Caring For Your Child’s Teeth

It’s finally time to start brushing your daughter’s teeth.  You’ve been using a damp gauzepad to wipe her teeth and gums and she now has enough teeth to justify using a small, soft-bristled brush.

And if you’re like me, the question is…now what?  How long until she can brush for herself?  When can she start doing it without my being there?  Just how long should each brushing session be?  When can we start flossing?

How long until she can brush for herself?

There’s no hard and fast answer for this question, unfortunately, and depends upon the parents’ judgment.  It can depend upon how well she can hold a brush and how thorough – and her thorough differs from your thorough – she appears to be in brushing.  You might consider doing it simultaneously and then letting her finish, or vice versa.  It will simply depend upon your comfort level.  But this leads to the next question.

How long do I have to be there while she brushes?

This is going to be for a long time.  My dentist’s hygienists asked me if I was there for my kids’ brushing, even when they were five years of age.  It’s only by being there that you can determine how she’s doing and correct anything that she might be doing wrong.  And it’s only by being there that you can develop that comfort level.

When we brush, how long should we brush?

A simple way to track how long you should brush is to hum "The Birthday Song" twice through.  Make it a standing tradition to hum the tune and then when she’s old enough to hum it, have her do it for you since you love to hear her hum it sooooo much.  It consequently becomes an ingrained habit.  Others have simply used an egg-timer set to two minutes.  Enterprising toothpaste manufacturers even now have a musical cap that plays a melody once the cap opens and the child brushes while the music plays.  Just bear in mind that with this method, your daughter should be old enough to swish and spit.  Or simply create your own song to accompany the act. 

When can we start flossing?

Flossing can also start very early, but you’ll have to do it at first.  To ease the job, your dentist can provide a small flossing device that resembles a tiny bow – as in arrow.  The floss is strung between two ends of bent plastic and it can easily be held and manipulated by small fingers.  There is no difference between when a child and an adult should floss.

There’s more than just a financial cost to a small child’s problem mouth.  Invest the time necessary and you’ll find that you hopefully won’t have to invest the time, money and emotional energy later.

Your Child’s Teeth – A Primer

While most guys are only unfamiliar with the medical development and needs of their kid, they are utterly lost about their kid’s mouth.  This is the child’s business end since the dollar cost of not caring for it properly can be huge.  Dollars aside, the child can become very insecure and embarrassed by their mouth’s condition as they age.

Baby Teeth Basics

Over the next 20 or so years, your child – who we’ll call Ramona – will first gain a full set of 20 baby (also called primary) teeth.  These will last until they are finally replaced by the adult complement of 32 teeth.  You will probably start to see the first tooth "erupt" at several months of age in the front of the mouth.  These are the incisors and they will later be flanked by the canines.  This process continues until all 20 teeth have arrived at about two years of age.  They will then remain intact until the first adult teeth start arriving at roughly six years of age.  Something which confuses most parents is the arrival of the six year molars, located immediately behind the primary molars.  These do not  replace the original primary molars, so their arrival isn’t preceded by the loss of any primary teeth.

You can expect that the first teeth lost will be the lower incisors (front teeth) at age six, followed by the upper incisors.  Molars and canine teeth are generally not lost until 10 – 12 years of age.  From the loss of the incisors, you then have several years in which to arrange financing for the coming orthodontia.

What is Teething, and How Many Buckets Will I Need?

Teething is the time when Ramona gains a new tooth and covers the period from its approach to the gum from below to its final arrival.  You’ll hear the term erupt to describe when the gum is breached; this is a misnomer penned by some sadist to induce you to hold out hope for some uninterrupted sleep.  You’ll know Ramona’s teething by:

  • increasing amounts of drool, as though this were possible;
  • a marked desire to chew and gnaw;
  • a shriek from Mom while breastfeeding.  Welcome to Extreme Nursing.

If you suspect that she has started teething, look in her mouth and you’ll find the gums inflamed.  An arriving tooth will also physically appear to be pushing through the gum as though a finger were pushing through a balloon.

