$Unique_ID{PAR00214} $Pretitle{} $Title{6 Months to 1 Year: Safety and Health} $Subtitle{} $Author{ Editors of Consumer Guide Mendelson, Robert A Mendelson, Lottie M Meyerhoff, Michael K Ames, Louise Bates} $Subject{6 Months to 1 Year Safety Health safe childproof room rooms kitchen kitchens latches drawers closets cabinets poisonous sharp dangerous garbage pail dishwasher refrigerator electrical appliances cord cords stove bedroom bedrooms hazards Jewelry choke chokes choking accidents accidental poisoning poisonings strangulation suffocation bathroom bathroom living room den dens furniture electrical outlet outlets stairways gates Climb Climbs Climbing stairs gate plants fireplace window windows unsupervised swim swimming pool car trip trips ride rides siblings sibling hostility jealousy visiting homes visit visits diphtheria tetanus pertussis DTP meningitis Hemophilus influenza B HiB temperature fever cold Colds cough humidifier humidifiers vaporizer vaporizers medication medications Acetaminophen medicine dropper droppers Wax buildup tympanic membrane eardrum hearing ear infection infections scaling Scaliness cradle cap seborrheic dermatitis sun suntan sunburn skin cancer sunscreen sunscreens SPF Sun Protection Factor rash rashes illness illnesses SAFETY-PROOFING PRODUCTS ACCIDENT ACCIDENTS overprotective overprotectiveness overrestrictive overrestriction oversupervision} $Log{ Older siblings often need a period of acceptance of the little one*0053401.tif} The New Parents' Question & Answer Book 6 Months to 1 Year: Safety and Health I can't imagine making my entire home safe for (and from) my newly crawling baby. Is it really necessary to childproof every room? Accidents remain the leading cause of injury and death in children up to five years of age. Most of these accidents occur in and around the home. Since many (but not all) of these accidents are preventable, you need to be scrupulous about ridding your baby's environment of any potentially harmful objects and substances. The more rooms you can make safe and accessible for your baby, the better, however, this does not mean you have to completely rearrange your entire home. Some rooms simply may be impossible to make safe for your baby--such as a workshop or laundry room. You may want to keep other rooms--such as a home office--in their regular condition for purposes of your own convenience. In such cases, it is imperative that you find a way to close off the area so as to effectively prevent unauthorized and/or unsupervised visits by your baby. Using a lock and key, installing a high hook latch, or placing a gate in the doorway will do the trick. It is still much too early to expect your baby to understand and follow verbal instructions concerning the concept of "off limits." The kitchen seems like such a dangerous room for a baby. Won't I have to get rid of a lot of essential stuff to make it safe? The kitchen can, indeed, be a very hazardous place for your baby. However, it also will be one of his favorite areas in which to play. Therefore, it is recommended that you make every effort to make this room safe for him--which does not necessarily mean getting rid of a lot of stuff. It does mean that you will have to install childproof latches on all drawers, closets, and cabinets containing poisonous materials and sharp or otherwise dangerous items. It also means that you will have to install similar devices on the garbage pail, dishwasher, and refrigerator. In addition, it will be a good idea to unplug all small electrical appliances when they are not in use; and when they are in use, be sure that the cords are not dangling down where your baby can reach them. When using the stove, remember to keep all pot and pan handles turned inward, be extra careful in handling hot liquids that could spill or splatter, and keep the baby away from the area when cooking is in progress. You might even consider removing the knobs that turn on the stove/ range whenever you are not using them. When serving or consuming hot foods or liquids, be sure to set them down on the middle of the table, not near the edge. Since your baby may grab onto the edge of a tablecloth to steady himself or keep himself from falling, save yourself some work and worry by putting these away for the time being. Fold and put away all step stools. And, turn all water heaters down to 120 degrees Fahrenheit. How can kitchen items be rearranged to make the room safe and more suitable for my baby? Although there are many things in the kitchen that are hazardous to your baby, there also are many items with which he can have a lot of fun. Therefore, rather than simply locking up all the drawers and cabinets, you might consider rearranging things so that the dangerous materials are safely secured in the high cabinets and drawers out of reach of your baby, while those that are suitable for play are left unlocked in the lower ones. For example, knives, forks, graters, and other such utensils should be placed well out of reach. Your baby will appreciate it, however, if you keep the spoons and spatulas where he can get to them. The same is true for glassware as opposed to plastic cups. All small appliances must be inaccessible, but pots, pans, plastic containers, etc. can be kept at his level. One thing to watch out for is the possibility of avalanche. For instance, if you have moved canned goods and paper products into a lower cabinet, make sure that the heavier items are on the bottom and the lighter ones are on top so your baby won't be harmed by things that come tumbling