Health and Safety Tips

Improves the lives of children and their families by:

1. Helping the child develop communication skills; developing social and adaptive skills; engaging in daily life skills; promoting health and safety; finding a position that makes it easy to play
2. Increasing the child’s ability to participate in activities in different environments—including early childhood programs, after-school programs, recreational activities, transportation and social environments
3. Facilitating the child’s participation in age-appropriate and developmentally appropriate activities
4. Assessing the child’s development, understanding of concepts, and ability to participate in typical routines and activities.
   Source: Highlights from DEC’s (Division for Early Childhood) Recommended Practices in Early Intervention/Early Childhood Special Education.

Fluoride in toothpaste is a primary means of preventing childhood caries, but it may also be an important risk factor for fluorosis (mottling of teeth).

A recent study examined the influence of fluoride toothpaste ingestion and suggests that fluorosis of the permanent teeth is influenced by ingestion of fluoride toothpaste during the first three years of life. These results support recommendations that young children use only a tiny speck—about the size of a grain of rice—of fluoride toothpaste, and need an adults’ help in brushing their teeth until they are 8-years-old.

For more information and laminated mini-posters showing proper procedures, Survival Tips Posters.

(Source: Oral Health Alert: Focus on Head Start, June 2006)

When a child enrolls in child care, licensed providers must obtain a health history from the parents or guardian. This process allows caregivers to become familiar with any health or developmental issues and meet each child’s unique needs. At enrollment time, child care providers should review each child’s history for completeness and discuss any questions they may have with the parents.

The National Health and Safety Standards for child care recommend that this health history include:

• contact information for the pediatric primary care clinician;
• developmental issues/disabilities;
• current developmental levels;
• any medications;
• special concerns such as allergies or other chronic conditions;
• any diet restrictions;
• a description of the child’s personality as relevant to child care;
• family considerations; and
• dates of communicable diseases

Start off the new school season right by making sure that your program follows the best practices for cleaning and disinfecting. Items which get used daily should be washed and disinfected daily. Heavily soiled areas will need longer contact time with disinfecting solution. After cleaning and disinfecting, air dry items before returning them to the setting.

Paper towels are the cleaning tools with the least risk of spreading infections. Use them only once. Germs grow easily in sponges, wash cloths and handy wipes.
Include children whenever possible in hand washing and the cleaning of table tops and chairs so they become familiar with the routine. Be sure to minimize children’s direct exposure to disinfecting solutions, however, as they are toxic. Wash and disinfect mops and other cleaning materials daily.

Children who have a dental home are more likely to receive appropriate preventive and routine care. The concept of the “dental home” is derived from the American Academy of Pediatrics’ concept of the “medical home.” This concept states that the care of infants and children ideally should be accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective. The child’s first visit establishes the dental home. This provides the opportunity to implement preventive health practices and reduces the child’s risk for preventable oral disease. If the child does not have a dental home, help parents obtain a source of care by providing a referral to a dentist who has experience in treating infants and young children with special health care needs, or a referral to local agencies to determine the child’s eligibility for public assistance programs.

Source: The National Maternal and Child Oral Health Resource Center at www.mchoralhealth.org.

Do you know how to handle a dental injury? The first step, as with any injury, is to remain calm. Then follow these procedures to minimize the effects of the injury:

• Clean the area around the injury thoroughly, wearing disposable gloves.
• Rinse the mouth with warm water to clean out any debris.
• Apply ice to reduce swelling.
• Child-appropriate pain relievers such as Tylenol may be given to relieve pain per the instructions on the label if requested by the parent or guardian.
• In case of a knocked-out permanent tooth, find the tooth. Do not handle it by the root. Sometimes permanent teeth can be replaced, so save the tooth in cool whole milk or water. Contact the parent or guardian to seek dental care immediately.
• If a fractured jaw is suspected, do not move the jaw.