You can help relieve Ramona’s pain – and it does hurt – by giving her a cold teething ring, available at any grocery or pharmacy.  You can give her a cold, damp washcloth to suck on, or even your clean finger.  Only consider using any form of pain reliever, like infant acetaminophen, after speaking with your doctor.  Oh, and remember to wipe the drool from her face or you’ll add insult to injury by allowing a rash to develop on her face.

How Do I Care for My Child’s Teeth?

Start mouthcare long before the first teeth arrive.  After feeding, whether breastmilk or formula, use a clean and damp gauzepad or cloth to wipe the gums.  This removes bacteria from the food and also gets Ramona used to the practice of doing something to keep her mouth healthy.

Because a toothbrush might cause undue distress to the baby with only a few teeth, continue to use a clean, damp washcloth to wipe the teeth.  When you do decide to move to a toothbrush, get one with soft bristles on a small head so as not to irritate the gums and create even more unnecessary problems.  Replace the brush every four months and also after any time that Ramona’s been sick.  Even after you start brushing her teeth, toothpaste shouldn’t be introduced until the third birthday when she has a clue about how to spit.  Even then, use a non-flouridated training toothpaste; she’s still going to swallow a fair amount of paste and the flouride can upset her stomach as well as potentially cause flourosis.  This condition will eventually show itself by a discoloration to the permanent teeth.  The training toothpaste is available in the baby section of any grocery or pharmacy and be sure that it’s approved by the American Dental Association.

And see?  Now you have a reason to teach your little girl to spit.

When Should My Child See the Dentist?

Today’s rule of thumb is that Ramona should see the dentist at about her first birthday, something endorsed by both the ADA and the American Academy of Pediatric Dentistry.  It might seem overprotective, but the dentist can advise on how you’re doing with mouthcare and see if the mouth and teeth provide insights into future problems.

These early visits would encompass an examination of her mouth and teeth, as well as what to expect with the sequence of eruptions.  The dentist can also advise you on childhood habits such as thumbsucking and pacifiers, as well as the use of sippy cups and bottles.  Excessive use of these cups with juice has led to a major rise in early childhood cavities, which is not something that you want.  Because not all water sources are created equal, you can also consider whether to supplement the flouride available to Ramona to forestall later teeth problems.

For additional information, visit the website of the American Academy of Pediatric Dentistry at

Many Thanks to Dr. Maria Meliton for her review and comments to this article.  You can visit Dr. Meliton’s website at


What Else Can You Do After Five Minutes?  Just Talk.

What else can you do with a very small child? If nothing else appeals, just talk. You’re doing far more good than you might expect.

According to a childhood language study from UNC’s FPG Child Development Institute, the language skills of three year-olds were examined. This study measured their verbal abilities in light of parent education, child care quality and finally, how the parents verbally interacted with them. The surprising finding was the impact of the father’s vocabulary on their language skills; two year-olds with fathers using a wider vocabulary scored significantly higher on tests given when they were three. This impact even outweighed the vocabulary of the mothers, who were found on tape to talk with them more frequently than the dads.

So what does this mean? Even at the earliest ages, talk to your child. Let her hear the rhythm of your speech and tone of your voice, and as she ages, expand the vocabulary. Describe things to her and talk to her about what she’s holding. Read to her – a lot – and even if she can’t yet speak, ask if she can point things out in the book. When she’s started speaking, ask specific and simple questions (what’s floating in the sky?) and then ask more open-ended, general questions as she progresses (what does that cloud remind you of?). Just keep talking and working with her.

But remember, the key to the kingdom is a wider vocabulary. Save the different meanings of “dude” for your buddies.

A Few Notes On Playing With the Kids

All parents live under a microscope in which our actions, attitudes and comments are subject to intense and early scrutiny.  But it’s generally more dangerous for fathers since we’re the gender that engages in the more tasteless behaviors.  I’ve been threatened with death if I teach the "pull my finger" gag and an accidentally pressed cell-phone key led to an answering machine recording of my belching contest with the kids.