down. My bedroom seems like a relatively safe place for my baby. Are there any special hazards I should be aware of in there? Bedrooms seem to be made for babies at this stage of development. They usually contain soft carpeted surfaces to crawl across, soft furniture to climb upon, and lots of relatively harmless things like pillows and slippers to play with. However, there also are a few typical hazards that should be removed or locked up before your baby is given free access to the bedroom. Jewelry is fascinating to babies, but it can result in serious choking accidents. Similarly, perfumes, deodorants, makeup, and other such substances can lead to accidental poisonings. Belts, ties, shoelaces, and especially plastic bags (like those that are used to protect dry cleaning) can cause strangulation and suffocation. And, as in the living room, den, or family room, all unstable furniture or floor lamps should be removed, and all dangling cords should be taped down, unplugged, or moved up out of your baby's reach. Although it doesn't take much to make a bedroom safe, you do need to give this room a little time and attention before you allow your baby to enter it unsupervised. Can the bathroom be made safe for unsupervised visits? It is extremely difficult, and probably impossible, to make a typical bathroom safe for a baby at this stage of development. Even if you could manage to secure all the medicines, soaps, shampoos, nail clippers, hair dryers, scissors, tweezers, etc., the basic materials and equipment that constitute the bathroom would still represent an unacceptable level of danger. There simply are too many slippery surfaces, hard tiles, hot water faucets, water receptacles, etc. After all, more adults get injured from accidents taking place in the bathroom than any other area of the house every year, so it is unreasonable to expect that your baby will be able to manage it armed with his recently acquired physical skills. Unfortunately, babies do find bathrooms irresistibly fascinating, so making it completely inaccessible to curious little ones is a must. A highly placed hook latch probably will be more convenient but every bit as effective as a lock-and-key. To indulge his curiosity, however, don't forget to take him in the bathroom yourself on occasion and show him some of its more fascinating aspects under your close supervision. My baby spends a lot of time in the living room and den. What can I do to make those areas safe? Living rooms and dens often contain a lot of furniture that can be hazardous to an eagerly exploring yet still relatively unstable baby. Sofas, coffee tables, desks, end tables, and the like usually have hard edges with sharp corners that can do damage to a newly crawling and climbing baby, so you might consider placing soft bumpers and round edge protectors on these trouble spots. Be sure to remove all unstable furniture (furniture that can be easily pulled or pushed over) to an area that is inaccessible to your baby. Also, watch out for rocking chairs and recliners. The little fingers of a crawling baby can get crushed underneath a rocking chair or caught in the folding mechanism of a recliner. In addition, table lamps and floor lamps can come tumbling down with a crash if your baby gets hold of the electrical cord, so see to it that the cords are either placed out of reach or taped down securely; if a floor lamp can be easily tipped over, remove it. Finally, particularly as your baby approaches the end of this period, keep in mind his growing ability to climb and his increasing tendency to reach very high places by climbing in increments, and be sure to rearrange your furniture accordingly. For example, make sure that he will not be able to climb onto the sofa seat, then onto the arm, then onto the back, then onto a bookcase, then up the shelves. Besides the furniture, what kinds of things in the living room or den represent trouble for my baby? In all rooms, you have to be careful about electrical outlets--which babies find irresistibly fascinating--and make sure they are scaled off with safety caps. Also, check all electrical cords to make sure that the insulation has not become frayed and that the wires are not exposed. The best way to spot hazards is to actually crawl around on your hands and knees in every room to get the baby's perspective of things. If you have any delicate and expensive video or audio equipment, make sure it is placed well out of reach of your curious but still clumsy baby. Go through all the knickknacks--such as cigarette lighters, remote control devices, paperweights--that are lying around on low shelves, and remove all those that are inappropriate for your baby's hands. Replace them with some suitable objects for his investigation. Keep in mind, too, that the floor or any other smooth and slippery surface will be hard enough for him to negotiate, but if there are small throw rugs on it, it becomes extremely hazardous. Should I close off all stairways with gates? Climbing stairs will be one of your baby's favorite activities toward the end of this period, and it would be a shame to deprive him of all opportunities to attempt and practice stair climbing on his own. However, particularly since it will be a couple of months after he learns to climb up stairs that he will learn to climb down stairs, this activity obviously can be hazardous when unsupervised. Therefore, placing a gate at the top of all stairways definitely is recommended. As for the bottom, it is suggested that you place the gate at the third step