1. Be warm, loving, and responsive
2. Respond to the child’s cues and clues
3. Talk, sing, and read to children
4. Establish rituals and routines
5. Encourage safe exploration and play
6. Make television watching selective. No TV for children under age 2
7. Use discipline as an opportunity to teach
8. Recognize that each child is unique
9. Chose quality child care and stay involved
10. Caregivers need to take care of themselves

Source: Using Early Childhood Brain Development
Research by Nina Sazer O’Donnell

California is overdue for a major earthquake. Here are some tips for injury prevention:

• Much damage occurs during an earthquake when heavy things fall or items shift on surfaces:
  • Remove or move heavy objects that are likely to fall from bookshelves or high shelving.
  • Latch or attach large objects that can’t be moved using heavy duty Velcro.
  • Use L-shaped brackets screwed into studs to attach bookcases and cabinets to the wall.
• To prevent injuries from broken glass, move cribs and beds away from windows or use solar/safety film on the glass.
• Fires are a frequent problem after an earthquake, so:
  • Know where the gas “shut-off” valve and master electrical switch are; know how to turn them off.
  • Leave a wrench close to the gas meter for turning off the gas

Studies have shown that contrary to the common belief that “exposure to cold air causes a cold,” fresh air is good and healthy. When children and adults spend a long time together in indoor spaces that are small, overheated and poorly ventilated, germs and illnesses pass easily from one person to another.

In fresh, outdoor air, children do not have to rebreathe the germs of the group, and the chance for spreading infection is reduced.

Children of all ages enjoy and benefit from playing outdoors in all except the most extreme weather. Daily outdoor play is healthy and burns energy. Even children who are mildly ill but active should go outside if the weather is not severe. Staff and children alike will feel refreshed when fresh air is part of the daily routine. Taking children outdoors daily, even in winter, can be a healthy part of their schedule, and is safe when clothing is appropriate. So bundle those children up and take them outside to play! You’ll all feel better.

• Have mothers express milk in small amounts to avoid wasting milk
• Have mothers label each container with child’s name, contents, date, and time milk was expressed
• Refrigerate or freeze milk promptly (milk retains its anti-infective properties when fresh but not frozen)
• Use frozen milk within three months
• Thaw milk by holding it under running tepid water (never use a microwave)
• Shake the bottle before feeding (this helps avoid the loss of nutrients in the milk)
• Discard thawed milk after 24 hours, do not refreeze
• Use never-frozen, refrigerated milk within two days
• Discard any milk after it has been at room temperature for four hours

Source: AAP (2006)

Healthy habits can protect you and your children from getting germs or spreading germs at home, work, child care and school. Simple actions can stop germs and prevent illnesses.

• Cover your mouth and nose. Use a tissue when you cough or sneeze and drop it in the trash. If you don’t have a tissue, cover your mouth and nose as well as possible.
• Clean your hands often. Clean your hands every time you cough or sneeze. Hand washing stops germs.
• Remind your children to practice healthy habits, too. Germs that cause colds, coughs, flu and pneumonia can spread easily.
• Healthy habits help reduce illnesses and sick days. Feel good about doing the right things to stay well.

Source: The Centers for Disease Control and Prevention and the Department of Health and Human Services To learn more, please visit www.cdc.gov/germstopper.

While spraying chemicals inside the house/facility may seem effective, it won’t prevent more ants from entering your home because most ants live outdoors. Instead, focus efforts on keeping ants from entering buildings. Combine several methods such as caulking entryways, cleaning up food sources, and baiting when necessary.

• Sponge-up invading ants with soapy water as soon as they enter.
• Plug up ant entryways with caulk.
• Take infested potted plants outdoors and submerge pots in a solution of insecticidal soap and water.
• Clean up food sources by wiping up spills or placing food in tight-fitting containers.
• Rely on outdoor baits to control the ant colony.
• Insecticide sprays should not be necessary.
• If you hire a pest control company, ask them to use baits rather than perimeter treatments or monthly sprays.

Source: UC IPM Online at www.ipm.ucdavis.edu/QT/

Many factors contribute to decreased air quality in the workplace. Formaldehyde, volatile organic compounds (VOCs) and ozone all contribute to degraded air quality. Poor indoor air quality can result in flu like symptoms including headaches, sore throats, itchy eyes, or in limited scenarios, chronic illnesses such as cancer. Sources of air pollution in offices include off gassing from furniture, carpets, cleaning products, and photocopy equipment.