These isolated examples aside, remember a few practical facts when you do play with the kids.

  • Children have no "off" button, so they don’t know when to quit.  Make the toddler laugh by chucking a wad of paper at his head and you’ll be inundated with paper wads until you’re ready to climb a wall.  Know how to end something if you’re going to start.
  • Children have no judgment, so all things for them are equal.  You toss a playful wad of paper at them and you’re likely to get smacked with Great-Grandma’s heirloom vase.  If you’re going to throw something, make sure it’s meant to be thrown.
  • Children have no sense of time and place.  All things being equal, they might think that Grandma might enjoy the fun by having that heirloom vase heaved at her head.

Perhaps the simplest way to remember these comes under the question, "will I regret this?"  If so, move on.

First Lullaby

In War of the Worlds, Tom Cruise croons a war-zone lullaby to his daughter – a horrible, tone-deaf rendition of Little Deuce Coupe.  He can’t sing and doesn’t know squat about lullabies, but he does manage to do it right.

During the first several weeks of a child’s life, the feedings happen every several hours, non-stop.  But that doesn’t mean that the baby will necessarily want to sleep after nursing.  My first night stint with our baby was terrifying; my wife was back to sleep and I carried this small package that was only grudgingly giving way to sleep.  "Ah," I thought, "hit the rocker and turn out the light, sing a lullaby and turn out the kid."  Simple.  So we settled into the chair in a darkened nursery and the only song that I could remember at 3 AM was the Washington Redskins fight song.  You know the one:

Hail to the Redskins!

Hail Victory!

Braves on the Warpath!

Fight for old DC!

No, wait.  What was that one that James Taylor did?  Oh yeah, the Redskins fight song.  Wasn’t there one about the cradle and a treetop?  How does that go?  Yeah, being circled by braves on the warpath, that’s the one.  Geez, it wasn’t even preseason yet.  Multiple efforts and that same sorry team song continued to clutter my mind.  So, I gave in and worked with it and it finally came out like Tom’s Little Deuce Coupe.  Very soft and calm, and I found that when sung in waltz time, it worked in this bizarro way.  My little girl finally gave up and I tucked her in, then stumbled out of the room.  Only then did I do the tomahawk chop.

And the next day, I made it a point to learn some real lullabies.  But I haven’t forgotten the Redskins fight song.

Dressing Your Child for the Weather

Even taking a walk or run outside with Junior requires additional thought and preparation, particularly in dressing him for the weather.  For the first several months of life, a baby’s body isn’t yet able to adequately adapt to cooler temperatures.  In fact, he feels better in temperatures that you find hot.  Consequently, he’ll be bothered when you find it comfortably refreshing.

My first child was born in Spring and it took time to grasp that she was underdressed – in a cotton sleeper – for a mid-morning Spring stroll.  What should have been a pleasant father/child session became an exercise in fret-management.  Unfortunately, I also underdressed her for the indoors as well until I adapted. 

So what are some guidelines in dressing Junior so that he’s warm enough?

  • As a rule-of-thumb, he should be wearing about one more layer of clothing that you are wearing.  In running shorts on a comfortable Spring/Fall day?  Keep him in clothing that covers his limbs and feet.  Wearing a sweatshirt or sweater in the house?  He needs likewise.  If it’s the height of Summer, shorts are fine but not during other seasons unless it’s justified.
  • If outside, dress him in layers so that you can remove or replace clothing as necessary.
  • He’ll tend to stay warmer in a chest carrier because of the proximity to your own body heat, but legs and arms still need to be covered.
  • Keep the head covered.  In colder weather, the bulk of a body’s heat loss is through the head; in warmer weather – colder, too – you want to provide protection from the sun.

He still can’t don ratty shorts and running shoes for a brisk Fall run with you, but give him time.  Until then, he’ll still like the run, but in something heavier.


I’ve Got the Baby…Now What?

So What Do I Do After the First Five Minutes?

