage.
For children on the cusp of mobility, it’s all about the childproofing. When crawling and walking are imminent, I talk with parents about getting the house ready. Parenting a kid that can get from place to place under his own steam is a whole new ballgame. I advise moms and dads to get on their hands and knees and crawl through the house themselves, the better to see what their kids can get at.
Some childproofing recommendations haven’t changed much over time. I still like plug-in plastic electrical outlet covers, though if parents remove them they need to be kept out of reach so they don’t become a choking hazard themselves. With apologies to Martha Stewart, I’m no fan of table runners, which are an efficient way for a toddler to pull a whole meal’s worth of items down onto himself. And all the household cleaning chemicals and medications need to be inaccessibly and securely stored.
However, there are a handful of new or idiosyncratic items that I throw into the conversation. The risks they pose often don’t occur to parents, and are worth mentioning.
The big story in the world of toxic ingestions (narrowly edging out news that apparently Doritos-flavored Mountain Dew is a thing now) is about laundry detergent pods. A new study in the journal Pediatrics reports that, in the year after they were introduced in the United States, the convenient little packets of laundry detergent in a water-soluble wrapper that you just drop in the wash poisoned nearly 20,000 children. In several cases, serious complications arose, and at least one death was documented. The pods are often brightly colored and candy-like in appearance, which only increases their appeal to kids who aren’t old enough to know better than to eat them.
The study only references laundry pods, but similar products are also available for dishwashers, which presumably carry similar risks. It recommends “traditional” laundry products for households with children under 4, which is obviously the most conservative approach. Given that even households with young children usually have a handful of toxic cleaning substances, if parents are going to use pods they should be well out of reach with the rest of them, preferably behind a door kids can’t open. They should be brought out one at a time and used immediately, rather than possibly leaving a container open.
Several months ago, an otorhinolaryngologist from a nearby hospital came to talk to my practice about common ENT issues for which we often refer patients to him. As he was concluding his talk, he showed us some slides of less common but still important problems he encountered from time to time. Among them were some horrifying images of severe damage to nasal tissue caused by a child lodging a button battery in her nose. The damage was nearly impossible to fix.
Also known as disk batteries, these found, flat, coin-like batteries are more than just a choking or aspiration hazard due to their size. They can corrode through whatever human tissue they contact if swallowed or stuck into an orifice, sometimes in a matter of hours. A swallowed button battery can be life threatening. No children’s toys should contain these batteries, and I recommend keeping any items in the house that use them to a bare minimum. For items that cannot be discarded (the controller for our Apple TV uses one, for example), they should be kept far out of reach and monitored.
Amber teething necklaces
I have a handful of mothers in my practice who swear by the latest thing in infant jewelry, little necklaces of amber beads that supposedly help with teething and support their health in general. Apparently the succinic acid in the beads has an anti-inflammatory effect. When I express skepticism that the beads are doing anything, I get pushback that the kids have been healthy since wearing them. That kind of post hoc analysis makes me think there might be a real market for tiger-repelling rocks.
The problem isn’t so much that the beads are medically worthless. It’s that they’re a strangulation and choking hazard. While the necklaces I’ve seen have a breakaway clasp that’s meant to prevent injury, there’s no reason to put your child’s airway at risk if the clasp doesn’t function the way it’s supposed to. The beads are also a risk in and of themselves if the strand breaks. The necklaces are simply a bad idea.
Crib bumpers are one of those items I’m surprised are still on the market. Meant to prevent infants from injuring themselves by wedging an extremity through the slats of a crib, they’re available at many major baby-related retail stores. Ostensibly meant to protect babies, these products are dangerous. Babies can suffocate if they get wedged against one. The American Academy of Pediatrics advocates for infants to be put to sleep in a bare crib to prevent SIDS. Even so-called “breathable” versions should be avoided.
Child-resistant cabinet locks
There are a variety of temporary, removable products that are meant to affix to the outside of cabinets to keep toddlers from accessing harmful contents within. My advice against using them often strikes people as counterintuitive—after all, they’re meant to make a house safer for kids, and, unlike crib bumpers, aren’t actually dangerous themselves. (Even the most enterprising toddler would have a hard time swallowing one.)
The trouble comes from overconfidence in their effectiveness. As both my own experience as a parent and at least one recall demonstrate, over time determined children can find a way to break through them. Some products are better than others, but in general I advise parents that the best bet is simply to render a cabinet lock unnecessary. Low cupboards shouldn’t contain anything dangerous in the first place. If there is a danger beyond annoyance if your toddler were to get into it, don’t put it at floor level.
The responsibilities of raising children often seem very daunting. (Believe me. I know.) But making a home as safe as possible simply requires a thorough approach and knowing what you’re buying. Keeping dangerous products out when necessary and out of reach when not takes a little bit of time, but is worth the effort to keep our kids from harm.