To improve air at work, when possible:

• Open windows to allow for natural ventilation
• Choose mild, non-toxic or biodegradable
• Choose non-toxic pest control methods, especially indoors cleaning products
• Choose furniture made from solid wood and ground
• Avoid wall-to-wall synthetic carpet coverings made from natural fibers
• Avoid air fresheners
• Make sure high moisture areas are well ventilated
• When remodeling choose low- to no-VOC paint to avoid mold and mildew

Source: Oregon Environmental Council at www.oeconline.org

• Keep hot beverages out of children’s reach
• Set water heater to 120 degrees or lower
• Childproof all electrical outlets
• Keep children out of the midday sun and off hot surfaces
• Keep hot appliances off limits

Source: CCHP Survival Tips Posters. You may download free limited-color posters, or purchase the full-color laminated versions.

• Children’s medications should be kept in an area that is easy to get to in case of an emergency, and out of reach of all children
• The medication should be properly labeled, in its original container and able to be quickly moved into a watertight container that can be hand carried to safety
• Keep all children’s medication permission forms and logs in an accessible area where they can also be quickly gathered and placed in a watertight container that can be carried to safety
• Gathering medications for the children in your care is a priority during a disaster.

Have ECE staff practice medication-gathering drills.

Source: California Childcare Health Program, Asthma Information Handbook for Early Care and Education Providers. Online at www.ucsfchildcarehealth.org

Each year in California, tragedy strikes when a young child is left unattended in a car. It is against state law to leave a child 6 years of age or younger unattended in a motor vehicle if conditions present a significant risk, the engine is running, or the key is in the ignition. Among the dangers posed to children left in cars:

• The temperature inside a car can reach a deadly level within minutes
• A child may inadvertently put the vehicle into gear and set it into motion
• A power window or sunroof may trap the child, causing injury or death
• A stranger may abduct the child, intentionally or in a car theft
• A running engine may cause carbon monoxide poisoning
• A child might attempt to leave the vehicle alone, to look for their parent

For additional information on children and car safety, visit www.kidsandcars.org.

The U.S. Consumer Product Safety Commission reports that more than two dozen children have been injured by swallowing magnets from toys since 2003. To help prevent serious magnet ingestion injuries the CPSC recommends the following:

• Seek prompt medical attention if you suspect your child may have swallowed a magnet
• Look for non-specific abdominal symptoms: abdominal pains, nausea, vomiting and diarrhea.
• Note that objects in X-rays may appear as a single object that could actually be multiple magnetic pieces separated by trapped intestinal walls.
• Keep small magnets and small pieces containing magnets away from young children who might mistakenly or intentionally swallow them.
• Look out for loose magnetic pieces - regularly inspect toys and children's play areas for missing or dislodged magnets.
• Check www.cpsc.gov to make sure your children's magnetic toys are not recalled products.

Adapted from the U.S. Consumer Product Safety Commission

Mercury is a powerful neurotoxin that can damage the brain and nervous system. You may get exposed to mercury by eating fish contaminated with methyl mercury, breathing vapors released from incinerators and industries that burn mercury-containing fuels (e.g. coal), and breathing vapors from broken thermometers or other products containing mercury. New research finds that high fructose corn syrup, used to sweeten beverages and other foods, may also contain mercury.