Okay guys, you now have sole custody of the kid while your other half takes some time to run errands or kibbitz with her friends. "Damn," you think, "this will be really cool." But as she rolls out of the driveway, it dawns on you that this is going to be for hours.

What on God’s green earth am I going to do with this little kid for that long? This is my chance to show that I do have a clue so just tossing him in the crib or in front of the TV isn’t really an option here.

So what happens first? Babies and small children won’t need things done at precisely the exact moment, but they really do best if kept on a fairly predictable routine. Creating a simple thumbnail schedule is a place to start. Does Junior take naps, and is your timeframe with Junior in that nap period? If so, jot it onto the schedule and bear in mind that he’ll probably have to spend some quiet, "wind-down" time before being tucked in for a nap. Does Junior usually have a meal or snack in the time frame? If so, jot it onto the schedule and then determine what Junior’s going to eat and how long it might take to prepare. By the way, I have kids of both genders but I’m using"he" for simplicity sake.

And then what happens? Here are a few basic rules before getting on with the good stuff.


Rule #1 Remember that perhaps the most important thing that your child needs is interaction. He will have to learn to occupy himself at times, but his needs – cognitive, emotional and physical – and his ability to cope with the world are dramatically improved by regular interaction with you and Mom. Yes, love is absolutely a given here but let’s be honest, there are a lot of folks around who love their kids but don’t spend enough time with them.

This is your time, take advantage of it.

Rule #2 A little TV is okay, but only in limited doses and only certain programs. TV might be an option while you fix a snack/meal, or tend to a few quick chores; but it cannot and must not become a staple. Spending the afternoon in the woodshop while Junior watches the idiot box is not the right idea.

Rule #3 You have a little leeway if Junior isn’t crawling yet, but you are still going to have to pay attention to where he is and especially what is withing his reach. If he can reach it, it’s going in his mouth faster than a cop with a doughnut.

Rule #4 Relax. This can and should be fun; it does get hairier when you are responsible for more than one and they’re at different ages.

Okay, enough rules. Now what can I do with Junior? Try these for size.

Read to him. Even if he’s a baby, hearing the use of language will give him a leg up on his own verbal skills. When we lived in DC some years ago, the only way to get my regular dose of Michael Wilbon and Tony Kornheiser was to read aloud to the baby while she lay next to me on the floor. If he’s older, cardboard page books are great: they are written for the youngest levels and he can work on his motor skills by helping to turn pages without the worry of tearing them.

Sing to him. In Spielberg’s War of the Worlds, a divorced and out-of-touch Tom Cruise lullabies his daughter – in a war zone, no less – with a lousy rendition of Little Deuce Coupe. It isn’t the melody and God knows not the singing, but the voice, language and rhythm that are important for the kid.

Get down on the floor with him. Play Peek-a-boo and lift him over your head. Wrestle. If he can sit up, spend time rolling a ball back and forth. Give him piggyback or bear rides. Build block towers and let him knock them down, but don’t get invested in creating masterpieces that you won’t allow to be destroyed. It might get monotonous, but it matters to him and believe it or not, this is part of your job as a parent. And not all jobs are exciting.

Go outside. If the weather isn’t bad, toss him into a backpack, stroller or wagon and go for a walk.

Make simple crafts. This doesn’t have to be rocket science and God knows I’m not Martha Stewart. Use your imagination. One neighbor spent an afternoon making more than a dozen light sabers out of rolled-up newspapers, water bottles and duct tape.  Make a space helmet from construction paper and a 24 pack soda case. Sometimes the simplest and goofiest looking stuff is the most memorable.

Pull out a deck of cards. You can use them to practice counting, teach him the difference between colors and shapes, or if he’s older, teach basic math skills by playing War. Smaller kids just get a kick out of 52 Pick-up.

Build a fort. If you have boxes, pull them out and let Junior climb in and through. Or just throw a blanket over the dining room/kitchen table to create a clubhouse.

Play "clayface". Let your kid mold your face into different shapes.

Teach cause-and-effect. If your child touches you, move something else. Touching a left cheek means a lifted left eyebrow or poking a lower lip rewards him with a wink. Have fun with it.