up--especially if the stairs are carpeted. That way, your baby will have a chance to attempt and practice going up and down to his heart's content. Even if he takes a tumble from the third step, he is not likely to get more than a minor bump or bruise. Of course, even a minor bump or bruise is more than some parents are willing to risk, so this is a judgment call. Most mothers and fathers, however, find they are willing to trade a little bit of anxiety for the tremendous amount of pleasure this practice gives their baby. I have a lot of plants around the house. Do they present a danger to my baby? They certainly do. Many common household plants are poisonous, and you have to keep in mind that your baby is likely to put anything and everything he finds into his mouth. Get a reference list from your local poison control center, and make sure you get rid of all plants that are potentially lethal. As for those that are reasonably harmless if ingested, you still have to be careful about where they are placed. Dangling vines are particularly troublesome, as curious babies will routinely grab them and pull them down. And any flower pot, planter, or similar container fragments, etc. will eventually get into his hands and mouth. Make sure to keep up with your plant maintenance as well. A well-placed plant still can pose a choking hazard if its leaves are routinely falling off and fluttering to the floor. I have a fireplace. Should I simply not use it until my baby is older? A fireplace clearly represents some serious dangers for your baby, but it also has the potential to provide him (and you) with hours of entertainment and enjoyment. Therefore, as long as you keep a close eye on your baby at all times when it is in use, there is no reason why the fireplace has to be retired completely. There are a few things to keep in mind, however. Whenever a fire is going, a screen should be secured or locked in place to keep sparks from flying out; a mesh screen is preferable to a glass screen in that it won't get as hot nor is it as likely to be touched accidentally by your baby. (If you have a wood-burning stove, it should not be used or it should be fenced in.) Also, take care with the pokers and other instruments--they typically are rather heavy and have some sharp points, so they should be kept well out of reach of your baby. Matches, lighters, and starter fluid likewise should be placed in inaccessible areas. And don't forget about the firewood. A neat pile of round logs next to the fireplace may look attractive, but they are an irresistible challenge to a newly crawling baby who will be in a lot of trouble when they come tumbling down. Do I really have to worry about my baby crawling out an open window? You certainly do, and you should make sure that all windows your baby might be able to get to are either locked or barred. It is not the case that babies are totally without self-protective senses, but those senses often are imperfect. For instance, researchers have conducted "visual cliff" experiments where babies at this age were allowed to crawl across a glass surface that extended out over the edge of a counter. When the babies reached the edge and looked down over the apparent "cliff," they usually seemed to sense danger and turned themselves around to go back. However, as they performed the turn-around maneuver, most of the babies managed to place their center of gravity over the edge, so if the glass hadn't been there, they would have fallen. Consequently, there is a good chance your baby may try to avoid falling out an open window, but the odds do not necessarily favor him succeeding. Is it safe to let my baby play unsupervised in the yard at this stage? That probably is not a good idea at this point. Given that everything he gets his hands on will likely end up in his mouth, there are simply too many things hidden in a typical yard that may present a problem. For example, a piece of broken glass that is easily noticed on the kitchen floor may be impossible to detect in the dirt. A small marble that is obvious on the carpet can get lost in the grass. Furthermore, insects, animal feces, and a variety of other items will be irresistible to your curious baby. Consequently, when you do take your baby outdoors, it is recommended that you spread out a large blanket for him to play upon with minimal supervision. When you cannot supervise his activities at all, place him in a playpen for the few minutes that you'll be away. And, of course, give him as many opportunities as possible to explore and investigate this special environment with your assistance as well. My baby really likes it when I take him in the pool with me. Is that okay? Taking your baby in the pool with you may not be a bad idea, but you must take proper precautions. First and foremost, you must realize that a baby cannot swim, nor can he really learn how to swim at this age. The American Academy of Pediatrics does not recommend group or organized swimming classes for children less than three years of age. One reason is that such instruction can give parents the feeling that their child is safe in the water--and this is not the case. No young child should ever be considered "water safe." Another major danger that is not well known nor always obvious is that when water enters a baby's mouth, he will swallow it. Because of his low body weight, it does not take much swallowing to create a chemical imbalance in his system, resulting in a condition called water intoxication. Water intoxication can lead to seizures and even death. The