Clinical Reference Systems: Pediatric Advisor 10.0
Spanish version

Most head injuries heal, but any damage to the brain is usually permanent. Many serious head injuries can be prevented by taking the following precautions:

• When you drive, place your child in a car safety seat. When your child weighs 40 pounds or more, use a booster safety seat. Don't use the regular car seat and lap belt until your child weighs over 60 pounds. All states now have child-restraint laws and with good reason: They reduce injuries by 80 percent and deaths by 90 percent.
• To prevent pedestrian accidents, teach your child to look both ways before crossing and while crossing a street or alley. Teach him to use crosswalks and not to run across the street. Most children cannot safely cross the street alone until age 7 or 8.
• Never leave an infant of any age alone on a high place like a bed, sofa, changing table, or an exam table in the doctor's office. Your baby may unexpectedly roll over for the first time or wiggle off and fall on his head.
• Always keep the side rails up on the crib. As soon as your child can pull to standing in the crib, lower the mattress.
• Don't buy a bunk bed. If you already have one, keep children under age 6 years out of the top bunk and use a side rail. Be sure the bed frame is strong enough to keep the mattress from falling through. And don't let your children jump on beds.
• Don't buy a baby walker. They do not help your baby develop walking skills. Thirty-five percent of infants using walkers have accidents requiring emergency care.
• Don't leave your child unattended in a shopping cart.
• Place a sturdy gate at the top of stairways. Keep the stairway cleared of clutter. When your child starts to climb stairs, teach him to hold onto the banister when he goes down the stairs.
• Keep doors leading to the basement or outdoors closed. Secure them with an extra latch above the child's reach.
• If you live on an upper floor of a building, install window locks or guards.
• Don't leave younger children under the supervision of an aggressive sibling.
• Always supervise your child's outside play until she can be trusted to stay in the yard (age 4 or 5). Three-year- olds can't be expected to keep promises not to go near the street.
• Don't teach your child how to ride a bicycle until your child is old enough (age 7 or 8) to understand safety issues such as emergency stops and rules about right-of- way.
• Never allow your child to ride a bike unless he is wearing a bicycle helmet. All-terrain vehicles (ATVs) and motorcycles are too unsafe to ride, even with a helmet.
• Forbid trampolines. Serious accidents have occurred even with close supervision.