All about Keeping Infants Safe

General statistics

In 2020, there were 2,226 deaths of children below the age of one in the UK. Whilst many of these can be attributed to chromosomal abnormalities and developmental diseases, there are many measures you can take to protect your young one from any accidental injury or mortality.

What challenges do new parents face?

Whether it’s your first child or your fifth, being a parent to an infant is challenging. It can be easy to become worried or anxious that you have not done enough to protect or look after your child.

These are common fears and are completely normal. Nevertheless, there are a number of steps that parents and carers can take to make sure that they are keeping their child directly out of harm’s way, protecting them from common accidents that, in some cases, can unfortunately lead to infant mortality.

How to help your infant sleep safely

It can be hard not to worry about your sleeping baby, especially due to a fear of Sudden Infant Death Syndrome (SIDS). SIDS is the unexplained death of an infant (aged under one), typically whilst they are asleep. A more common term for this in the UK is ‘cot death’. The majority of fatalities occur in the baby’s first six months.

Whilst it is not precisely known why infants can suddenly stop breathing during their sleep, it is thought that they stop breathing due to poor oxygen circulation. This may be due to the position they sleep in, the breathable nature of the materials in their crib, and their fragile body’s inability to understand when their oxygen levels are too low.

It is thought that their body temperature plays a role as well, with warm temperatures and multiple layers being cited as factors in SIDS. SIDS is not the same as suffocation, as suffocation is due to the obstruction of the airway. SIDS is also linked to low birth weight and young parents. Low birth weight can be caused by certain conditions, but also by drinking alcohol and smoking throughout pregnancy.

This can be worrying for any parent, and though no statistical figure can be reassuring, awareness of the condition has grown dramatically since the risk was made widely known in the 1990s. According to the Lullaby Trust, in 2020, the recorded figure of unexplained infant deaths in the UK was 0.25 in every 1,000 live births. More than half of these (63%) were boys.

There are a number of things that can be done to reduce the risk of SIDS and suffocation:

• It is advised to share a room with your baby for at least the first six months of their life, and ideally for a year. This is so that you can check on your baby and hear if they are in any discomfort.
• Always place a baby on their back to sleep, which greatly reduces SIDS. If your baby rolls onto their side or front, which would not usually occur until around four months, roll them gently onto their back again.
• Ideally, stop smoking and drinking alcohol whilst you are trying to conceive, but definitely as soon as you know you are pregnant. Drinking alcohol whilst you are pregnant can lead to a set of conditions called Foetal Alcohol Syndrome. This involves second-hand smoke inhalation too.
• Ensure that the baby has their own space to sleep. They should not co-sleep in their parents’ bed, as they could be crushed or suffocated. This also involves falling asleep on the sofa with the baby. If the baby falls asleep, they should be put in their crib.
• Ensure that they are not too hot or cold. Buying a thermometer to measure the temperature of the room is a very useful tool to know how many layers your baby needs. The general rule is that your newborn needs one more layer than you are wearing.
• Avoid loose materials and toys in the cot. Make sure cot sheets are fitted and that any cot bumpers are tied to the cot. Babies do not need to sleep with a pillow or duvet until they are above the age of one. Until then, they can sleep in sleepsuits or a sleep sack, and young infants can be swaddled.

How can I safely feed my infant?

Feeding your child, whether you have chosen to breastfeed or bottle feed, is a time of extreme bonding with them. Nevertheless, there can be incidents that can become dangerous when you do not know what to do.

There are a number of precautions that can be taken to prevent any accident whilst feeding:

• It is very important to ensure that your baby’s bottles are sterilised before each use, up until they are one year old. Sterilising bottles kills harmful bacteria that can form in ageing milk, which can cause your baby to become ill.
• Formula milk that has been kept at room temperature but not finished after two hours should be discarded. A new, sterilised bottle should be used for the next feed.
• Use freshly boiled water to make formula milk. This is because the formula is not sterile and may contain bacteria, as may the water. You should boil the kettle 30 minutes before feeding time, and make the feed 30 minutes later. Then, allow the feed to cool down by running the bottle under cold water or leaving it in a bowl of cold water. Pour a drop of milk on your wrist to gauge when it feels warm, not hot. If you are on the go, fill up a flask with boiled water.
• Always try to burp your infant when they have taken two to three ounces of milk, and always after they have finished the bottle. Burping is important as babies ingest a lot of air when they feed, which can easily cause trapped gas. This is very uncomfortable. Furthermore, if a baby has not burped and they are put to lie down, they may experience reflux, or ‘spit up’, whilst they are lying down. This can lead to choking.

When you begin to give your infant solid food, around 5-6 months old, the risk of choking may become more prevalent. They may be beginning to try and hold their bottles themselves, and have become very exploratory, putting anything they grab into their mouths.

Here are some tips for safe feeding:

• Never fully allow an infant to bottle feed themselves.
• Keep small objects away from the infant.
• Cut all food into small chunks, and make sure it is soft and chewable. Never give a baby a whole grape or cherry tomato.
• Do not leave an infant to eat alone.

In the event that your child is choking, you should:

• See if you can see what they are choking on and try to remove it, being careful not to force it further down.
• If the child cannot cough it up, or looks distressed, perform back blows. Back blows should be delivered with the infant facing downwards on your lap, with back blows in the middle of the back, in between the shoulder blades.
• If this fails, you should perform a chest thrust (chest compression), by placing two fingers on the centre of the breastbone.
• Call 999 if you cannot fully dislodge the obstruction, or if you think your infant may have been hurt during the thrusting.

