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13 Things You Should Do When Your Baby Starts Crawling

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Baby Crawling

Photo by Douglas LeMoine, Flickr Creative Commons

I must admit I am a completely neurotic mom when it comes to safety. If my girls are sick, I am actually pretty relaxed. A sick child usually takes a while to get to the point of hospitalization, and I am very well versed on every red flag for a sick child; but injuries happen in a fraction of a second. They are preventable, but in the real world no one can predict every move of a very unpredictable baby or toddler. There are moments when you will gasp or scream as you realize that your baby is in danger, and you can’t stop it. These moments happen to all of us, and we never forget them even when the outcome was just a few tears. The safety things I have listed below are the most common causes of serious injuries, causing hospitalizations or death, in crawling infants and toddlers. If your baby is crawling or even scooting across the room then you need to read this.

1- Put up baby gates at the top AND the bottom of any stairs. About 100,000 kids under 5 visit an Emergency Room in the U.S. each year after falling down stairs. More than a third of these are babies under a year old.

2- Crawl yourself! Everyday you should get down on the floor and make sure there are no hazards within his reach. Look for hidden items under the couch that he can (and will) stick in his mouth, or electric cords that he may pull (along with the lamp attached to it), or an outlet that is unprotected. If your baby were to swallow a button battery, magnets, or a push pin, he could be dead in a few hours. Remote controls, key fobs, calculators, hearing aids, thermometers, and holiday ornaments often have button batteries in them. Be sure to always keep these out of reach.

3- Drain any ditches, ponds or fountains that she could get into, or cover them with a heavy grate. If your baby is going to have access to a bathroom while you are out of the room or even showering, you should also consider a toilet lock. Over 100 children drown in the U.S. each year in bathtubs, buckets, toilets, spas, hot tubs and other containers of water.

4- Strap down large furniture, TVs and appliances that your crawler-soon-to-be-climber can pull onto  himself. Every 3 seconds a child in the U.S. will have one of these items topple on them, and every 2 weeks one is killed. Even the most stable dresser becomes very unstable once your child figures out how to pull the drawers out and use them to climb to the top.

5- Make sure any medications, cleaning agents, or chemicals are placed in a cabinet out of your child’s reach and locked. I have cared for countless numbers of little ones who got hold of grandma’s pills and ended up on my pediatric unit or ICU to monitor or resuscitate. Little boys seem to be the most common offenders- something about that Y chromosome!

6- Remove any furniture that has sharp edges and cover any sharp corners like the hearth on a fireplace. Crawling will soon become cruising, and babies have very large heads that usually make contact with the floor before any of their limbs. A sharp corner can turn that little fall into a lot of tears, hours in the ER, stitches and a not-so-small bill from the hospital.

7- Don’t use a baby walker. These walkers can actually delay when a baby starts to walk and they are ridiculously dangerous. The AAP (American Academy of Pediatrics) has tried to have these banned for sale for over a decade now. Babies can move 3 feet in 1 second in a walker. They can fall down stairs (in a way that will almost guarantee a severe head or neck injury), flip on the edge of a carpet, and even reach hot stoves or table tops that would normally be out of reach.

8- Tie up any cords that may be in reach. Cords from things like window shades or baby monitors can entangle and strangle an infant or young child.

9- Be careful when placing your infant in a shopping cart. It is safest to wear your infant in a carrier if you are shopping. If you do put her in a cart be sure that you strap her in correctly, never step away from the cart, never let another child push or climb on the cart, and never use an infant carrier or car seat in a shopping cart. I can tell you first hand, a toppling shopping cart with your child in it is one of the most terrifying moments a parent can witness.

10- Your baby is no longer safe in his bassinet or bouncy seat once he can sit up on his own (or exceeds the weight limit). He may also be too big for his baby swing now. Most crawling infants are too big and too strong to safely remain in these momma-really-needs-a-shower gadgets.

11- Make sure he is always strapped properly in his high chair. There are almost 10,000 Emergency Room visits each year from high chair injuries.

12- Take an infant CPR class, and make sure anyone caring for your child is CPR certified too.

