The Safe Nursery

Consumer Product Safety Commission
The Safe Nursery
A booklet to help avoid injuries from nursery furniture and equipment

Major Hazards(con't)

High Chairs

Each year, thousands of children are treated in hospital emergency rooms for injuries associated with high chairs. Deaths also occur. The majority of the injuries result from falls when restraining straps are not used and when children are not closely supervised. The majority of deaths occurred when children slipped down under the tray and strangled. Most often, these children were either unrestrained or were restrained only by a waist belt.

To help prevent injuries and deaths, high chairs should have a waist strap and a strap that runs between the legs. While in the high chair, children should ALWAYS be restrained by both straps. The tray should not be used as a restraining device in place of the straps.

Without these two straps, children can stand in the chair seat and topple from the chair, or slide under the tray and strangle on the waist strap or when their heads become trapped between the tray and the chair seat.

Other accidents occur when the chair tips over. High chairs may tip if an active child pushes off from a table or wall, stands up in the high chair, or rocks it back and forth.

If You Are Buying a New High Chair

1. Select one that has a wide base for stability.

2. Examine the restraining straps to ensure that the waist belt has a buckle that cannot be fastened unless the crotch strap is also used.

3. Since the restraining straps must be used every time a child is placed in the chair, look for straps that are easy to use. If the straps are difficult to fasten, you might not use them.

4. Consider a high chair that has a post between the child's legs to prevent the child from slipping down and becoming trapped under the tray.

If You Already Have a High Chair or Are Buying One Secondhand

1. Check the condition of straps and their attachments to make sure they are securely attached and work properly.

2. If the high chair does not have adequate safety straps, contact the manufacturer for replacement.

Safety Tips

1. ALWAYS USE ALL RESTRAINING STRAPS PROVIDED. The crotch strap and belt around the waist should be fastened as soon as a child is placed in the chair and unfastened only when the child is removed. Remember, the feeding tray is not a restraint. Only safety straps keep the child from climbing out or sliding down and strangling.

2. Be sure that the locking device on a folding high chair is locked each time you set up the chair.

3. Never allow a child to stand up in a high chair.

4. Don't stray too far from the high chair - especially if the child has shown an ability to unfasten safety straps.

5. Keep the high chair far enough away from a table, counter, wall, or other surface so that a child can't use them to push off.

6. Don't let children play around a high chair or climb into it unassisted.

7. Don't let older children hang on to a high chair while a baby is in it. The high chair could tip over.
Playpens

Deaths have occurred when the drop-sides of mesh playpens and cribs were left in the down position. When a mesh side is left down, the mesh hangs loosely, forming a pocket or gap between the edge of the floor panel and the side. Young infants, even a few weeks old can move to the edge and fall into the loose mesh pocket where they can be trapped and suffocate.

New mesh-sided playpens with drop-sides have warning labels that alert parents and others never to leave infants in playpens with sides in the down position. Be aware that older mesh playpens or cribs do not have these warning labels. Many of these products are still in use.

Deaths have also occurred in playpens or travel cribs that have a rotating hinge in the center of each top rail to enable the product to be folded into a compact package. These deaths resulted when the top rails collapsed and formed an acute 'V' shape that entrapped the child's neck. In the entrapment incidents, the hinges were either not turned inward and down or they somehow rotated during use to the unlocked position. CPSC has recalled several brands of playpens with these rotating latches in the center of the top rails.

Some playpens or travel cribs have a hinge at the center of each top rail with a latching mechanism that locks automatically when the rail is lifted into the normal use position. To fold these products, a button or other release mechanism must be used to release the latch. Such products, while similar in appearance to those with rotating hinges, are not known to have been involved in any fatal entrapment incidents.

If You Are Buying a New Playpen

1. For playpens with a hinge in the center of each of the four top rails, look for a playpen or travel crib that has top rails that automatically lock when lifted into the normal use position.

2. Look for mesh netting with a very small weave (less than 1/4 inch)-smaller than the tiny buttons on a baby's clothing.

3. Slat spaces on a wooden playpen should be no more than 2-3/8 inches (60 mm) in width.

If You Already Have a Playpen or Are Buying One Secondhand

1. Check the slat spacing on older, wooden playpens. The Commission does not recommend using it if the space between slats is more than 2-3/8 inches (60 mm).

2. Check to see if it has a hinge at the center of each top rail that must be turned toward the inside of the crib and down to prevent folding. CPSC does not recommend that you use this type of product.

Safety Tips

1. Always show babysitter/caregiver how to properly set up playpen according to the manufacturer's instructions. Improper setup can cause the playpen to collapse, resulting in injury or death to the child.

2. Never leave an infant in a mesh playpen or crib with the drop-side down. Infants can roll into the space between the mattress and loose mesh side and suffocate. Even when a child is not in a playpen, leave the drop-side up. Children may try to climb back into a playpen and cut or pinch their fingers on the unlocked hinge mechanism.

