By Nancy Gottesman

One reason toddlers love the irrepressible Curious George so much is that they relate to him! To your 1- to 4-year-old, everything is exciting because inquiring toddler minds are hardwired to explore all they confront. Although their drive to discover is glorious to behold, it can also put them in harm’s way.

To help keep your tot on the straight and narrow, we have assembled the following 10 tips based on the U.S. Office of the Surgeon General’s “healthy list for toddlers.” The Surgeon General’s agenda is the same as yours: to keep toddlers safe and healthy without hindering their sense of wonder. “Remember, the greatest gift we can give a child is a safe environment,” concurs Rene Hopkins, R.N., coordinator of the nonprofit accident-prevention organization Safe Kids East Central at the Medical College of Georgia’s Children’s Medical Center in Augusta. Although he may not agree, Curious George could learn a thing or two from these tips, too!

Promote Healthy Eating

»Why it’s vital: “Childhood obesity is a tremendous epidemic,” cautions Seema Csukas, M.D., Ph.D., director of the Child Health Promotion department and a pediatrician at Children’s Healthcare of Atlanta. “The earlier you introduce healthy eating, the better.” This means serving portions that are appropriate for a child—so toss out that ancient “clean-plate club” way of thinking. Your toddler will eat when she’s hungry, and when she’s not, she won’t, says Csukas.

Don’t fret about it. The USDA recommends that children age 2 consume 1,000 calories daily; at age 3, it’s 1,000 to 1,400 calories, depending on activity level; at age 4, 1,200 to 1,600 calories daily. Make sure your child’s daily dose of calories includes these nutritious foods: whole grains (think healthy breakfast cereals), fruits and veggies, and calcium-rich foods for growing bones. (Children over age 2 should consume two cups of skim or low-fat milk or dairy products daily; whole milk is recommended for children age 1 to 2.) Be sure to limit sugary foods and Juicy Juices!


Institute Good Oral Health Habits

»Why it’s vital: According to a report released earlier this year by the National Center for Health Statistics, decay in baby teeth of children age 2 to 5 is on the rise: 28 percent of children in that age range have at least one cavity. Early dental exams every six months will not only prevent cavities today, but also help prevent the decay that can lead to malocclusion, which is the improper positioning of the teeth and jaw when your child is older. Begin brushing your child’s teeth once that first tooth appears.

By age 1, you should be brushing her teeth twice a day with a soft washcloth or soft toothbrush dipped in warm water; at age 2, introduce fl uoridated toothpaste. By age 4, toddlers can usually handle the brush themselves. The foods you choose will help prevent cavities as well: Replace sugar-laden snacks with healthier choices and serve 100 percent fruit juices to your toddler. “It all goes back to establishing good habits early in life,” maintains Csukas. “Teach them to care for their teeth now to help prevent not only decay, but bacteria and abscesses in the gums that may cause illness.”

Don’t Smoke (or Let Others Smoke) Around Your Child

»Why it’s vital: We know you’re aware of the health consequences for yourself, but did you know that secondhand smoke can affect your toddler’s breathing and may have longterm respiratory consequences like impaired lungs, chronic coughing and wheezing? Children of smokers visit the doctor more often for respiratory infections and wheezing episodes than nonsmokers’ kids. “Secondhand smoke causes more ear infections, more upper respiratory infections, more allergies and more asthma,” says Andrea McCoy, M.D., an associate professor of pediatrics at Temple University’s School of Medicine in Philadelphia. “It also sets a bad precedent since kids model their parents’ behavior.”


Give Positive Feedback

»Why it’s vital: When you praise good behavior, you not only encourage your child to learn about her environment (which is pretty much a toddler’s job description), you also promote parent-child bonding. Your job as a parent is to guide her through these experiences in a positive way. “A child who is encouraged feels good about herself and her accomplishments,” explains McCoy. “It makes a huge difference in self-esteem.”

When you criticize too often, your child may become withdrawn and unsure of herself, and may fear trying new things. So offer hugs and compliments as often as possible. “We don’t realize how many negative messages we give toddlers,” explains McCoy. “We’re always saying ‘No, no, no’ to protect the child, and it can have an effect if the child isn’t praised as well.”

Use Car Safety Seats Correctly

»Why it’s vital: This stat says it all: Child safety seats reduce the risk of death in passenger cars by 71 percent for infants and by 54 percent for toddlers 1 to 4 years old. You’d probably never dream of not using a safety seat, but you need to make sure you’re using it correctly. In one study by the National Highway Traffi c Safety Administration (NHTSA), 72 percent of safety seats were misused in a way that could increase a child’s risk of injury during an accident.

“One of the biggest mistakes is putting a 12- to 18-month-old in a forwardfacing seat too soon,” says Rene Hopkins, R.N., coordinator of the accident-prevention organization Safe Kids. “Keep a child rear-facing until he’s 30 to 35 pounds to provide signifi cant protection to the head, neck and spine.” For older toddlers, a booster seat can reduce injury risk by 59 percent compared to safety belts alone, but again, make sure your tot is developmentally ready for one. This means your child must weigh at least 40 pounds, which usually doesn’t happen until she’s 4 to 6 years old.

