Health and Safety, Ages 2 to 5 Years

Safety Measures Outside the Home

It is a constant challenge to keep your child safe. Children between the ages of 2 and 5 years often do not recognize dangers without constant reminders because they reason with self-centered (egocentric) perceptions and magical thinking. These thought patterns lead children to overestimate what is in their control, which contributes to their vulnerability. They are often unaware of the consequences of their actions.

You cannot protect your child from every danger he or she can possibly encounter outside the home. But you can equip your child with some basic safety rules and precautions. Let your child's natural surroundings give you ideas for general training to help prepare your child for a variety of situations he or she may face.

To help avoid accidents, injuries, and unsafe situations outside the home, establish and review basic rules before outings and frequently reinforce them.

Basic safety precautions

• Always use a car seat. Car accidents are the leading cause of death and injury in young children.⁵ Many injuries and deaths can be avoided by using proper child restraints. Because state regulations vary and may not include important points to keep your child as safe as possible, follow basic guidelines established by the American Academy of Pediatrics:
  • When your child is at least 1 year of age and weighs at least 20 lb (9.1 kg), use a forward-facing, safety-approved, and properly installed seat. Stay with this type of seat until your child is about 4 years old and weighs about 40 lb (18.1 kg).
  • After that, use a booster seat. Stay with this type of seat until at least age 8 or when your child is 4 ft (1.2 m), 9 in (22.9 cm) tall.
  • The back seat is the safest place for a child to ride. Never allow a child younger than age 13 to sit in the front seat of any vehicle with a passenger side air bag that cannot be turned off.
  • Your child should be in a car seat every time he or she rides in a vehicle, without exception. Do not make it negotiable—rather, be firm that riding in a car seat is required for every car trip.
• Never leave your child alone in a car. Heat inside the car and other factors could cause long-lasting injury—or death—in a matter of minutes. A young child's body temperature can raise 3 to 5 times faster than that of an adult. Keeping the car windows down will not protect your child in hot or warm weather. Other injuries could also occur from a child getting stuck in the trunk or setting the car in motion.
• Help your child become "street smart." Teach your child basic rules about the dangers of cars and streets.
• Help your child understand "stranger danger." Many parents fear child abduction. Most children who are abducted are not taken by strangers, but rather by a parent, relative, family friend, or acquaintance. But it is still important to teach your child to be cautious of strangers and how to react when they feel they are threatened.
• Teach proper behavior around animals. Your child should learn how to respond to unfamiliar animals. Teach your child how to interact with family pets and other animals that he or she is likely to come across.
• Wear sunscreen to prevent sunburns (radiation burns). Radiation burns are caused by the sun, tanning booths, sunlamps, X-rays, or radiation therapy for cancer treatment. Radiation burns in children usually are caused by sun exposure and can cause permanent skin damage. Keep children out of the sun or use sun-protection measures when your child is outdoors.
• Use insect repellents to prevent bites and stings. Also, take action to prevent exposure to stinging insects, such as having your child wear closed shoes, socks, and clothes that fully cover his or her body when outdoors.
• Teach your child swimming safety. You can help prevent a drowning accident by making sure your child knows how to behave while in and around water. If you have a swimming pool at home, make sure to take safety measures. If you live near irrigation canals, teach your child not to play in or near them.
• Keep your child safe on the playground. Make sure all play equipment is safe, in good repair, and appropriate for your child's age. Closely supervise all young children while they are playing on any equipment.

Before your child visits an unfamiliar home, ask whether you need to be aware of any dangerous areas, weapons in the home, pets, or other safety issues. In addition, it is always a good idea to see the household for yourself. Don't be afraid to voice any concerns you have about safety. You are ultimately responsible for protecting your child.

Choosing child care

Before enrolling your child in day care, evaluate the environment and talk with the care providers. Ask questions about their safety guidelines. Identify any hazards and ask how they are handled. Inspect the food preparation area and ask how often it is cleaned and with what kinds of products. For more information, see the topic Choosing Child Care.

Going along for the ride: Exercising caution

Many parents and caregivers want to share their favorite activities with their young children. This can help build common interests and appreciation for exercise and other pursuits. Be sure, however, to recognize the safety issues related to these activities. Remember that your child's comfort and safety are most important.

• Keep your child safe in strollers and carts. Use the safety straps and follow the printed instructions. For example, signs on shopping carts usually advise against putting a child in the area reserved for shopping items.
• Use extra caution when riding bikes and tricycles. Make sure you and your child always wear helmets and practice safe riding habits, such as avoiding busy streets. Bike ride only during daylight hours.
• Prevent sunburns by taking extra precautions, such as applying sunscreen and putting on a hat before going outdoors. In addition, be careful your child does not develop heat exhaustion from being out in warm temperatures. Small bodies can develop these problems much more quickly than adults. Do not keep your child out in warm weather for long periods. Keep water or other drinks on hand, and never leave your child alone in a car, even with the windows down. For more information, see the topics Sunburn and Heat-Related Illnesses.
• Monitor air pollution when planning to take your child with you for outdoor activities. Children's lungs are especially sensitive to pollution. You can check your newspaper or local weather station for details about air pollution levels.

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Author:	Debby Golonka, MPH	Last Updated: December 3, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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