13- Keep the number for Poison Control on your fridge and telephone. 1-800-222-1222


You can click on the links below to access more information:

Button batteries


Shopping cart safety

Bouncer seats

Infant swings

High chairs

CPR classes

The Runt of my Litter. Why I Worry About my Smallest Child and When You Should Worry about Yours.

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CharlottesWebEvery day in the office at least one parent expresses concern over their smallest child: “His siblings were so much bigger at this age”; “Why is she sick all the time?”.

I can completely relate to their concerns. My 4 year old daughter is a runt1. Like Wilbur the pig2,3, she is sweet and brilliant, but small and often sickly. My husband and I are both tall, athletic people. Her sister has always been in the 95th percentile for her height and weight. Little E is taller than average, but she is scrawny, and she gets sick… a lot. Her sister didn’t have a cold until she was 2 years old. E had her first cold at a few weeks of life and seemed to be sick constantly for her first 3 years.

Why do I worry? Since I first entered medical school 18 years ago I have studied everything that can go right with a child’s health and everything that can go wrong. I have seen innumerable children who have suffered from accidents, cancer, infections, genetic disorders, and autoimmune diseases. When I was in training we used to say “the sweeter the child, the more horrific the diagnosis will be”. There was no truth in our statement. It was just a reaction to the heartbreak we felt; time after time we had to share devastating news about a child to the family that cherished him.

Unfortunately I have kept that superstition with me. My little E is a cup-half-full kind of girl. She dances around the house singing “Let It Go”, yells “wheeeee” the whole time she is flying down the trail on her bike, and shows more determination and grit than almost any child or adult I know. She is also prone to covering me with thousands of kisses and 10 second bear hugs on a daily basis. I have tears in my eyes when I write this because my overwhelming love and admiration for this child is matched by my overwhelming fear that something bad will happen to her. I try to reassure myself by remembering that many of my friends, and parents I see in the office, share my neurosis about their littlest child.

So when do we really need to worry?

  1. Is my child continuing to grow? Your child may be in the 3rd or 30th percentile on her growth curve. What really matters is if she is continuing to follow that percentile (normal) or if she is continuing to drop off the curve (concerning).
  2. Is my child reaching his developmental milestones appropriately (or is he doing well academically)? Check here for more information on developmental milestones.
  3. Does my child get frequent infections requiring antibiotics or hospitalizations? Frequent ear infections in the first year of life are often due to anatomy (small, flat eustachian tubes that don’t drain the middle ear space well), but frequent ear infections are unusual after the age of 2. Recurring bacterial pneumonia, frequent skin infections, or blood infections are more concerning for an immune deficiency.
  4. Does my child have bloody stools or frequent cramping and diarrhea? These can be signs of inflammatory bowel disease or celiac disease.

So how do you protect your runt? Fortunately there are a few great things you can do to keep your children healthier: good hand washing, proper nutrition, consistent sleep schedules, limiting screen/TV time, regular exercise, and vaccines. We do all of these things in our home but my baby still get sick. If your child is in daycare or preschool (or his older sibling attends school) then he may get 10-12 viral respiratory infections per year. Exposure to second-hand smoke will also significantly increase his risk of frequent infections.

Thankfully now that E is 4 years old, her illnesses are less frequent and less severe. Hopefully her physical composition will eventually match her emotional one. In the meantime I will still snuggle up next to her when she has a fever, and I will hold her all night when she has a cough. It makes us both feel better.

1. runt (definition from

– an animal that is small or stunted as compared with others of its kind.

– the smallest or weakest of a litter, especially of pigs or puppies.

2. E.B. White, Charlotte’s Web, (New York: Harper and Bros, 1952).

3. No children or animals were harmed in the writing of this post. Both Wilbur and my 4 year old can’t read yet. If little E does read this in the future I am fairly certain she will forgive her mommy for calling her a “runt”.

Baby Safety: The 2 Leading Causes of Death and How You Can Prevent Them

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Safe to Sleep® campaign, baby safety, SIDS

Image courtesy of the Safe to Sleep® campaign

Recently I was asked to speak at a childbirth education class at my local hospital. I love talking to expecting parents as it brings back my own memories of that time: the excitement, hopes, fears…My topic tonight was baby safety.  I want to share this information with you as well.