symptoms usually do not appear until an hour or more after the water is ingested, so it is difficult to detect when a baby is getting into trouble in this regard. Therefore, if you do take your baby into the pool with you, you must hold him and watch him carefully at all times, and you should not allow his head to be submerged. Both the water and air temperature should be warm enough so the baby does not experience a decrease in body temperature. At this age, the water should be warmer than 85 degrees Fahrenheit, and exposure should be brief. Are there any new dangers associated with taking my baby for a trip in the car? Your baby's increased physical skills are likely to cause many new problems during rides in the car. Using a car seat is still mandatory, but if he gets overly bored or overly excited, keeping him in the car seat may be difficult. Also, as he plays with various items, there now is the danger that those items can become dangerous projectiles if he starts throwing them around. In other words, you can no longer expect that your baby will simply fall asleep or in any way remain mostly stationary for long periods of time when he is in the car. Therefore, you must make sure that he is secured into his car seat as firmly as possible, and you should take care to provide him with suitable objects and activities that will keep him entertained and out of your hair as much as possible. And, if he does start to get out of control, you must resist the temptation to try and deal with him while you are still driving. As inconvenient as it may be, you should pull over to the side of the road and turn off the engine as soon as trouble starts, and don't try to get going again until you've got things back, under control. Can my baby get seriously hurt just playing will his three-year-old brother? He certainly can, and you have to be very careful about the possibility at this point. After an initial unpleasant reaction to the new arrival, the older sibling very often goes through a period of acceptance, or at least tolerance of the little one. However, once the baby becomes mobile and demands a lot more immediate attention from the parents, the old feelings of jealousy and hostility usually return even more powerfully. To make matters worse, the baby may unwittingly intrude upon or interfere with his older sibling's activities on occasion or innocently take something that belongs to him; such actions can provoke some pretty intense reactions. Of course, some closely spaced older siblings don't express any physical aggression toward younger siblings. Some seem to adjust quite well and are even very protective of the baby; some show temporary signs of regression, such as wanting a bottle; and still others take out their frustrations on their toys. For safety's sake however, it's important to be aware of the possibility and to keep an eye on them when they're together. Your baby is becoming increasingly capable of "taking care of himself" but his brother also is getting bigger and stronger every day, so your baby can be in danger if things get out of hand when the two of them are unsupervised. How can his five-year-old brother be hazardous to my baby even when the older boy isn't around? Keep in mind that the safety regulations concerning toys for older children are a lot more lenient than those for babies. Items that may be perfectly appropriate for your older child can be extremely hazardous in the hands of your baby. For example, a little toy truck may be a favorite toy of the older child, who will run it along the floor and go "rrumm, rrumm!" However, the baby is very likely to be interested in this toy in another way. There is a good chance he will pluck off the little wheels and put them into his mouth, saying "yumm, yumm!" Not only does this present a choking problem, but the sharp spoke that is now exposed may cause a lot of trouble as well. Therefore, it is a good idea to keep the toys of each child separate, and to do what you can to make the older child's room "off limits" to the baby unless you can be there to protect him from his brother's toys--and to protect his brother's toys from the baby. How can I protect my baby when visiting other people's homes? At this point, you probably won't have much choice but to place your baby in a portable playpen when visiting other people's homes. Even if they have small children themselves, you can't assume that their home has been safety proofed. And even if people who are eager to have you visit assure you that they will take appropriate precautions, you can't assume that they have done an adequate job of safety proofing. As long as your baby won't have to be restricted for several hours, keeping him in the playpen and/or under your supervision on such occasions probably won't present too many difficulties--especially if you keep a few favorite toys and some interesting new items in reserve and use them to keep him entertained at such times. Of course, if you are going to be spending a lot of time at someone's house and/ or visiting regularly, you might consider asking them if at least one or two rooms can be safety proofed under your supervision so that your baby will have an opportunity to do some exploring and investigating on his own while he is there. Finally, whenever you take the baby to someone else's home or you have someone visiting you, be sure that all purses and/or luggage are put up and out of the way. Sometimes they contain medications, cigarettes, cosmetics, and small, sharp objects that can be very hazardous to