How can I safely bathe my infant?

After a baby is born, one of the first milestones with your newborn is often their first bath. This is usually advised to happen after their umbilical cord has fallen off and has healed, or if they have been circumcised, when that has healed.

Up until then, it is advised that babies are ‘top and tailed’, meaning that only their face, neck, hands, arms and bottom areas are washed. It can be nerve-wracking to think of how slippery your grip may become on your baby in water, but in their first few weeks, there will be time to adjust and learn, as they will not be submerged in water.

Here are some tips to safely bathe your infant:

• Use a baby bath until they are able to sit unaided and safely.
• Ensure that the water is warm but never hot. It should be a comfortable 38°C, and even 36°C for a newborn.
• Never leave a baby unattended – keep your eyes on them at all times.
• Ensure that you have laid everything out that you will need, as you cannot leave a baby alone in water at all.
• For the first month, they do not need any cleansing gels, as their skin is sensitive. Warm water is effective and the best choice.
• When washing their hair, try to pour the water backwards, away from their face.

Vaccines

For a child under one year old, they receive vaccines on three occasions. These vaccines are recommended by the NHS to protect them from dangerous, yet preventable infections. You should aim to have the vaccines administered at the time they are directed.

• At eight weeks old, your baby will have the first dose of the 6-in-1 vaccine, which is a combined vaccine against diphtheria, hepatitis B, Hib, polio, tetanus and whooping cough. This will be given in the baby’s thigh. They will also receive the rotavirus vaccine and the vaccine against the meningococcal group B bacteria.
• Four weeks later, at 12 weeks old, your baby will have their second dose of the 6-in-1 vaccine, a vaccine against pneumococcal, and the second dose of the rotavirus vaccine.
• Again, four weeks later, at 16 weeks old, your baby will have their last set of vaccines before they are one year old. These are the third dose of the 6-in-1 vaccine and the second dose of the vaccine against the meningococcal group B bacteria.

Children will continue to receive vaccines until they are 14 years old.

How can I prevent my infant from falling?

Around 45 children under five visit A&E each day due to a fall. Babies are especially vulnerable to falling as they are not aware of danger. As soon as they begin to gain strength, and start to kick and roll, they can easily fall.

There are a number of things you can do to ensure that your baby does not become injured from falling.

• Never leave your baby unattended on any surface where there is a fall. This includes beds, changing tables, worktops and sofas.
• Make sure that any hazards are cleared from stairs or walkways when you carry your baby, to avoid tripping whilst holding the baby.
• Make sure that your baby is securely strapped into their bouncers, pushchairs, car seats and high chairs.
• Put car seats and bouncers on the floor rather than on surfaces.
• Change your baby on the floor rather than on a high surface.
• Install gates or use playpens to keep your baby contained in certain areas when they begin crawling.
• Do not let your baby crawl up and down stairs.
• Make sure your cot railings are high enough that they cannot climb out.

If your baby does fall from a small height, remain calm and check for any visible injury. Use your judgement to take them to the hospital. If your baby is awake and acting as they usually do, they may be able to remain at home. However, if your baby has fallen from a bed or from a height of more than 3ft, or is sleepy, refusing food, and crying more than usual, take them to hospital immediately.

How can I safely play with my baby?

Sometimes, we can forget just how fragile an infant is. In these cases, we can play with them a little too forcefully, which could have a big impact on their development. Their heads are still disproportionate to their bodies, and their neck muscles are not yet strong enough to support them.

Shaken Baby Syndrome is usually brought on intentionally, as a form of abuse, but it can happen accidentally. This is when a baby is vigorously shaken, causing the baby’s head, which is not well supported by weak neck muscles, to move around aggressively. This can cause brain injury, haemorrhages and death. It is highly unlikely that the syndrome will occur from gently bouncing babies, but throwing newborn babies into the air, putting them on swings or bouncing them too violently is not appropriate.

How can I safely keep pets around my infant?

Bringing your newborn home is a special moment, and maybe even more so if you have a furry friend to introduce them to. Most pets are very comfortable around infants, but there are still hazards. It can be easy to believe that your pet would not act in a hostile way towards a baby, but animals are unpredictable.

Dogs in particular can become jealous of your baby, as it has been used to taking the majority of your attention. They may be curious about the baby, and will often try to come close to inspect this new addition to the family. Give your pet time to adjust, never leaving them alone with the baby. Set boundaries and offer treats as rewards. Never allow your pet to sleep in the same bed as your baby.

As your baby becomes more playful, particularly when they begin to crawl or walk, your pet may take some time to understand how they should play. They may be rough, and might nip, bite or scratch. Most bites are minor and are common in children who live with pets. Still, you should be monitoring how your baby and your pets play. Many pets, especially dogs, become aware of how to play with infants, and even become protective and very caring towards them.

Newborns are particularly vulnerable to germs, so it may be best to keep your pets and your baby separate for the first few months of their life. Your baby may also develop a pet allergy.

Who can offer more support?

Parenting is hard, but you don’t have to do it alone.

There are a number of organisations that offer support to parents:

• The National Charity for Pregnancy, Birth and Early Parenthood (NCT) is dedicated to supporting parents through the first 1,000 days of parenthood. They can connect you to support groups and fellow parents, and offer advice and programmes for looking after the baby, or yourself.
• Peanut is an app that connects women who are at a similar stage of pregnancy. Here, you can make friends who are parents, and share any concerns or questions that you have.
• Best Beginnings supports pregnant families and new parents to look after their mental health whilst supporting your journey from pregnancy to your child’s first birthday.