1- SIDS (Sudden Infant Death Syndrome) and accidental suffocation is the leading cause of death in infants in the U.S. from 1 month to 1 year old.  Your child’s sleep environment is the most important thing you can control to keep your baby safe.  It is important that your baby always sleeps on her back on a firm surface with no crib bumpers, pillows (or breastfeeding pillows), sleep positioners or soft bedding. The safest place for your baby is in a crib that is in your room for the first 6 months. Breastfeeding is also associated with a lower risk of SIDS. If you choose to have your baby sleep in bed with you it is really important to keep in mind the risks and what makes a sleep surface safe.

Our first child was a really fussy baby and we did end up sleeping with her occasionally during her fussiest months (1-3 months). It is not something I recommend to others, but it was a decision we made out of desperation and with all of the risks in mind. We have a firm mattress (pillowtop removed), we slept with no pillows or blankets, and we placed her in the middle of a king size bed. This would have been especially dangerous if there were any other risk factors for SIDS (secondhand smoke, obesity, alcohol or drug use, or pain medications). We never let her sleep on her stomach and we never slept on a couch or chair with her. Sanity trumped absolute safety in our house, but we did our best.

For more information on SIDS prevention and safe sleeping please go to Safe to Sleep.

2- The leading cause of death in infants 1 month to 1 year worldwide is respiratory infections, including pneumonia and influenza. Thankfully in the U.S. we have free access to vaccinations. Unfortunately our vaccination rates in many areas of the country are below 90% and we can’t protect our infants unless everyone they are surrounded by is fully vaccinated. We also have access to clean water. Good hand washing can be very effective in reducing the spread of disease. Unfortunately not everyone (especially young children) does a great job of washing their hands after coughing, sneezing, wiping their noses, or using the restroom.

So what can you do to keep your baby safe from infection?

  • Remind people to wash their hands or use hand sanitizer before touching your baby.
  • Ask people who are sick to visit another time. The first sign of many illnesses that can be dangerous to your baby is just a clear runny nose (whooping cough, measles, RSV…).
  • Make sure anyone who is around your baby is fully vaccinated. This should include a yearly influenza shot and whooping cough (pertussis) booster.
  • Avoid crowded places for the first few months. If you have to go somewhere crowded try to keep your baby in an infant carrier or stroller with a blanket thrown over the top. Carry hand sanitizer and avoid anyone that looks like a grandma! She will want to touch your baby 🙂

For more information go to the AAP (American Academy of Pediatrics)

So I am curious (and maybe neurotically overprotective based on my career choice): Do you ask your friends and family to stay away if they are sick? Do you ask them if they are vaccinated before they come visit your newborn? How do they react?


Guide to Baby’s First Year- Updated and Expanded!

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  • Breastfeeding section expanded to include tips for successful breastfeeding, hand expression of breast milk, and more!
  • Added glossary terms

If you purchased the book and want to receive free updated versions please go to your Amazon account > Manage Your Kindle and sign up for automatic book updates. This works for the Kindle app on an ereader or computer.

Parenting MD: Guide to Baby’s First Year

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This book, written exclusively for e-readers, is filled with straightforward and up to date information to guide you from preparing for your baby’s birth to celebrating her first birthday.

The ebook format includes links to useful resources within the book and online.

Quickly access helpful information about feeding, sleeping, development, and common ailments, as well
as a glossary of terms and conditions.

Every day, research continues to expand our knowledge about keeping our children safe, healthy, and thriving. The information and recommendations contained in this book are based on the most current evidence available. Printed books can take years to get to publication, and medical knowledge and safety recommendations often change before the book even hits the shelves. This electronic format allows the reader to have access to the information within days of the final edit. Dr.Raja will also provide periodic updates to the ebook for free. Subscribe to and follow Dr.Raja on Facebook to find out more.

10% of proceeds will be going to St. Jude Children’s Research Hospital