your baby should he get his hands on them; if they do, your baby will find them given the chance. My six month old had a cold and fever, and he couldn't receive his third DTP. Will a delay affect his immunity? The series should be completed soon to ensure your baby's immunity to diphtheria, tetanus, and pertussis (DTP). The delay won't change or lessen the efficiency of the series. The reason for not immunizing a baby who has a cold and fever is to protect him from a possible reaction to the vaccine, which would add to his discomfort. Common side effects of the vaccine include fever, malaise, or irritability for 24 to 48 hours after the vaccine is given and some soreness and/or swelling at the injection site; these side effects, if they occur, are generally mild. Many times, parents are advised to give their baby acetaminophen drops at the time of the injection to help minimize fever and discomfort. Some pediatricians prefer a wait-and-see attitude. If your baby had no side effects previously, he'll most likely have none this time. Remember, giving your baby the proper immunizations is a very important part of preventive pediatric care. My son will be going into day care soon, and I'm worried about his chance of catching meningitis. How can I protect him? Is he too young for the shot? The "shot" that is available is to protect your baby from the most common cause of bacterial meningitis in children, Hemophilus influenza type B (HiB). At present, the recommendation is that this vaccine be given at 15 months of age because this is the youngest age for which it has been proven effective. By the time you read this, a new vaccine may be available that can protect babies as young as two months of age. Your pediatrician is the best source of information about this vaccine, which is currently being tested. In the meantime, continue to avoid exposing your baby to ill children whenever possible (check into the policies regarding ill children at the day-care center, too), and be sure to have your son immunized at 15 months of age. When should I take my baby's temperature? An elevated temperature is only one sign of illness. If you suspect that your baby is coming down with something, you'll want to take his temperature. You may suspect that he's ill if he isn't drinking or eating well; if he is unusually cranky and irritable; if he vomits; if he acts like something is hurting him; if he's perspiring or looks or feels flushed and warm; or if he seems lethargic. Any one or more of these observations may prompt you to take his temperature. Again, the baby's temperature is only one sign of illness; if you notice other signs that concern you, even if his temperature is in the normal range, you should consult your pediatrician. At this age, the most accurate way to take your baby's temperature is rectally. For instructions on how to take a rectal temperature, see "Safety And Health" in the Birth To 6 Months section. How high should a fever get before I call the doctor? Fever is an ally, not an enemy. It is a method for the body to more efficiently fight an infection. At a temperature above 100 degrees Fahrenheit, the body more efficiently fights viruses and bacteria. In other words, the fever itself is just one sign that your baby is fighting an infection, so you want to look at other signs to try and determine the seriousness of the illness. How is the baby eating and drinking? Is he acting lethargic? Has the fever responded to acetaminophen, and does the baby seem more comfortable when the temperature is down? Your pediatrician may be much more concerned about a baby who is acting very ill but only has a temperature of 101 degrees Fahrenheit than one who is acting normally but has a temperature of 104 degrees Fahrenheit. As stated before, one of the most important factors is how your baby is acting. If you are worried, call your pediatrician. If my baby's fever is very high, should I give him a cold bath to bring his temperature down? There is never any reason to give a baby a cold bath. If you are trying to bring down a fever, a warm (normal bath temperature) bath is much more effective. If you give him a cold bath, the blood vessels in his skin may constrict to prevent heat loss, thus driving up the temperature. Indeed, even a warm bath is rarely recommended to decrease the baby's temperature unless it is over 104 degrees Fahrenheit and does not respond within one to two hours to an appropriate dose of acetaminophen. If this is the case, you should consult your pediatrician before giving the baby a bath or taking any further measures. How can I care for my baby when he has a cold? Plan to provide as much comfort to your suffering little one as possible. Keep him warm and dry, and be prepared to rock and cuddle him to help prevent extra crying, which may increase stuffiness and swelling of the mucous membranes of the nose and throat. You can increase the humidity in his sleeping area by using a cool-mist vaporizer. You can use saltwater nose drops (see instructions for making these in "Safety And Health" in the Birth To 6 Months section) to flush his nose (especially before feedings) and allow him to suck more comfortably. You can also gently insert a soft-tipped bulb syringe into his nostrils to remove mucus before feedings; this takes some skill and caution, however, because even the soft tip of the syringe can further irritate the nasal membranes. Depending upon the baby's comfort level, you can elevate the head of the crib; this may facilitate drainage of the nasal passages. Although your