Taking Care of Your Grandchildren

Hand Washing

Thorough hand washing — particularly after going to the bathroom and before preparing or eating food — is now recognized as one of the most important ways to prevent the spread of any illness, from the flu to infectious diarrhea.

To really get rid of germs: wet your hands with warm water, then rub with soap for at least 15 seconds (long enough to sing a few rounds of "Happy Birthday") before rinsing well. In a public restroom, dry your hands on a disposable towel, then use that towel to turn off the faucet.

Teach your grandkids this important habit to help the entire family stay healthy. If you have a tough time getting them to make a stop at the sink, try soaps with bright colors, fun shapes, or appealing smells. Or have them sing a favorite song during the scrubbing.

Medications

Know what medications you can give your grandchild in the event of illness. If you have any questions, call the child's doctor before giving any over-the-counter medications.

Also, kids who are 12 years old or younger should never be given aspirin, as it has been linked to Reye syndrome, a serious illness that can cause nausea, vomiting, and behavioral changes, and often requires treatment in a hospital. Also, never give a child medications that have been prescribed to someone else, whether it's an adult or child. Even if two people have the same illness, they may require different drugs with different doses and directions.

Sleep

Infants younger than 1 year old should be placed on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). Infants should not be placed on their stomachs or their sides to sleep. Babies should sleep in a crib or bassinet on a firm mattress, without soft bedding, plush toys, or other soft objects. Loose bedding, such as blankets and sheets, should be tucked under the crib mattress to avoid covering the infant’s face.

Other ways to lower the risk of SIDS include:

• Keep room temperature comfortable and avoid over-bundling.
• Give the infant a pacifier at naptime and bedtime, but do not force it if the baby refuses it.
• Do not replace a pacifier that has fallen out during sleep.
• Do not expose the infant to cigarette smoke.

In addition, infants who sleep in the same room (though not the same bed) as their mothers have a lower risk of SIDS. Consider having a crib or bassinet in the room where you or the child's parents sleep.

TV, Computers, and Video Games

Kids under 2 years old should not have any time in front of a screen, including TVs, DVDs or videos, and computers. After age 2, kids should have no more than 1 to 2 hours of quality programming a day.

Offer your grandkids a variety of free-time activities to try instead of TV or videos, video games, and the Internet. The TV should be turned off during meals and homework, and you can set a good example by limiting your own TV watching. To help you decide what programs are appropriate for your grandchild, look for age-group rating tools on some TV programs and video games (they're usually listed onscreen).

Vaccines

Immunizations are one of the most important ways to keep kids — and everyone around them — healthy. Find out if your grandchildren are up-to-date on all their immunizations.

Also, it's particularly important for grandparents to get annual flu shots, which are recommended for any adult between the ages of 50 and 64. Also, anyone with a chronic illness (such as diabetes or heart disease) is considered high-risk and should get flu shots every year. Flu shots usually are given between September and mid-November and throughout flu season.

Car Seats

Babies and children should be in child safety seats that meet current standards. All kids younger than 12 years should ride in the back seat with the appropriate safety restraint.

The AAP recommends that infants and toddlers ride in a rear-facing seat until they are 2 years old or until they have reached the maximum weight and height limits recommended by the manufacturer.

All kids 2 years or older, or those younger than 2 years who have outgrown the rear-facing height or weight limit for their car seat, should use a forward-facing car seat with a full harness for as long as possible.

Booster seats are vehicle safety seats for kids who have outgrown forward-facing or convertible car seats but are still too small to be properly restrained by a vehicle's seatbelts.

Many states have laws requiring booster seats for kids up to 8 years old and 80 pounds, or 4 feet 9 inches tall. The AAP states that kids should use a booster seat until the car's lap-and-shoulder belt fits properly, which is typically when they've reached 4 feet 9 inches in height and are between 8 and 12 years old.

All 50 states and the District of Columbia have safety seat laws and more than half have booster seat laws. Ask your local government office or department of motor vehicles about child safety restraint laws in your state. Even if your state does not require booster seats for older children, put safety first when traveling with your grandkids. Follow manufacturer recommendations and instructions and do not exceed weight limits.

Cribs

Use a firm crib mattress. To avoid suffocation hazards, keep soft objects and loose bedding out of the crib, including pillows, quilts, comforters, sheepskins, stuffed toys, etc.

Cribs manufactured after 1974 meet current safety standards, including slats that are no more than 2-3/8 inches apart so that infants can't get their heads stuck. A crib that has been in the family for generations may not be suitable or safe — cribs made before 1974 may be covered in lead paint, have slats that are too far apart, or pose other safety hazards.

Before using a crib, check the side rails for locking devices. Remove mobiles when an infant is 5 months old or can get on his or her hands and knees. Remove crib bumpers as soon as an infant can pull to stand.

Toys

Guidelines published by the U.S. Consumer Products Safety Commission (CPSC) can help you determine which toys are age-appropriate for your grandkids. You may think that because a grandchild seems mature, he or she can handle a toy that was meant for an older child. But that's not a good idea, as age guidelines for toys are determined by developmental appropriateness as well as safety.

When you shop, look for sturdy, well-made toys that don't pose choking hazards. Cribs, toys, and equipment you might have used with your kids may have sentimental value, but often aren't safe options now.

Walkers

Doctors strongly discourage the use of walkers (devices with wheeled frames and suspended seats that allow babies to propel themselves forward using their feet). Infant walkers don't let infants walk any sooner than they would without one and they pose a high risk of injury, particularly from falls down stairs that may result in serious head injuries.