No matter what you do here, remember that the key is interaction. This benefits him immensely, as well as you with stronger bonds.

And one other note. If you have to leave the room for any period of time – regardless of the length – make sure that he is back in his crib or playpen. This requirement will diminish as he grows, but pay attention as an accident will happen in the blink of an eye. Trust me on that one.

Father’s Lesson #1:  Your Life is no longer your own (and ceased at the moment of conception)

Wrap your head around the fact that your life is now very different from what it was before.  The idea of thinking in terms of three is easier for your mate since she’s driven by in-born nesting instincts with which you are simply not equipped.

You probably noticed a change in your mate when she found out that she was pregnant.  Some of these changes are insidious and others more apparent.  In many instances, she changes her diet either because of nutrition or her stomach just can’t handle the food.  She might change exercise and health regimens and re-examine recreational activities.  If you missed these, you’ll understand when you find that she’s painted the nursery in bilious, glossy primary colors.

The pregnancy can be a delightful, insightful, confusing and stressful time for the expectant father.  Find a good source of information – What to Expect When You’re Expecting is the bible – and pay close attention to your mate.  Armin Brott’s The Expectant Father is another good source, written from the dad’s perspective.

While she will probably want to handle the more personal issues, take a different view and help create the structure within which she can build the nest.  Do you have a will and durable power of attorney?  Does she?  These mundane, boring boilerplate issues matter because you are now thinking for a third – and utterly helpless – person.  Who will care for your child?  Will they be responsible for financial management of the estate as well?  What are the appropriate financial needs if either of you, or both, die?  Is there sufficient insurance to provide for these contingencies?

Even after your new child arrives, there will be major differences.  There are huge domestic demands for caring for a baby, both in the child’s personal care as well as meeting the requirements of running the house.  The together time – romantic or otherwise – is probably going to suffer so don’t take it personally.  And earlier decisions that were previously simple must now account for the child.  Want to eat out?  Can we afford it and can we take Junior along?  If not, where can I find a dependable babysitter and can we afford her – or him?  Going to visit a friend’s home?  With Junior crawling/toddling, do we need to take a gate?  What other hazards are there?  You get the drift.

To get past this, you just have to be prepared to step up and take greater domestic responsibility.  It eases her stress level and strengthens your bonds in this new phase, which puts you in a better relationship for when the kids are a bit more self-sufficient.  The nature of the questions and concerns will change, but the idea of thinking for three, or more, will continue.

And if this bothers you, at least be glad that you and your mate aren’t Praying Mantises.



What do you do with a crying baby?

What Do You Do With a Crying Baby? 

Probably the greatest dread of a new Dad is – dah dah duh – the crying baby.  Remember that this is equally daunting to Mom at first, but she’s expected to know what to do about it and has plenty of resources available to her.  So here are some things that you should know about crying babies and what you can do for them.

So…Why is the Baby Crying? 

Understand first that a baby will pretty much cry about everything because that is the only way that they have to communicate with you.  Whatever the reason, they can’t tap you on the leg and say “Yo Dad”, so they’ll cry instead.  Think of it as a jarring, frustrating translation game.  Not all cries are necessarily the same and if you pay attention, you’ll start to recognize what each one means to her.

Until then, what do you do?  Start by developing a checklist of possible complaints to consider. 

1.       Hunger.  She wants fed and if she’s having a growth spurt, her typical schedule will be thrown off.  If she was just fed, then move to the next item on your checklist but if it’s been awhile, then consider this one.  What is an indicator that she’s hungry?  Gently rub the clean tip of your finger against her lower lip and see how she responds; if she opens her mouth and moves to latch onto it as though it’s a nipple, then it’s probably hunger.  If she doesn’t respond to that, then it’s time to move on.

