Summer Safety for Infants and Toddlers

Toddler in lifejacket on boatThe sun is shining, the corn is knee-high, and everyone wants be out in the sun before winter rolls back in. As people are planning their summer vacations, many pediatricians are asked about how and when infants or toddlers can participate in their parents’ or siblings’ favorite summer activities, such as biking, swimming, and boating. Being outdoors and active is great for the whole family, but safety – as always – comes first when you’re thinking about having your little one along.

Biking

Bicycling is a wonderful way to be active and get around in the summer, but many parents are unsure when their infant or toddler can join them for the ride. Most importantly, infants need to able to sit well in an infant bicycle seat or bike trailer for a long period of time and strong enough to control their head while wearing a bicycle helmet that is appropriate for their age. For these reasons, children less than 12 months of age should not be transported by bicycle.

Safety should be fun! Celebrate your child’s birthday with a bicycle helmet and a ride in their bike seat or trailer!

The two primary options available for supporting a toddler for bike travel are mounted seats and bike trailers. Children, including infants, should never be transported in infant carriers or backpacks, as these are not secure, generally do not allow for helmet wear, and can lead to serious injury if an adult or older child lands on an infant during a crash. Bike trailers are generally thought to be the safest option, as they are low to the ground, allow for a child to be securely harnessed while wearing a helmet, and provide structure that can be protective in minor crashes. Mounted bicycle seats for toddlers also allow for secure harnessing with a helmet in place and can be less bulky than trailers, though their height can add to the momentum of falls. Front-mounted bicycle seats have entered the scene more recently and their safety compared to rear-mounted seats is unclear; front-mounted seats are more limited in their weight requirements, so be sure that the seat is appropriately sized for your child. If you are considering a mounted seat, ensure that the seat is securely and appropriately attached to your bike frame, that the seat has a sturdy harness and high back that can support a sleeping child, and that spoke guards are in place to prevent injury to a child’s feet or hands.

No matter the mode that you choose for including your child in biking, you can make your trip safer by:

  • Taking less-traveled roads and roads with clearly marked bike lanes
  • Using hand signals to let drivers know when you’ll be turning
  • Making sure that your bike is highly visible, with bike lights and visibility flags for trailers
  • Double-check child seat and trailer attachments before every ride
  • Taking into account that adding an infant seat or trailer to your bike may add to your brake time and bike instability
  • Making sure that you and your child always wear a helmet when on a bicycle!

Swimming

Nothing says summer like a day at the beach, and many children love the sand and the water. Sometimes, however, crowded areas and unfamiliar undertows can make it difficult to keep your young child safe, and drowning is a leading cause of death for 1-4 year olds. Knowing your surroundings and committing to appropriate supervision can keep children safe and lead to great play that involves the whole family. For infants and toddlers, “touch supervision” – where an adult is within reach of the child at all times – is recommended whenever a child is in or near the water.

Safety should be fun! Sing songs and play games in the water with your child while practicing touch supervision.

To ensure that the supervising adult is able to devote full attention, it’s also important to make sure that smart phones or other distractions are put away and to clarify which adults are supervising particular children. Designate one adult as a “water watcher” so that the role is clear. Choosing beaches and pools that have life guards on duty also help to ensure that an individual trained in CPR and rescue is available in case of emergency. For young children, wearing a personal flotation device (PFD, or life jacket) helps to ensure safety when they are playing in or near the water (see Boating section below for more information).

Many parents wonder whether their infant or toddler should take swimming lessons so that they are more comfortable in the water. Swimming lessons can be a fun way to get outside with your child at this age, and should always involve a parent or guardian for children under three. This makes for a great activity that families can share, but does not change the importance of close supervision in water. While a few small studies have suggested that swimming lessons may decrease risk for drowning in this age group, no lesson or intervention can promise to prevent a child from drowning.