Tips to Reduce Your Exposure

• Limit intake of large, long-lived fish (e.g., shark, tuna, and swordfish). Pregnant women and children under six years old should not eat more than two 6-ounce servings per week
• Do not use mercury thermometers; use digital thermometers instead
• Recycle used batteries, mercury thermometers, fluorescent light bulbs, and other mercury-containing products (Do not break fluorescent light bulbs)
• Support green alternatives to coal-fired power plants, such as wind and solar energy
• Avoid beverages sweetened with high fructose corn syrup

To prevent deaths from soft bedding, the U.S. Consumer Product Safety Commission, the American Academy of Pediatrics and the National Institute of Child
Health and Human Development (NICHD) recommend the following:

• Place baby on his/her back on a firm, tight-fitting mattress in a crib that meets current safety standards.
• Remove pillows, quilts, comforters, sheepskins, stuffed toys and other soft products from the crib.
• Consider using a sleeper as an alternative to blankets, with no other covering.
• If using a blanket, put baby with its feet at the foot of the crib. Tuck a thin blanket around the crib mattress, only as far as the baby’s chest.
• Make sure your baby’s head remains uncovered during sleep.
• Do not place baby on a waterbed, sofa, soft mattress, pillow or other soft surface to sleep.

• Always read the package insert of a medication and follow the specific instructions for its storage.
• Store inhalers away from sunlight at room temperature; on field trips, keep medications from getting too hot or cold.
• Liquid medications for the nebulizer should not be refrigerated
• Keep dry powder inhalers dry.
• Foil-wrapped medications must be used within a certain period of time once the foil pouches are opened; keep a log of when the foil pouch was opened. Source: California Childcare Health Program, Asthma Information Handbook for Early Care and Education Providers

Do not use raw or uncooked kidney beans in play tables and art projects. Eating raw or inadequately cooked beans can lead to symptoms that indicate food poisoning. According to the U.S. Food and Drug Administration, eating as few as four or five uncooked kidney beans can cause severe nausea, followed by vomiting and diarrhea within two to three hours. Several varieties of raw kidney beans, including red kidney beans, contain large amount of a poison called phytohaemagglutinin that may also cause reduced growth, diarrhea and interference with nutrient absorption. While the toxic chemical is destroyed when the beans are properly cooked by boiling, undercooked beans may be more toxic than raw beans. The following procedure has been recommended to make kidney beans safe for consumption:

• Soak in water for at least five hours.
• Pour away the water.
• Boil well in fresh water, stirring occasionally, for at least 10 minutes. In addition to their toxicity, raw beans are small objects that may put young children at risk.

If put into an ear canal or nostril, the bean may get stuck, swell and become very difficult to remove.

Caregivers of small children may find their job rewarding and fun, but that doesn’t mean it isn’t stressful at times. It’s very important to take steps to reduce stress. Caring for Our Children standards (1.049 and 3.058) recommend workplace interventions in the form of written personnel policies for break times away from the children. In addition to breaks, child care programs should also implement the following policies to reduce stress:

• Written job descriptions and policies to insure clarity about responsibilities
• Regular staff meetings so staff can share feelings and concerns
• Involvement of staff in decisions
• Regularly scheduled breaks
• A staff lounge separate from the child care area

Influenza (flu) is a contagious respiratory illness that can cause mild to severe illness and can lead to death. The best way to protect against the flu is by getting a flu vaccination each year. There are two types of vaccines. Children and adults can either receive the "flu shot" which contains killed virus or the nasal spray (made with live, weakened flu viruses that do not cause the flu. The nasal spray is only approved for healthy children ages 2-4 years old and healthy person’s ages 5-49 years who are not pregnant.

Summer is almost here, and the sun is shining all over California. During the summer months children spend more time out of doors, increasing their exposure to the sun, so remember the American Academy of Dermatology’s ABCs for safe fun in the sun:

• Avoid the midday sun, especially from 10 a.m. to 4 p.m. when the sun’s rays are the strongest. Keep infants under 6 months of age out of direct sunlight and in the shade at all times.
• Block the sun’s rays with an SPF of at least 15. Apply at least 20 minutes before sun exposure. Reapply every two hours and after swimming and sweating.
• Apply sunscreen beginning at 6 months of age. (Parental consent is needed).
• Cover up outdoors with a wide-brim hat or sun visor, tightly woven clothing and sunglasses.
• Share information on sun protection with family and friends.

AB 2977 (MULLIN), a new California legislation (effective 1/1/07), states that one of seven drowning prevention measures must be followed before a building permit may be issued for a new pool or spa.