3. Remove large toys, bumper pads, or boxes from inside the playpen. They can be used for climbing out.

4. Avoid tying any items across the top or corner of the playpen; they can be a strangulation hazard.

5. Toys should not be hung from the sides with strings or cords because they could wrap around a child's neck. Use another method for attaching the toys to the playpen.

6. Children may use the top rail of the playpen for teething. Check vinyl or fabric-covered rails frequently for holes and tears. A teething child can chew off pieces and choke.

7. If staples are used to attach the mesh side to the floor plate, make sure none are loose or missing.

8. Examine the mesh and its attachment to the top rail and floor frequently for loose threads. There have been reports of entanglements in threads (stitching) that unraveled.

9. Never use a playpen with holes in the mesh sides. These could entrap a child's head and cause strangulation.

10. Never use a playpen with a hinge in the center of each of the four top rails that fold if each top rail does not automatically lock when the rail is lifted into the normal use position.

11. Never use a pad that does not fit snugly and never add a second pad or mattress. Babies have suffocated when trapped between mattresses or between the playpen side and mattress that was too small.
Rattles/Squeeze Toys/Teethers

Because children have choked to death on baby rattles, the Commission issued a regulation in 1978 requiring 1) that rattles be large enough to prevent them from becoming lodged in an infant's throat and 2) that they be sturdily constructed to prevent them from separating into small pieces that can be swallowed or inhaled. To date, the largest rattle known to have lodged in an infant's mouth/throat had an end about the size of a golf ball. Squeeze toys and teethers have been involved in similar choking incidents. Rattles, squeeze toys and teethers involved in incidents had handles or ends small enough to enter a baby's mouth and lodge in the throat, blocking the airway.

Safety Tips

1. Check all rattles, squeeze toys and teethers for small ends that could extend into the back of the baby's mouth. If you feel that the toy may be too small for safety, throw it away.

2. Take rattles, squeeze toys, teethers, and other small objects out of the crib or playpen when the baby sleeps.

3. Teethers, like pacifiers, should never be fastened around a baby's neck.

4. Avoid rattles and squeeze toys with ball-shaped ends.
Toy Chests

CPSC has received reports of death and brain damage as a result of toy chest lids falling on children's heads or necks. These chests include those specifically manufactured for toy storage, as well as trunks, wicker chests, wooden storage chests, and other similar items.

Most of the children were under two years of age. Accidents occurred when children were reaching over and into the chest when the lid dropped, either falling on their heads or trapping them at the neck between the lid and the edge of the toy chest.

Another potentially fatal, but less frequent, hazard is suffocation, which has resulted in the deaths of several children. These accidents happened when children climbed into toy chests to hide or sleep. Because the toy chests were not adequately ventilated, the children suffocated in the enclosed space.

If You Are Buying a New Toy Chest

1. Look for one that has a support that will hold the hinged lid open in any position in which it is placed or buy one with a detached lid or doors.

2. Look for a toy chest with ventilation holes that will not be blocked if the chest is placed against the wall, or a chest which, when closed, has a gap between the lid and the sides of the chest. Many chests are ventilated by a space between the underside of the lid and sides or front of the box.

3. Make certain that the lid of the toy chest does not have a latch.

If you already own a toy chest or trunk with a freely falling lid, CPSC recommends that you REMOVE THE LID to avoid possible tragedy. Otherwise, you may wish to install a lid support device designed to hold the lid open in any position. Buy a spring-loaded lid support that will not require periodic adjustment.
Walkers

The Commission estimates that more children are injured in baby walkers than with any other nursery product. The accidents happen even when a caregiver is nearby. Almost all of the victims are children under 15 months of age. Most of the injuries are caused by:

1. Falling down stairs - Children in baby walkers can quickly move to the edge of the stairs and fall. This kind of accident frequently happens when someone forgets to close a basement door or safety gate.

2. Tipping over - Baby walkers can tip over when children try to cross uneven surfaces such as door thresholds or carpet edges.

3. Burns - Children in baby walkers can be burned when they touch hot surfaces such as range doors, radiators, heaters, and fireplaces. Children can also be burned when they reach and spill hot liquids such as soup, coffee, or cooking oil.

You May Want to Use an Activity Center Instead of a Walker

In an activity center your child will be protected from most injuries associated with baby walkers. Some activity centers are stationary; others allow your child to walk within a limited area.

If You Plan to Use a Walker

It is important to buy a new walker that has safety features to help prevent falls down stairs. However, it is not possible to find a product that is safe in every situation. Therefore, it is very important to follow all safety instructions on the warning labels.

Safety Tips

1. To prevent accidents, always keep your child within view. A walker increases your child's mobility and his/her reach.

2. To avoid a fall down stairs or steps, make certain that the door or gate is closed at the top of the stairs every time you use a walker.

3. To avoid a tipover, use a walker only on smooth surfaces. Carpet edges, thresholds, and uneven pavement can cause a child in walkers to tip over.

4. To avoid a burn injury, keep your child in a walker away from hot surfaces and containers with hot liquids. Beware of dangling appliance cords.

5. To avoid a drowning, keep your child in a walker away from swimming pools, toilets, and other sources of water.