baby may not want solid foods while he is suffering from a cold, you do need to increase or maintain his intake of liquids. Colds in babies are rarely treated with any medication except acetaminophen and sometimes a decongestant. The symptoms may linger for two to three weeks. Colds are caused by viruses so there is no specific medication to shorten the course. Sometimes parents request an antibiotic, mostly because they feel they should do something, but an antibiotic won't cure a cold. You'll want to consult with your pediatrician about symptoms if your baby maintains a significant fever (over 100 degrees Fahrenheit measured rectally) for more than a few days, if he develops a fever after the first few days of a cold, if he refuses fluids for two or more feedings, or if he seems to be getting more ill than you think he should be with a simple cold. Babies can develop secondary infections (including ear infections, bronchitis, pneumonia, etc.) anytime during the course of a cold. If your baby develops a secondary infection caused by bacteria, then your doctor will prescribe the treatment of choice. Babies usually handle their colds well, although they will be uncomfortable for a few days. Parents, however, should never be shy about consulting with their pediatrician whenever they are worried about their baby's health. How will I know when a cold becomes serious? Most babies with colds at this age are not very ill. They may have a low-grade fever for a few days and be congested and cranky. If the baby develops a fever after the first few days of a cold or if he refuses all nourishment, including liquids, you should consult your pediatrician. More importantly, if you are really worried about your baby for any reason, discuss it with your pediatrician and, between you, decide if the baby should be seen. When should I worry about a cough? Any cough that concerns you should be reported to your pediatrician. You may be advised to have the baby examined. If you're sure the baby has just a cold, and that the cough is a "getting rid of mucus" kind of cough, it's probably okay to go a day or two and watch him. If he has a fever or other symptoms along with the cough, you may want to consult with your pediatrician. Babies can become ill quickly. If his cry ever sounds weak or if he acts lethargic or is having any difficulty breathing, you should consult your pediatrician. Sometimes babies (and young children) awaken with a cough that makes them sound like a barking seal. They sound and act like they're having trouble breathing. This condition is called croup and is usually caused by a virus that inflames the larynx and/or trachea. It's very frightening to parents as well as to the baby. To treat it, go into the bathroom, close the door (and any windows), and steam up the bathroom by turning the hot-water taps on full force. Take the baby into the bathroom and, after a few minutes, his breathing should become easier. If his breathing doesn't improve quickly or if he also has a fever, call your pediatrician to determine if the baby needs to be seen. This is especially important since a very serious type of bacterial disease can start with similar symptoms. Fortunately, the disease, called epiglottitis, is much less common now that we have a vaccine (HiB) to prevent it. Can a humidifier or vaporizer be harmful to my baby? Humidifiers in the past have been harmful to children. The old hot-steam vaporizers were notorious for causing burns when tipped over or handled by little ones. Hopefully there are none around anymore. The theory of warm vapor sounded good, since warm air should feel better than cool air. In reality, by the time the mist reaches the throat or sinuses, the body has cooled or warmed it to body temperature anyway. The cool-mist vaporizers are safer as long as they are used and cared for properly. If you need to use an extension cord (which is unadvisable after the baby is mobile), make certain it's the right size and kind, and always avoid overloading electrical outlets. The vapor mustn't drench the baby, or it defeats the purpose. The mist stream should be a few feet from the crib and not pointed directly at the baby's face. The humidifier must also be kept scrupulously clean; otherwise, it may harbor mold and bacteria and spread them into the air. Follow the manufacturer's cleaning instructions, and always put clean water in for each use. Vaporizers can be a comfortable asset to cold sufferers (adults and children alike) when used properly. They're helpful to have around. Is it okay to give my baby over-the-counter medications? At this age, babies require very little medication of any kind. Acetaminophen to treat fever and perhaps some mild cough or cold preparations are often tried by parents prior to seeking medical advice. As previously mentioned, most colds go away spontaneously without any medication, and most fevers should be reported to your pediatrician if they persist or begin after the first few days of a cold, so there is very little reason to consider the use of over-the-counter medications (other than acetaminophen drops) without talking to your pediatrician. Many medications that were formerly available by prescription only are now available over-the-counter. This does not always mean that they are safer or milder, so if you have any questions about a specific medication, call your pediatrician How do I give medications to my baby? A soft plastic dropper can be used to give the baby any necessary liquid medicine. Some droppers have lines on them that indicate