Safety Issues

Safety for babies, toddlers, and preschoolers

Keeping children with bleeding disorders safe is not really very different from what you do to keep other kids safe. All young children fall, cut themselves, and bump their heads. Parents can keep the number of accidents down by making the area around the child safe. If parents prepare, they can prevent many accidents. Parents of a child with a bleeding disorder should not worry so much about safety that they become over-protective. It is impossible to have a totally safe room or yard. It is also impossible to prevent all accidents and bleeds. Parents should check the child's home and yard for safety, watch the child and then recognize that bleeds will happen. 

While the child with Hemophilia is very young, parents can begin to teach them the signs of a bleed. They can help them understand that when they get hurt, a bleed may start. Parents should show them that a bleed has to be treated right away. 

Infants with Hemophilia seldom have bleeds that need factor concentrate. If parents are considering circumcision in a child with a known bleeding disorder like Hemophilia or von Willebrand disease, discussion with a hematology doctor is recommended first due to the risk of significant bleeding. Bleeds usually begin to happen when the baby starts to crawl or becomes a toddler. The most common problems are mouth bleeds, bruises on the arms, knees, and legs, and head bumps. There are few joint bleeds. In a young child, bruises are not a problem unless they hurt or keep the child from using their arm or leg. You should call your doctor right away when the child hurts their head. 

Since very young children with Hemophilia bruise easily, parents are often afraid to touch them. However, a child must be touched if they are to grow up healthy. Holding, hugging, and rocking a baby won’t hurt. Parents should play with their babies. Babies like gently swinging or playing games like peek-a-boo and pat-a-cake. Many toddlers like to be swung or lifted high in the air. Always hold the child around their chest. Swinging them by their arms can hurt their elbow and shoulder joints. 

Keeping a baby where they cannot move around (for example, in a car seat or carry-cradle for a long time) is not good for them. A baby who is left in a playpen for a large part of the day becomes bored and lonely. Babies like to explore, and it helps them learn. Babies and toddlers enjoy playing with things around the house like spoons or pots and pans. They also learn about shapes, sizes, and the way things feel from these items. 

Although active young children have to be watched all the time, parents can help the children grow by giving them chances to satisfy their curiosity. Children who are allowed to poke around safe rooms without being constantly told "no" and "be careful" gain from the experience. If a child falls down a lot, try sewing foam rubber pads into the inside of shirts at the elbows or pants at the knees. These pads will soften the blows. You can also buy knee and elbow pads for the child to wear on the outside of clothes. 

When making your home safe, it is helpful to think not only of what the child can do now. You also need to think about what they are likely to learn to do next. A common mistake parents make is misjudging how much a child can do. Making a house safe for a small child with a bleeding disorder is the same as for any small child. The first thing for the parent to do is get down on the floor and see the house the way the child sees it. Look for unsafe things that are within their reach.

Things parents can do

Basic childcare books give advice on making a home safe for a small child. These are some of the common tips:

To prevent bumps and cuts, a parent can do these things:

• Always strap the baby in and stay with him or her when the baby is in the infant seat, walker, or high chair.
• Stay close beside a baby on a changing table, bed, or sofa. All babies can wriggle off.
• Place baby carriers on the floor since they can fall or be knocked off high places.
• Put child security gates at the top and bottom of stairs.
• Use nonskid strips on the bottom of the bathtub. You can buy foam covers to go over the bathtub faucet to pad it.
• Remove furniture that tips over easily.
• Do not let older children jump off of high things like furniture.
• Move coffee tables away from where a child plays or pad the corners. Coffee tables hurt a lot of kids each year. You can buy plastic corners to stick on the table at a baby supply store. This also works for bricks around a fireplace.
• Keep knives and scissors where children cannot get to them.
• Teach children not to run when they are carrying something sharp or have something in their mouths.

To prevent choking, a parent can do these things:

• Stay with a child when they are playing with a balloon. Many children choke when they put burst balloons in their mouths.
• Keep tiny things like pins, buttons, or beads away from a baby. These things are easy to swallow.
• Do not give a baby peanuts, popcorn, or small pieces of candy. Grapes and cut-up hot dogs are foods that often make children choke.
• Give a child peanut butter only if it is on another food like bread or crackers. Peanut butter eaten by itself can get stuck in a child's throat.
• Take the pull cords for curtains, drapes, and blinds and tie them up where kids cannot reach them.  Move the baby's crib away from cords.
• Do not put a pacifier on a string around the baby's neck.
• Take mobiles off the crib when a baby gets big enough to reach them.

