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Taking Care of Your Grandchildren

When you take care of your grandkids — whether it's for a few hours or a few days — you're probably excited to put all your great parenting experience to good use.

But you may want to brush up on a few childcare basics. These tips can make the experience enjoyable — and safe — for all of you!

Have Emergency Information Ready 

Be prepared in case you need to take your grandchild to the doctor or hospital. It's important to know a child's medical history, including any allergies and any medicines your grandchild takes. Also have information about the child's insurance coverage and written permission from the parents authorizing you to get medical care for your grandchild.

Numbers to know:

  • Poison Control: 1-800-222-1222. If you have a poisoning emergency, this toll-free number will put you in touch with the poison control center in your area.
  • Police/ambulance: If your grandchild has collapsed or is not breathing, call 911.
  • Phone number for your grandchild's doctor.
  • Parents' work and cellphone numbers.

Medicines

Know what medicines you can give your grandchild in case of illness. If you have questions, call your grandchild's doctor before giving any over-the-counter medicines.

Also, don't give aspirin to kids or teens, as it has been linked to Reye syndrome, a serious illness that often requires treatment in a hospital.

Never give a child medicines that have been prescribed for someone else. Even if two people have the same illness, they may require different drugs with different doses and directions.

Sleep

Always place infants younger than 1 year old on their backs to sleep to reduce their risk of sudden infant death syndrome (SIDS). Never put babies on their stomachs or their sides to sleep. Babies should sleep in a crib or bassinet on a firm mattress with a fitted sheet but no soft bedding, plush toys, or other soft objects, which can be suffocation hazards.

Other ways to lower the risk of SIDS include:

  • Keep the room temperature comfortable and avoid over-dressing your grandchild.
  • Give babies a pacifier at naptime and bedtime, but do not force it if a baby resists. If the pacifier falls out during sleep, you don't need to replace it.
  • Keep babies away from cigarette smoke.

Babies who room-share (sleep in the same room, but not the same bed) with parents have a lower risk of SIDS. Consider having a crib or bassinet in the room where you sleep.

Keeping Your Grandkids Safe in the Car

Babies and children should be in child safety seats that meet current standards. All kids younger than 12 years should ride in the back seat with the appropriate safety restraint.

Infants and toddlers should ride in a rear-facing seat until they are 2 years old or until they have reached the maximum weight and height limits recommended by the manufacturer.

All kids 2 years or older, or those younger than 2 years who have outgrown the rear-facing height or weight limit for their car seat, should use a forward-facing car seat with a full harness for as long as possible.

Booster seats are vehicle safety seats for kids who have outgrown forward-facing or convertible car seats but are still too small to be properly restrained by a vehicle's seatbelts.

Many states have laws requiring booster seats for kids up to 8 years old and 80 pounds, or 4 feet 9 inches tall. Kids should use a booster seat until the car's lap-and-shoulder belt fits properly, which is typically when they've reached 4 feet 9 inches in height and are between 8 and 12 years old.

Even if your state does not require booster seats for older children, put safety first when traveling with your grandkids. Follow the manufacturer's recommendations and instructions, and do not exceed weight limits.

Helmets

Helmets save lives and prevent serious head injuries. Many areas have laws that require kids to wear helmets every time they ride their bikes. So make sure that your grandkids always wear one when riding a tricycle or bicycle. Make sure that the helmet fits well. Be a positive role model (and protect your own head) by wearing your helmet too.

Helmets also should be used for skating sports, such as skateboarding, rollerskating, and inline skating. The AAP recommends that kids also wear wrist, elbow, and knee padding for those sports.

Cribs

Use a firm crib mattress. To avoid suffocation hazards, keep soft objects and loose bedding out of the crib, including pillows, quilts, comforters, sheepskins, stuffed toys, etc.

Cribs made after 1974 meet current safety standards, including slats that are no more than 2-3/8 inches apart so that infants can't get their heads stuck. A crib that has been in the family for generations may not be suitable or safe — cribs made before 1974 might be covered in lead paint, have slats that are too far apart, or pose other safety hazards.

Before using a crib, check the side rails for locking devices. Remove mobiles when an infant is 5 months old or can get on his or her hands and knees.

Walkers

Walkers aren't safe and don't let infants walk any sooner than they would without one. They pose a high risk of injury, particularly from falls down stairs that may result in serious head injuries.

Toys

Guidelines from the U.S. Consumer Products Safety Commission (CPSC) can help you see which toys are age-appropriate for your grandkids. You may think that because a grandchild seems mature, they can handle a toy that was meant for an older child. But that's not a good idea, as age guidelines for toys consider developmental appropriateness as well as safety.

When you shop, look for sturdy, well-made toys that don't pose choking hazards.

Childproofing the House

Supervision is always the best way to keep grandkids safe. But it's also wise to childproof your home.

Walk through your house with an eye for anything that may be unsafe for kids, including tools, knives, and choking hazards. For babies and toddlers, put outlet covers on all of the outlet plates. And don't forget safety latches and locks for cabinets and drawers in the kitchen and bathroom. Look for products that adults can easily install and use, but which are sturdy enough to withstand pulls and tugs from children.