Summer safety and drowning prevention is also critical at home, as infants and toddlers can drown in even small amounts of water. Home pools should be appropriately covered and fenced on 4 sides by a fence that is at least 4 feet high. This is true of “inflatable” pools as well. Pop-up pools are popular with families because they’re larger than a kiddie pool, but don’t have the expense of an installed pool. This is a concern not just for the children living in the home, but for other children in the neighborhood. Often, these pools are not fenced, making it possible for young ones to climb in unsupervised. If you have a pop-up pool, put a fence around it. And, if you have a kiddie pool, be sure the empty the pool after use and supervise children closely around yard ponds and other bodies of water.

Boating

Children can be brought along as passengers on a boat when they are big enough to wear a personal flotation device (PFD, or life jacket) that is appropriate for their weight, approved by the U.S. Coast Guard, and fits well. PFDs for infants and young children should have flotation collars, straps that go between their legs, and handles to ensure that the PFD will stay on and cause an infant to face up and be easily removed from the water if needed. The fit of a PFD can be assessed by having your child raise their arms up over their head in the “touchdown” sign: if the PFD bumps into the child’s ears or chin, it is too loose. Water wings do not provide appropriate flotation, do not cause the wearer to float on their back, and should never be used to replace a PFD.

Safety should be fun! Let your child get used to their PFD by wearing it on land and pretending to boat! Older children can be designated “safety captains” and can be in charge of verifying that every passenger has a PFD before the boat leaves the dock.

Boats, like homes, should be childproofed and have limits and rules for safety. Consider what your child can access from their position in the boat and set limits around unsafe activities, such as running or putting hands or feet outside of the boat. Adults operating a boat should have the appropriate license and should never operate a boat after consuming alcohol or other drugs.

When out on the water, it’s also important to consider the risks from exposure that can occur. Small children are at higher risk for hypothermia than adults; plan ahead with extra changes of dry clothes, layers, and towels to help dry a wet child off. Lightweight clothing can also be good protection against the sun, but don’t forget to bring sunscreen (at least SPF30) and reapply frequently when you are out on the water.

Getting outside and being active is fun and an important part of your family’s health! Use these tips to help you safely include your infant or toddler in biking, swimming and boating so that the whole family can have fun in the sun!

Additional Resources:

Your state or local Department of Natural resources also will have information on boating legislation in your area.

Summer Safety for Infants and Toddlers
About Brittany Allen, MD
Dr. Allen is a pediatrician at UW Health University Station. Her special interests include preventive pediatric care, adolescent health and care of LGBT and transgender youth.

View all posts by Brittany Allen, MD
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Get Fit Together Family Activity Guide (Giveaway)

We know that children are little mimics – they will copy behaviors that they observe and repeat words that they hear (nearly every parent can attest to this with stories of awkward situations involving particular word choices not appropriate for 5-year-olds to utter). So if mom and dad relax in front of the TV after dinner, chances are that’s going to be the preference for the kids as well. But, if mom and dad instead say it’s time to do something fun together after dinner, that helps create an environment where activity is normal and encouraged. Family Hiking in the Woods

While it can be hard with busy lifestyle – whether it’s work, or scheduled activities like music lessons or sports – you really have to make the time, otherwise it’s too easy to put things off until the next day. Block time on the weekend – whether it’s an hour or half the day – and do something fun as a family. Go for a hike, go for a bike ride on a trail, go geocaching, discover a new park – just go. Do something. You can even let the kids decide – chose between a hike or bike ride. Go for a walk after dinner. Just get out together.

Keep in mind, this isn’t your time to get your daily exercise in. You’ll get too frustrated if you’re focused on “miles” and the kids are wanting to look at the pretty flowers by the side of the road. It’s about them. It’s about spending time together as a family. Let them discover their world and enjoy re-discovering the world through their eyes. And, if you’re hearing them complain, “It’s too long to walk! Are we there yet? Why can’t we play our video games!” that’s actually a sign they’re bored. So think about how you can keep it fun. Play a game of I Spy. Make up stories. Do some research and find out the history of the place before you go.