the correct dosage level of medications such as acetaminophen. If you're using an unmarked dropper to give liquid medicine, premeasure the medication with a measuring spoon, and pour it into a small container. Then, fill the dropper from the container by squeezing the rubber bulb. You may have to fill the dropper more than once for each dose, depending upon the amount required or prescribed for your baby. Slowly and gently squeeze the medication into the baby's mouth between his gums and the inside of his cheek. You don't have to hurry or give it all at once. He should swallow the medicine. If he is very upset, calm him before you give him the medicine; if you introduce the medicine when he is upset, he'll be more likely to resist, choke, sputter, or spit up. If you are patient and firm, he will learn that sometimes taking unpleasant medicine is necessary. I don't use swabs to clean my baby's ears. Will wax buildup affect his hearing? Wax buildup will not impair the baby's hearing, but it may need to be removed in order for your pediatrician to view the tympanic membrane (eardrum). When this is the case, the canal can be irrigated and the wax washed away. Any wax that you see outside the canal can be gently removed using a damp washcloth. The ear canal has its own ability to push wax to the outside. Wax lubricates and protects the ear canal. Never use cotton swabs or anything else in the baby's ear. You can damage the thin laver of skin, cause infection, and push wax down against the eardrum. If you are concerned about your baby's hearing, consult your pediatrician. How can I check my baby's hearing? It is very important to diagnose a hearing loss as early as possible because of the importance of early hearing ability to normal speech development. Usually, the first people to become aware of impaired hearing in a baby are the parents. You notice how your baby responds to your voice when you know he is not looking at you. How does he respond to unexpected loud sounds? If you have any suspicions about your baby's hearing, discuss them with your pediatrician. There are very accurate methods to test hearing in children of this age, and your pediatrician can arrange for such testing to be done when it is indicated. How can I tell if my baby has or is getting an ear infection? Most babies who have ear infections are fussy and irritable, and many have rectal temperatures over 100 degrees Fahrenheit. The baby usually has had a cold or congestion for one to several days prior to developing the ear infection; ear infections are the most common complications of colds. If you suspect that your baby has an ear infection, discuss it with your pediatrician, who will probably want to see the baby if the symptoms persist. Many parents are concerned when their baby pulls on one or both ears. This is common among babies at this age, and if there is no accompanying fever, fussiness, or irritability, there is probably no ear infection. How can I keep my baby from getting ear infections? Allowing a baby to take a bottle to bed is recognized as a contributing factor in some ear infections. Formula or milk pooling in the mouth can be a good medium for the growth of viruses and bacteria (it's also known to be harmful to teeth). Because of the proximity of the openings of the eustachian tubes and the shortness of these tubes in babies, the ears can easily become infected. Therefore, you should never allow your baby to drink from his bottle while he is in his crib. Of course, you should avoid using anything to probe or clean the baby's ear canals, since some external ear infections are caused by damaging the thin skin covering of the canal. You should also try to avoid allowing water to enter the baby's ears as well; be sure to bathe him with his head well above the bathwater. If water does get in, it can be removed by gently tilting the baby's head from side to side. In addition, since most ear infections develop along with or after a cold, try to avoid exposing your baby to people who have upper respiratory infections (colds) whenever possible. Keep in mind, however, that no matter how cautious parents are, most babies, at some time or other, develop a congested or infected middle ear. My baby has some scaling behind his ears. How should this be treated? Scaliness behind the ears is often related to cradle cap or seborrheic dermatitis. If this is the case, first treat the scalp condition (see "Safety And Health" in the Birth To 6 Months section), and the dry scales behind the ears may go away spontaneously. If the scales are dry and the skin is not cracked, lubricating the area with a baby lotion may speed healing. If the skin is cracked, moist, and red, there may be a low-grade infection, which usually responds to treatment with warm, wet packs followed by application of an antibiotic ointment. If these simple treatments don't seem to improve the situation, consult your pediatrician. I know that some sun is healthy for my baby, but how much? You won't be doing your baby any favors by exposing him to hot or strong sunlight for any extended period of time. There is no good reason for a baby to have a suntan and very good reasons for you to prevent him from getting a sunburn. Besides being a painful experience, sunburn can contribute to skin cancer later on. Babies also get prickly heat rashes from being too warm; they are most comfortable when temperatures are moderate. Therefore, if you want to take your baby on an outing in the sun, avoid doing so during midday, when the sun's rays are strongest. Schedule