Store medicines, household cleaners, and other dangerous substances safely and out of reach. Consider doorknob covers and door locks to help keep kids away from places with hazards, like bathrooms and swimming pools.

Child safety products are typically sold at drugstores, big-box stores, and hardware stores.

Strangulation Hazards

Babies and toddlers can strangle or become entrapped in the most unexpected ways — curtain cords, strings on clothing, and infant furniture and accessories can be dangerous.

Reduce the risk of strangulation by not putting necklaces or headbands on your grandkids and not dressing them in clothes with drawstrings, which can get caught on play equipment and furniture. And while it may be handy, don't tie a pacifier around your grandchild's neck or tether it to clothing.

Tie up all window blind and drapery cords so that they aren't within kids' reach. Mobiles that dangle above the crib should be removed by the time babies are 5 months old or when they can get on their hands and knees.

Install safety gates, but don't use old accordion-style ones, which can trap a child's head.

Choking Hazards

Putting things in their mouths is one of the ways that babies and youngsters explore their worlds. But certain foods, toys, and other small objects that we probably take for granted can easily lodge in their little airways.

Common choking hazards for kids under 4 years old include foods like peanuts, popcorn, raw carrots and other raw vegetables, hard fruits, whole grapes or cherries, or hard candies. Watch out for small plastic toys that come from vending machines or parts of older siblings' toys, such as (Barbie) doll shoes or small construction pieces (like Leggos).

Be watchful during adult parties, when nuts and other foods might be in reach of small hands. Clean up promptly and carefully, and check the floor for dropped foods that can cause choking. Keep small refrigerator magnets and other small items out of kids' reach.

Lead Exposure

It's important to do what you can to reduce kids' exposure to sources of lead, particularly if they're younger than 3 years old.

Lead, which is in paint, soil, and other household areas, has been linked to physical and behavioral problems. Though the government banned lead-based paint and gasoline in the 1970s, many older homes, toys, cribs, and even some furniture are covered in lead-based paint because they were painted before the ban.

If you live in an older house, chances are that lead-based paint was used at some time. To minimize exposure to lead-based paint chips, use a wet cloth to wipe windowsills and walls, and watch for water damage that can make the paint peel. And limit your grandchild's exposure if you have major renovations done.

Be sure that your grandkids wash their hands before eating, after playing outside, and at bedtime. Your doctor or local health department can provide more tips.

Older Furniture

When grandkids comes over to stay with you, don't use old cribs or baby furniture that your own kids might have used many years ago. Though these items may have served your kids just fine, they may not meet current safety standards, could be covered in lead paint, and may be worn down. Equipment needs to be in good condition and up to current safety standards.

Hand Washing

Washing hands well and often — particularly after going to the bathroom and before preparing or eating food — is one of the most important ways to prevent the spread of any illness, from the flu to stomach bugs.

Teach your grandkids this important habit to help the entire family stay healthy. You might try soaps with bright colors, fun shapes, or appealing smells.

Vaccines — Yours and Your Grandkids'

Vaccines are one of the most important ways to keep kids — and everyone around them — healthy. Find out if your grandchildren are up-to-date on all theirs.

It's particularly important for grandparents to get annual flu shots and an updated COVID-19 vaccine, both of which are recommended for everyone over 6 months of age, including adults.

Be sure you've had the Tdap vaccine. It will help prevent you from spreading pertussis (whooping cough) to your grandchild. Pertussis can cause very serious illness or death in infants. And talk to your doctor about whether you can get an RSV vaccine — it can help protect you and any babies you care for from getting very sick from RSV.

Screen Time Rules

Use these age-related guidelines to keep your grandkids' screen time under control:

  • Babies and toddlers younger than 18 months: No screen time, except for video chatting.
  • Toddlers 18–24 months: If screen time is allowed, choose only high-quality programming/apps, and use them with your grandchild. 
  • Preschoolers: Limit media to 1 hour or less per day of high-quality programming. Watch with your grandchild.
  • Big kids: Place consistent limits on hours of media use per day.

Offer your grandkids a variety of free-time activities to try. Turn off devices and TVs during meals and homework, and set a good example by limiting your own screen time.

Look for age-group rating tools on some TV programs and video games (they're usually listed onscreen) to help you decide what's OK for your grandchild.

Online Safety

Your grandkids may amaze you with their ability to navigate a computer or tablet. But it's important to reduce risks that kids might be exposed to online.

Online tools can restrict access to adult material and protect kids from online predators. Many Internet service providers (ISPs) have parent-control options to block certain material. Software also can help block access to certain sites based on a "bad site" list that your ISP creates. Filtering programs can block sites from coming in and can restrict your grandchild's personal information from being sent online.

Also, it's wise to create a screen name that protects a child's real identity. And consider adding house rules for device use, such as: never give your name or address online and never click on pop-up ads or offers to buy things.

After raising your own kids, now is the time to enjoy being a grandparent!

Reviewed by: Elana Pearl Ben-Joseph, MD
Date Reviewed: Oct 1, 2023

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