That said, remember kids do need breaks. Kids younger than 5 usually need a break every 15 minutes. So if you’re planning an hour hike, that could easily turn into a two hour venture. For elementary age kids that usually turns into a break every half hour. You know your child best, but aim for under-doing rather than over-doing. Trying to do too much can make it a frustrating experience for kids, and one they’ll not want to repeat.

When you’re thinking about what to do, remember they may not like everything you try so expose them to a lot of different things – biking, hiking, ice skating, roller skating – you never know what might click. And help them remember it’s not about doing things right. It’s about having fun and laughing. It may be challenging the first time the family tries things, but that can also help create fond family memories (“Do you remember that time dad tried roller skating?). And, it’s also a good way for kids to see even adults have to practice and work at an activity.

And, you’ve heard it before, but it’s always a good reminder to use sunscreen and sun protection, and any safety equipment like helmets you may need.

So, what are some ideas you can try? Check out Wisconsin’s State Parks, find out what’s going on around Wisconsin, learn some simple things to do around home or explore our Exercise for Kids Pinterest board.

They’re only young for a fleeting time so enjoy every moment of it while you can. When you make a family habit of doing things together when they’re young, they’ll continue to enjoy doing family activities as they grow. And, there is a special bonding that takes place when you’re active together. A simple walk with the dog can turn into an hour spent laughing and learning more about what’s going on in your child’s life. It’s a gift for the whole family.

Smiling Sun

Enter this week’s giveaway

Leave a comment below with your favorite place for a family hike or bike ride.

Prize: 1 - Picnic package including a picnic blanket, water bottle and sunscreen.
Rules: Giveaway closes on Sunday, July 27, 2014 at 11pm CST. Open to Wisconsin, Iowa and Illinois residents only. One entry per email address is permitted. The winner will be selected using random.org and announced on the following Monday as an update to this post. Winner will be notified via email and asked to provide a mailing address to receive the prize; if the winner does not respond within 7 days, the winner forfeits the prize and another winner will be selected. Subscribe to the blog and you’ll get new posts delivered to your inbox as soon as they’re posted.

About Judy Hilgers, RN, BSN and Ellen Heiser, MS
Judy is a clinic nurse with the UW Health Pediatric Fitness Clinic. Ellen is Clinical Exercise Physiologist at the the UW Health Pediatric Fitness Clinic.

View all posts by Judy Hilgers, RN, BSN and Ellen Heiser, MS
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Campfire Safety Guide

Campfire SafetySummer nights are perfect for having a campfire with your family. You can sing songs, tell stories and roast marshmallows to make s’mores. Keep your campfire experience fun and safe with these tips from the UW Health Burn Center:

  • Always have an adult around. Children should never build a fire alone
  • Keep the campfire small so that you can manage it
  • Choose one person to be in charge of adding wood to the fire
  • Do not throw or use flammable liquids on a fire
  • Never throw trash on a fire
  • Keep a safety zone of at least 3 feet when standing around the fire. You can use long sticks to roast marshmallows.
  • Make sure everyone knows how to stop, drop and roll. Explain to your kids that if their clothes accidentally start on fire they should stop, cover their face, drop to the ground and roll around to put out the flame.
  •  Have plenty of water and a shovel nearby in case the fire starts burning outside of the fire area. If you don’t have water, you can use dirt!
  •  Never leave a campfire unattended.

When you are ready to leave, pour water on the fire until the hissing sound stops and make sure everything is wet and cold to the touch. Remember what Smokey the Bear says: “If it’s too hot to touch, it’s too hot to leave!”

What is your family’s favorite campfire activity?

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Swimming in a “Waterproof” Cast (Giveaway)

Blue Arm CastThis giveaway is no longer accepting entries. Congratulations to our winner Jeanne

Broken bones are a common injury for children during the summer. It’s important to help your child take care of the cast until it’s time to get it removed.