“A car seat is a positioning device that’s effective only if the child is sitting in it properly at the moment of the crash,” explains Hopkins. “If a child is leaning, picking up stuff from the car floor or moving around, the seat isn’t going to protect him as intended.” For more information on how and when to use child safety seats, visit the NHTSA website at


Set Your House Up for Tot Safety

»Why it’s vital: Safety gates, edge bumpers, doorknob covers and the like are just some of the childproofing devices you can purchase that will help prevent injury. But you’ll have to spend time, rather than money, to truly make your house safe for your toddler:

• Set your water heater to 120 degrees F. “When exposed to 140-degree tap water [the average water-heater temperature], a toddler’s skin will sustain third-degree burns,” says Hopkins.

• Place cooking pots on the back burners. If a tot can reach the pot handle, she can also pull it down. Also, do not leave cups of hot liquid on tables or counters for the same reason.

• Move all medications, cosmetics, plants, pesticides and cleaning products to out-of- reach or locked shelves. Every 13 seconds, the U.S. poison centers receive a call; 40 percent of these poisoning incidents involve a child under 3 years old.

• Place fencing around pools, spas and hot tubs. Installation of four-sided isolation fencing could prevent more than half the childhood residential pool drowning and near drowning reported.

• Install a toilet lid lock on every toilet. Drowning is the leading cause of accidental death among children ages 1 to 4—and it doesn’t always happen in a pool. Children can drown in as little as one inch of water in toilets, bathtubs, buckets, diaper pails and wading pools.

• Give toys the paper-towel-roll test. If a toy or part can drop through a paper-towel roll, it can be a choking hazard and therefore is too small for a young toddler.

• Make sure all smoke alarms are working. “There should be one on every level of the home and one in every sleep area,” says Hopkins. “Twice a year, check that the batteries are working.”

• Remove infant mobiles from the crib. As soon as your tot can stand, she’ll grab for it.


Never Leave Your Toddler Unattended

»Why it’s vital: “Supervision is the single most important thing a parent can do—and I can’t say this enough,” stresses Hopkins. It only takes a second for a curious toddler to get into an unsafe situation. Even with the most sophisticated and extensive childproofing, nothing will protect your toddler more than your watchful eye. “Supervision is number one; childproofi ng barriers are number two,” emphasizes Hopkins.

Secure a Pediatric Primary Health Provider

»Why it’s vital: In addition to the standard checkups, you need to have a regular pediatrician or family practitioner to call when your child gets sick, has an injury, displays developmental delays or has any other medical issue. “An ongoing relationship with one doctor is important,” says Csukas. “You need someone who knows your child’s health history because what’s normal for one child may not be normal for another.” Plus, it’ll provide you with peace of mind: You’ll have someone to call for “minor” emergencies like teething pain or knee raspberries.

Fully Immunize Your Child

»Why it’s vital: Fortunately, vaccination requirements for entering kindergarten have been effective in increasing vaccination coverage for toddlers. The CDC recently reported that in 75 percent of the U.S., 95 percent of the children received the fi ve vaccinations recommended for children starting school (polio, varicella, diptheria/tetanus/pertussis, measles/mumps/ rubella and hepatitis B). That’s the good news. The bad news: A small percentage of Americans believe vaccines are either unsafe or unnecessary. “Some people are frightened that vaccines can cause autism,” says McCoy. “That’s been completely disproved.” Complacency is another reason parents shun immunization. “We need to remember that just because we don’t see the disease anymore doesn’t mean it can’t come back,” she explains. “Pertussis did.”

Learn Toddler First Aid and CPR

»Why it’s vital: “It never hurts to know what to do when your toddler gets bumps, scrapes and bruises, and everybody should be CPR-certified,” says Hopkins. CPR (cardiopulmonary resuscitation) is an emergency procedure that can be performed on anyone of any age who is not breathing or whose heart has stopped. When this happens, seconds count because brain damage or death can result.

For toddlers, most emergencies revolve around their airways as a result of near drowning or choking. It’s essential that parents learn how to re-establish air for their child, maintains Hopkins. To find a CPR or first aid class near you, visit the website of the American Red Cross ( or the American Heart Association (


The Best Parenting Tip Yet:

Have Fun! Parenting a toddler can be a stressful job, we know. But if you’re too busy trying to control your tot’s world, you’ll miss out on all the fun. “The toddler years are challenging, but wonderful,” acknowledges Andrea McCoy, M.D., an associate professor of pediatrics at Temple University’s School of Medicine in Philadelphia. “It’s easy to get caught up in ‘terrible twos’-type battles, but you may miss out on the amazing accomplishments your children make in these three little years!” In addition to reading, playing and exploring with your toddler, McCoy offers two indispensable pointers that will help enhance your fun:

» Let your toddler control as much of her world as possible. Step in when it impacts your child’s safety, but the more you try to fi ght, the more frustrating it will be for your toddler (and for you!).

» Make sure your toddler sleeps 12 to 14 hours daily. A well-rested child is a happier child (which, in turn, leads to happier parents).

Nancy Gottesman, a freelance writer and mother in Santa Monica, Calif., is a regular contributor to Toddler.


Keep your tot safe this school year by following these guidelines.

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