Infant walkers also allow access to hazards normally out of reach and they don't give babies the necessary pulling up, creeping, or crawling experiences that are the foundation for later movement. Stationary walkers are a safer alternative, but limit the amount of time spent in them.

Helmets

Helmets save lives and prevent serious head injuries so make sure that your grandkids always wear one when riding a tricycle or bicycle.

Many states and local municipalities have laws that require kids to wear helmets every time they ride their bikes. Fortunately, helmets are now being made in colors and styles that appeal to kids, so they're not as much of a hard sell as they once were.

Make sure that your grandchild's helmet fits well. Be a positive role model (and protect your own head) by wearing your helmet, too.

Helmets should also be used for skating sports such as skateboarding, rollerskating, and inline skating. The AAP recommends that kids always wear helmets and wrist, elbow, and knee padding for those sports.

Strangulation Hazards

Babies and toddlers can strangle or become entrapped in the most unexpected ways — curtain cords, strings on clothing, and infant furniture and accessories can be dangerous.

Reduce the risk of strangulation by not putting necklaces or headbands on your grandkids and not dressing them in clothes with drawstrings, which can get caught on play equipment and furniture. And while it may be handy, don't tie a pacifier around your grandchild's neck or tether it clothing.

Tie up all window blind and drapery cords so that they aren’t within kids' reach, and avoid having telephone cords that dangle to the floor. While mobiles that dangle above the crib can offer babies great visual stimulation, they should be removed by 5 months of age or once your grandchild can get on his or her hands and knees.

Be sure to install safety gates but don't use old accordion-style ones, which can trap a child's head.

Choking Hazards

Putting things in their mouths is one of the ways that babies and youngsters explore their worlds. But certain foods, toys, and other small objects that we probably take for granted can easily lodge in a their little airways.

Common choking hazards for kids under 4 years old include foods like peanuts, popcorn, raw carrots and other raw vegetables, hard fruits, whole grapes or cherries, or hard candies. Watch out for small plastic toys that come from vending machines or parts of older siblings' toys, such as (Barbie) doll shoes or small construction pieces (like Leggos).

Be especially vigilant during adult parties, when nuts and other foods might be easily accessible to small hands. Clean up promptly and carefully, and check the floor for dropped foods that can cause choking. Make sure small refrigerator magnets and other small items are out of kids' reach.

Childproofing the House

Supervision is always the best way to keep grandkids safe. But it's also wise to childproof your home.

Walk through your house with an eye for anything that may be unsafe for kids, including tools, knives, and choking hazards. For babies and toddlers, put outlet covers on all of the outlet plates. And don't forget safety latches and locks for cabinets and drawers in the kitchen and bathroom. Look for products that adults can easily install and use, but which are sturdy enough to withstand pulls and tugs from children.

Safety latches and child-resistant packaging are not guarantees of protection, so be sure to keep medicines, household cleaners, and other dangerous substances locked away and out of reach. Consider doorknob covers and door locks to help keep kids away from places with hazards, like bathrooms and swimming pools.

Child safety products are typically sold at drugstores, big-box stores, and hardware stores.

Lead Exposure

It's important to do what you can to reduce kids' exposure to sources of lead, particularly if they're younger than 3 years old.

Lead, which is in paint, soil, and other household areas, has been linked to physical and behavioral problems. Though the government banned lead-based paint and gasoline in the 1970s, many older homes, toys, cribs, and even some furniture are covered in lead-based paint because they were painted before the ban.

If you live in an older house, chances are that lead-based paint was used at some time. To minimize exposure to lead-based paint chips, use a wet cloth to wipe windowsills and walls, and watch for water damage that can make the paint peel. And limit your grandchild's exposure if you have major renovations done.

Be sure that your grandkids wash their hands before eating, after playing outside, and at bedtime. Your doctor or local health department can provide more tips.

Older Furniture

When grandkids comes over to stay with you, don't use old cribs or baby furniture that your own kids might have used many years ago. Though these items may have served your kids just fine and have undeniable nostalgic appeal, they may not meet current safety standards, might be covered in lead paint, and may be worn down. Equipment needs to be in good condition and up to current safety standards.

Internet Safety

The Internet can be a great resource, and your grandkids may astound you with their ability to navigate a computer keyboard or an Internet search engine. As technology has improved, it's become an integral part of school and kids' lives. But it's important to reduce risks that kids might be exposed to online.

Online tools can restrict access to adult material and protect your grandchild from Internet predators. Many Internet service providers (ISPs) provide parent-control options to block certain material from coming into a computer. Software also can help block access to certain sites based on a "bad site" list that your ISP creates. Filtering programs can block sites from coming in and restrict your grandchild's personal information from being sent online.

Also, it's wise to create a screen name that protects a child's real identity. And consider adding house rules for computer use, such as: never give your name or address on the computer and never click on pop-up ads or offers to purchase things.

Emergency Information

Be prepared in case you need to take your grandchild to the doctor or hospital. It's important to know a child's medical history, including any allergies and any medication your grandchild may be taking. Also have information about the child's insurance coverage and written permission from the parents authorizing you to seek medical care for the child.

Numbers to know:

• Poison Control: 1-800-222-1222. If you have a poisoning emergency, call for the poison control center in your area.
• Police/ambulance: If your grandchild has collapsed or is not breathing, call 911 or local emergency numbers.
• Phone number for your grandchild's doctor.
• Parents' work and cell phone numbers.
  
  

After raising healthy, safe kids now is the time to enjoy being a grandparent. Respecting your own child's role as a parent and taking safety precautions will make your visits — and your grandparenting experience — a whole lot smoother.

Reviewed by: Steven Dowshen, MD
Date reviewed: May 2009