The number one rule of casts are to keep them dry. This includes  “waterproof” casts, too since these cast are NOT really waterproof. The outer shell is water resistant, but the cast has openings on each end that lets in water.

To prevent skin problems, your child should avoid water and keep the cast as dry as possible.  If water gets underneath the cast it can hold the water next to your child’s skin since the inside is slow to dry. Also, chlorine from pool water can burn the skin as the water evaporates.

If your child’s cast gets wet:

  • Use a hairdryer on the cool setting to speed drying.
  • If still wet after 24 hours, call us at (608) 263-6420.

If your child goes swimming:

  • Flush cast with tap water for 10 minutes to rinse out the chlorine.
  • Use hairdryer on the cool setting to speed drying.
  • Do not swim every day; allow the cast to dry for 24 hours before swimming again.
  • If still wet after 24 hours, you are in pain or see a rash under the cast, call us at (608) 263-6420.

These photos show what can happen to your child’s skin if their cast is not kept dry. These types of injuries may become infected or cause permanent scarring.

Learn more about taking care of casts and splints and what to expect when a cast comes off.

Smiling Sun

Enter this week’s giveaway

Leave a comment below with your suggestion for ways to keep cool (and dry) with a cast during the summer.
Prize: 1 – $10 Dick’s Sporting Goods gift card
Rules: Giveaway closes on Sunday, July 20, 2014 at 11pm CST. Open to Wisconsin, Iowa and Illinois residents only. One entry per email address is permitted. The winner will be selected using random.org and announced on the following Monday as an update to this post. Winner will be notified via email and asked to provide a mailing address to receive the prize; if the winner does not respond within 7 days, the winner forfeits the prize and another winner will be selected. Subscribe to the blog and you’ll get new posts delivered to your inbox as soon as they’re posted.

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Helping Ease Summertime Anxiety (Giveaway)

Summertime Anxiety

This giveaway is no longer accepting entries. Congratulations to our winner Kati

How can having no school, going to bed when they want, and sleeping in be causing kids anxiety? It may seem counter intuitive, but it’s true. And if your kids are showing signs of being restless, irritable and maybe even reluctant to go do things , chances are they may be feeling anxious. Kids need a framework for their day. If there’s ambiguity – too much unstructured time or unpredictability – there’s increased anxiety.

Put into perspective – kids go from the highly structured five days a week, nearly every hour of the day of knowing exactly where they’ll be and what they’ll be doing. Summer arrives and suddenly the day is wide open. And while parents may think that’s a good thing – to take a break from the rigid structure of the school year – kids will start to become agitated and restless because they need something to grab onto in order to organize their day.

To start providing some framework,  stick to the basics – keep bed time and meal times the same. And while sleeping-in may seem like a great thing, limit it to an hour or hour and a half max. Any longer and it can offset the sleep cycle.

A Family Calendar

Sometimes kids attend camp during the summer, and through camp kids will get the routine they need coupled with activities that help keep them engaged physically and mentally. But, for kids who might be at home with a parent, grandparent or nanny during the summer, it can be easy to fall out of any kind of routine.

Develop a weekly calendar that’s easy to see, like on the front of the refrigerator. It isn’t meant to schedule the kids as much as during the school year, but rather, provide a basic layout of what the week will look like.

To create the calendar, split each day into morning and afternoon. Then assign activities to days based on four categories:

  • Physical exercise – bike riding, swimming, etc.
  • Brain exercise – reading, workbooks, things that use academic pieces
  • Social Interaction – time with family and friends, playdates, etc.
  • Playtime – unstructured creative, relaxing and fun time

An example of a week might be Tuesday and Friday mornings are brain exercise time. Monday, Wednesday, Friday afternoons are physical exercise time. Thursday morning is social playdate time.

You can always add more time to each category, too, like having additional playdates, or spending more time reading. Having items written down helps ensure stuff gets done, and reminds kids that they have a mix of activities, just like a school day has different classes mixed in with recess and lunch.