1. Pool enclosure
2. Safety pool cover
3. Exit alarms on doors providing direct access to the pool or spa
4. Self-closing, self-latching doors with direct access to the pool or spa
5. Other means equal or better than the previous items
6. Removable mesh fencing meeting American Society for Testing and Materials (ASTM) standards (new for 2007)
7. Pool alarms meeting ASTM standards (new for 2007)

Also, any modification to an existing pool or spa must include an upgrade to anti-entrapment suction outlet standards as set for the ASTM.

To prevent the spread of infection from respiratory illnesses and runny noses, follow routine healthy practices:

• Avoid contact with mucus as much as possible
• Make sure that all children and staff use good handwashing practices, especially after wiping or blowing noses, after contact with any nose, throat or eye secretions, and before preparing or eating food
• Clean and sanitize all mouthed toys and frequently used surfaces on a daily basis.
• Wash eating utensils carefully in hot, soapy water, then sanitize and air dry. Use a dishwasher whenever possible. Use disposable cups whenever possible
• Make sure that the facility is well ventilated and that children are not crowded together, especially during naps on floor mats or cots. Open the windows and play outside as much as possible, even in the winter
• Teach children to cough and sneeze into their elbow, wipe noses using disposable tissues, throw the tissue into the wastebasket, and wash their hands

To prevent the spread of infection from respiratory illnesses and runny noses, follow routine healthy practices:

• Avoid contact with mucus as much as possible
• Make sure that all children and staff use good hand washing practices, especially after wiping or blowing noses, after contact with any nose, throat or eye secretions, and before preparing or eating food
• Clean and sanitize all mouthed toys and frequently used surfaces on a daily basis
• Wash eating utensils carefully in hot, soapy water, then sanitize and air dry. Use a dishwasher whenever possible. Use disposable cups whenever possible
• Make sure that the facility is well ventilated and that children are not crowded together, especially during naps on floor mats or cots. Open the windows and play outside as much as possible, even in the winter.
• Teach children to cough and sneeze into their elbow, wipe noses using disposable tissues, throw the tissue into the waste basket, and wash their hands.

Frequently inspect and clean toys. Repair them as needed.

• Provide a variety of toys for each age group
• Have enough toys (including duplicates of popular items) for all children to have something and to prevent fighting
• Use toys that are easily washed and sanitized. Stuffed animals should be machine washable
• Set toys aside for sanitizing after a child has placed them in his or her mouth.
• Use riding toys that are the right size for the children using them
• Keep objects smaller than 1 ¾ inches diameter, and toys with small parts away from children who put objects in their mouths
• Make sure toys are free of lead

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, people who should get vaccinated each year are:

• People at high risk for complications from the flu, including children aged 6 months until their 5th birthday, pregnant women, people 50 years of age and older, people of any age with certain chronic medical conditions, and people who live in nursing homes and other long term care facilities
• People who live with or care for those at high risk for complications from flu, includingHousehold contacts of persons at high risk for complications from the flu (see above), household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated) and healthcare workers.

Fall is a season of adjustments for children—to new classrooms, new teachers and new classmates. This transition may also be stressful for caregivers and parents. To help children adjust to change, try the following:

• Establish predictable routines
• Move in an unhurried pace. Allow plenty of time for child-centered activities
• Greet each child in a warm and welcoming way
• Prepare children for the events of the day by talking or reading books
• Plan for fewer outside activities, errands and distractions
• Build supportive relationships to help children be successful in coping with change
• Allow children to bring transitional objects from home

Unintentional injuries are the leading threat to the lives and health of children in America. These injuries don’t happen because of fate, chance or bad luck. Injuries
to children are understandable, predictable and preventable. Injury prevention is an essential part of quality child care programs, and a major responsibility of child care providers. By understanding how injuries happen, planning ahead and taking simple precautions, you can prevent most injuries. The best ways to prevent injuries are to:

• Conduct regular safety checks to identify hazards
• Modify the environment to reduce hazards
• Supervise children
• Set and enforce rules for playground activities
• Educate children, parents and staff members about the importance of injury prevention.