To prevent burns, a parent can do these things:

• Always check the temperature of the baby's bath water. Stick your elbow in the water or, even better, use a water sensor made to check babies' baths. You can find these at baby supply stores.
• Never leave the baby alone in the bathtub.
• Put plastic covers over electrical outlets. Keep electrical cords out of sight. Turn pot handles on the stove so they are pointing to the wall.
• Keep matches and lighters where children cannot get to them.

To prevent a child from being poisoned, a parent can do these things:

• Check the house for things that are poisonous. Cleaning supplies, drugs, bug spray, and things like these should be locked up.
• Buy medicines and other things that can poison in containers that children cannot open.
• Do not call medicine "candy" in order to get a child to take it.  A young child may try to get more of it on his or her own later.
• Keep the Poison Control Center's number, 1-800-222-1222, posted by the phone.
• Do not give honey to a baby under one year old. Germs in the honey that are harmless to older kids and adults can make a baby very sick.
• Look around your house and yard for poisonous plants. The Home & Garden Education Center of the University of Connecticut has a list of safe and poisonous houseplants on its website.

To prevent drowning, a parent can do these things:

• Keep a close watch on a child who is swimming.
• Stay with a baby all the time he or she is in the bathtub. Do not leave the baby alone.
• Put high fences with locked gates around swimming pools. Buy a floating alarm that sounds when someone gets in the water.
• Beware of tall plastic buckets. Toddlers can fall over into these and not be able to right themselves. Children can drown in buckets that are used for mopping.

Outdoor safety for small children

Outdoor areas where children play need to be checked for safety hazards too. Examples of these hazards are sharp objects or deep buckets with water in them. Parents can encourage children to wear shoes outside to protect their feet. Small children need to be watched all the time they are outside. It is a mistake to think that a child under four will stay out of the street.

Car safety for small children

Most states, require that children under four be strapped into an approved car safety seat. Plastic baby carriers are not made to be used as car seats. The car seat must be fastened in correctly and should be in the back seat. Car seats save lives when there is an accident. They prevent a child from being extremely hurt. They also keep small children from moving around and distracting the driver. The National Highway Traffic Safety Administration has information about selecting and using child safety seats on its website. The website can also help you find a free inspection station near your home that will check to be sure your child safety seat is installed correctly. 

Older children and adults should always wear their safety belts in the car. Children should sit in the back seat away from airbags. 

Toy safety for small children

Children with bleeding disorders can play safely with most of the same toys that other kids enjoy. The first thing for parents to check is whether the toys are right for the child's age and development. A toy one child plays with safely may be a hazard for another child the same age. Children do not always play with a toy like the instructions say. 

It is a good idea to check even new toys for damage. Broken or sharp edges are unsafe for a small child. Small parts that can be removed and swallowed are not good either. Some plastics break more easily than others. Stay away from toys made of brittle plastic. The plastic can be sharp and pointed when it breaks. 

Riding toys need to be checked to see if they will tip over. A "Big Wheel" is safer than a regular tricycle. It is built low to the ground and is less likely to fall over. Attach a tall bicycle flag to the back of the Big Wheel so that it is easier to see it from a car. 

Safety for school age children 

The school age child with Hemophilia needs and wants to talk and play with children their own age. They want to be able to have fun on the playground like everyone else. If a child shows common sense and some caution, parents should let them. The child needs to know how to tell when they are bleeding. They need to agree to come and get factor right away. 

Parents can help prevent injuries by teaching the child about safety. School age children should know rules about walking on the sidewalk and crossing the street. They should also know about bicycle safety. When a child is learning to use a tool or a kitchen device, parents need to watch the child the first few times. They can let the child use it on their own once the child shows that they know the right way. 

It is not enough just to teach children safety rules. They also need adults to set an example. Adults who do not wear seat belts can hardly expect their children to do so. A school age child is old enough to learn the reasons behind rules. For instance, it helps to tell a child why abandoned cars or buildings are dangerous or why they cannot shoot a gun. 

Safety for teenagers

A major concern for teenagers with bleeding disorders is safety while playing sports. To prevent bleeds, they should physically train for the sport. They need to know how to play the sport correctly. And they need to use safety gear like bicycle helmets and basketball knee pads. 

Some teens must be warned about doing risky tricks. A teen does not have to slide into base to play baseball or jump on a horse to ride it. Teens often choose hobbies or crafts in which they use tools that can be dangerous. By learning the correct use of the tools or equipment, a teen can lower the risk of getting hurt. 

Learning to drive a car safely is important for teens. Safe driving habits and the use of seat belts can save their lives.