Providing structure and variety helps kids know what to expect while still allowing for a fun and relaxed day. There is still room for the staying in PJs, or watching cartoons. Just set expectations like, “Everyone dressed by 8:30am” or “Cartoons from 7:30-8am.”

Most parents are aware of how reading, spelling and even math skills decline over the summer if kids don’t actively use those skills. The calendar can help ensure that time is being spent on those activities, instead of being put off to another week. Find ways to make it fun like math puzzles or reading new books, and talk with your kids about what they’re learning to show them you’re interested and value the time too.

And, keep in mind the calendar is meant to be very flexible. If kids get an invitation to go to the waterpark on a library day, that’s okay. Or, perhaps they have summer camp on a particular week. The schedule is really the default schedule – it is what happens when there is nothing else going on.

Create a Menu of Activity Ideas

Once you’ve created a calender, the next step is to develop a menu of activities that fit within the categories. It’s like when you go to a restaurant. You know you’re hungry and so you look at the menu and choose an option that sounds the most appealing. It’s the same concept – create a menu of activities that fit within each of the categories, then when a particular category is scheduled on the calendar, you can look at the list and choose an item. With a variety of ideas, it enables kids to mix it up from day to day. And, when kids come to you saying, “I’m bored,” you can point them to the list.

For summer activity ideas follow UW Health Kids on Pinterest.

Family Responsibilities

On the calendar, it is also good to identify time spent for family responsibilities (or chores depending on the terminology you prefer). Again, it can be flexible. But giving kids tasks like picking up their room or helping with the dishes gives kids the message that they have responsibilities and that their contributions are important to the family. Accomplishing the tasks also helps with their self-confidence and creates a feeling that they have done something important and valued.

Warning Signs

All kids will have anxiety from time to time, but when should you start to wonder if there’s more concern? Irritability and avoidance are common signs of anxiety. You avoid the things that make you anxious and consequently, you won’t want to participate in activities or try new things. That might mean not wanting to go on play dates or joining kids in new activities , and instead, spending more time alone at home playing games on the computer.

Speaking of screen time -

Video games, television, even texting can be addictive. And it can be hard for kids to turn it off. Without structure and limits, kids could easily go six hours or even more playing video games. But balance is critical. It’s not that kids can’t have any screen time, but it definitely needs to be limited. Playing video games all day can lead to your child’s thinking becoming more narrow and rigid instead of flexible and creative.

Think about it in terms of physical exercise – you don’t just exercise your upper body to stay healthy and fit. Instead, you do exercises that work all parts of the body. The brain is the same way. You need to have a variety of activities – math, spelling, social interactions, and new experiences etc. – to give your brain a good work out to optimize both mental and physical health.

Having basic consistency and structure to each day gives kids a sense of security and stability, even tho you may hear them complain from time to time that it’s boring. In other words, you know you’re doing a good job when kids say, “We do the same thing all the time.”

Smiling Sun

Enter this week’s giveaway:

Leave a comment with your favorite boredom busters or Pinterest board with activity ideas.
Prize: 1 $10 Target gift card
Rules: Giveaway closes on Sunday, July 13, 2014 at 11pm CST. Open to Wisconsin, Iowa and Illinois residents only. One entry per email address is permitted. The winner will be selected using random.org and announced on the following Monday as an update to this post. Winner will be notified via email and asked to provide a mailing address to receive the prize; if the winner does not respond within 7 days, the winner forfeits the prize and another winner will be selected. Subscribe to the blog and you’ll get new posts delivered to your inbox as soon as they’re posted.

Helping Ease Summertime Anxiety (Giveaway)
About Marcia J. Slattery, MD
Marcia Slattery, MD, is a UW Health child and adolescent psychiatrist, and Director of the UW Anxiety Disorders Program.

View all posts by Marcia J. Slattery, MD
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