it for before 10 a.m. or after 3 p.m. instead. In addition, it's generally recommended that you protect your baby from the sun whenever you take him outside during the day (it is possible to get a sunburn even on a partly cloudy day, especially if you are near water or sand). Before the two of you step outside, be sure he's wearing a bonnet or cap that shades his face and neck and lightweight clothing that covers his arms, legs, and torso. It's also wise to apply sunscreen to all exposed areas of your baby's skin. There are many good sunscreens on the market, some made especially for babies. Choose a sunscreen with an SPF (Sun Protection Factor) of 15 or greater. A sun protection factor of 15 means that if your baby's skin would naturally start to burn after 20 minutes in the sun, with proper use of the sunscreen, he could be in the sun 15 times longer (300 minutes or five hours) before his skin would start to burn. That, of course, does not mean you should expose your baby for five hours--remember, babies do not like hot or bright sunshine or very warm temperatures. Many sunscreens are also waterproof--for a certain period of time (after which they must be reapplied, so read the label to find out when you should reapply it). When applying a sunscreen to your baby's skin for the first time, it's preferable to cover a small test area first to make certain the sunscreen doesn't irritate his skin or cause a reaction. Most sunscreens work best if applied 30 minutes prior to sun exposure. Be sure to keep the sunscreen away from your baby's eyes and out of his reach. If your baby is under six months of age, keep him out of the sun. How do I know if my baby's rash is caused by a serious illness? Most rashes in babies are not significant and go away on their own. Most serious rashes are accompanied by other symptoms that tell you that there is something wrong. Fever, vomiting, respiratory symptoms, lethargy, irritability, and pain along with a rash may mean that something more serious is going on and should be reported to your pediatrician. If the baby is well and the rash is not bothering him, don't let it bother you. SAFETY-PROOFING PRODUCTS Today's parents have a lot of help available to them when it comes to making their home safe for their newly crawling baby. Children's specialty shops and mail-order catalogs, as well as many hardware and department stores, now carry a complete line of items and gadgets that make safety proofing considerably easier than it used to be. You can purchase a variety of products such as door and cabinet latches, furniture bumpers, caps for electrical outlets, etc.; you can even get complete "kits" that come with extensive instructions and suggestions as well. If you are willing to spend just a little more money, you also can take advantage of some recent advances in battery-operated safety devices. These include not only walkie-talkie or intercom-type monitors, but things like door guards and water-level indicators as well. Door guards sound an alarm when the door is opened by an unauthorized little one, and water-level indicators sound an alarm when the water in the bathtub reaches an unsafe height. It certainly is recommended that you avail yourself of as many of these technological wonders as possible; however, you must be careful not to allow yourself to get lulled into a false sense of security. No such gadget is foolproof, and even those operating perfectly can't take into account every conceivable type of trouble. Going high-tech in safety proofing is a good idea, but it is in no way a total substitute for continued involvement and constant vigilance on your part. At best, these products should be regarded as capable backups rather than the primary guardians of your baby's safety ACCIDENTS WILL HAPPEN This period is filled with many exciting opportunities for babies. Unfortunately, it also is filled with incredible anxieties for their parents. No matter how adept you are at safety proofing, and no matter how vigilant you are in supervising your baby's activities, accidents will inevitably happen. When they do, it is important for you not to overreact. Despite their small stature and delicate appearance, babies actually are rather hearty creatures, and they are capable of withstanding quite a bit at this point. Although they may scream and carry on a great deal when they first suffer a bump or scrape, within a few minutes, they probably will be on their way to resume whatever it was they were doing, with the unpleasant incident largely forgotten. On the other hand, no matter how slight the damage to their baby, the parents are likely to continue their suffering for quite some time. This is normal and natural, but you should make an effort to keep it from getting out of hand. If you go overboard in trying to make sure that another accident will never happen, you probably will do little more than make yourself crazy. More importantly, overprotectiveness usually results in overrestriction and/or oversupervision. The advantages that your baby will gain in physical safety as a result probably will pale in comparison to the disadvantages he'll suffer in terms of reduced opportunities to explore and investigate independently. While you must do everything in your power to see to it that major accidents are avoided, it is suggested that you try to relax and realize that a few bumps, scrapes, and bruises are a small price to pay for indulging your baby's curiosity and allowing his mind to expand to the fullest extent possible during this period.