Like most 2-year-olds, Kevin Osborne enjoys playing in the kitchen cupboards. But when the game of dropping heavy soup cans left bruises on his toes, Laura Osborne put a stop to her son's dangerous pastime. All the cabinets in their new El Toro home now have safety latches to protect Kevin and 5-month-old Kristina from injury.
Kevin has forgotten his bruised toes, but many children don't get off so easily. The U.S. Public Health Service estimates that 19 million children under age 15 were involved last year in home accidents that resulted in injuries serious enough to require treatment.
Earlier this year, former Surgeon General C. Everett Koop told a U.S. Senate committee, "The greatest potential threat to the average American child is that child's own family and home environment."
The Orange County Health Care Agency's recently formed Injury Coalition has begun to study the problem here, but figures aren't yet available on the total number of children's injuries that happen at home, according to Hildy Meyers, a county epidemiologist who is doing research for the Injury Coalition. What is apparent, child safety experts say, is that there are too many injuries that could be prevented.
Safety experts say injuries to children in the home result primarily from fire-related accidents, drownings, poisoning and falls. But the variety of ways in which young children can be hurt at home is limited only by their own inventiveness.
The best way to make sure your home is safe for tiny explorers is to look at it from a toddler's point of view.
"If you really want to know what can be seen and grabbed, get on your hands and knees and crawl around the floor," says Davine Abbott, program director of the Orange County Trauma Society.
The peanut hidden in deep pile carpet, the dangling lamp cord, the nail polish remover left on the coffee table are all potential dangers when you are 3 feet tall.
Cords should be shortened or concealed, electrical outlets covered with safety plugs and doorknobs covered with protective sleeves that tiny hands can't manipulate.
Windows that children can climb up to should have guards, and stairs should be gated at top and bottom. Cabinets should have safety latches to keep dangerous objects out of children's reach. Hardware stores offer a choice of cabinet locks that slide through or around handles or pressure-release or spring-type latches that require adult skills to open. None are foolproof, however.
"The best ones are whatever your child can't get through," says Abbott, noting that a determined toddler can outmaneuver parents' safety efforts. She cautions that you may have to try more than one device to find one that is effective with your child.
But child-proofing isn't permanent, so you have to take the toddler-level tour more than once, Abbott says.
"Infants' and toddlers' growth is so rapid, you should constantly reassess your home," she urges.
To keep up with a child's growing size and skill, a thorough home-safety inspection should be done every six months, she says.
No household safety measures can substitute for constant supervision, however.
"Don't leave a child alone even for 15 minutes; take him with you to answer the phone," Abbott says.
She cites the cost of momentary distractions. "There's a child poisoned in this country almost every 30 seconds. And in Orange County, drownings are the No. 1 cause of injury and death for children under 4, surpassing even traffic accidents. The majority of children drowned were last seen inside the house."
Most drownings of young children occur in back-yard pools and spas, she says, but they also happen in diaper pails, ice chests, bathtubs, showers and toilets. Lock container lids, keep bathroom doors closed and use protective sleeves on doorknobs, Abbott advises.
Pools and spas should be enclosed in layers of barriers, including pool covers, fences and self-closing, self-latching gates, she says. Don't leave toys in or around the pool, learn cardiopulmonary resuscitation and keep a phone near the pool.
"Almost no precaution you can take is too much to prevent drowning," emphasizes Dr. Barry Behrstock, a Newport Beach pediatrician and author of "The Parents' When-Not-To-Worry Book."
Still, he notes, the most common accidents among young children are not drownings but falls. "They usually scare the parents but rarely cause significant injury," he said. Take precautions against serious injury by selecting nursery equipment carefully. Choose highchairs that are sturdy and broad-based (low feeding tables are even better). Make sure crib bars are closely spaced and mattresses fit tightly. Avoid cribs with decorative posts or cutouts--babies' clothing could catch on them, causing strangulation. For the same reason, don't attach cords to pacifiers or teething rings, Behrstock said.
It also helps to have a playpen or safe area where the child can be confined.