2.      Diaper Change.  She’s telling you that she’s uncomfortable and wants a change.  If she’s dry and not messy, take a moment to check her bottom and groin.  Redness there – or on the penis if a boy – would indicate a developing rash that will cause discomfort.  This frequently happen if you’ve had to use more wipes because of more frequent diaper changes.  If this is the case, you can apply cream and then do follow-up cleanings with a warm, damp washcloth instead of wipes; you can even opt to just let her air out without a diaper.  Put a dry towel on the floor and let her rest there but as always, be careful of what’s within her reach.

3.      Teething.  This typically starts at about four months of age.  Again, use clean fingers to check her mouth for and gums for redness or evidence of erupting teeth.  If this is the situation, you can give her a cold teething ring or cold, wet washcloth to chew on.  You can even let her suck on your clean (do you think there’s a trend here?) finger for awhile if you’re desperate.

4.      Too Cold or Hot.  A decent rule of thumb is that she should have one more layer on her than you are wearing.  After adding more clothing, hold and comfort her until she settles.  This was my particular specialty, if I might add.

5.      Wants Held.  Some kids just want close body contact and just holding her close to your chest where she can hear your heartbeat – a la in utero – might do the trick.  You can’t spoil a child from holding her too much, but remember that babies with minimal head and neck control need to have them supported and stabilized.

6.      General Discomfort.  If everything else appears alright, take a quick look to see if anything else strikes you as odd.  Is the diaper fitted properly or is the sleeper too small and pinching toes?  Both have happened in my experience.

And What About This Dreaded Colic? 

A baby who cries a lot doesn’t necessarily have colic.  A “colicky” baby is one which cries for several hours each day, several days a week and the crying will generally happen at the same time – typically late afternoon or early evening.  It can start as early as four weeks of age and last until the child is about 16 weeks, which makes for the longest three months of your natural life.  There are multiple reasons for colic, including chronic gas and abdominal distension, and any one of these can wreak havoc.

You can adopt several methods to help your child with colic.

1.       Repetitive movement in a carrier close to your body.

2.      Some form of white noise like a vacuum cleaner or radio static.

3.      Gentle infant massage with baby oil.

4.      Gently – and carefully – holding her face down while you cradle her as though she were a football in a handoff. 

If these don’t help, consult your pediatrician or check any number of colic sources online.  Just remember that while it’s an interminable three months, there is light at the end of the tunnel.

Dads and Nighttime Crying Babies 

A British magazine surveyed new parents and found that fully 52% of the dads were sleeping through the baby’s nighttime crying.  And yep, there is nothing better for a new Dad than a sleep-deprived, hormonally challenged new Mom.  Although it may be due to a natural inclination on the mother’s part to awaken to the crying, dads should split the effort here mutually.  If mom does hear the crying on your duty night, have her wake you so she can get some rest too.  Mom didn’t just decide to have a kid without telling you first.

You can ascribe night cries to hunger for the first very months, but after the baby is sleeping for five or more hours, any crying out that norm has to be considered for other causes.  Go back to your checklist and work from there before just plugging her up to the pump for a refill.  You want to avoid teaching her to sleep when she has a nipple in her mouth; after she stops nursing, you’ll get into the habit of giving her a bottle for sleep and in many cases, that bottle will have sugar-laden juice.  The cascade effect is that this is considered one of the reasons for the rise in childhood tooth decay.  You might sleep better now, but you will pay for it emotionally and financially down the road. 

A Dad’s Response to a Crying Baby 

I know that it can make you nuts since there were nights that I didn’t think that I would ever sleep again.  But remember first and foremost – crying doesn’t automatically mean you are doing anything wrong and continued crying doesn’t make you a bad father.  Now repeat that five times.  And then repeat it five more times.

While it’s important to work with the baby during this period, she’ll survive in her crib for 10 minutes while you leave the room for a sanity check.  Give yourself a schedule with which to work and stick to it provided that you a secure place in which to put her.  If you feel close to losing your cool outside of that schedule, put her in her spot and leave the room – just don’t lose your cool.  When you have it together, go back in.  If necessary, get someone else to come and relieve you or at least talk to you; on several occasions, I called my own father and had a long-distance sanity check.

Although she’s just a baby, she’s learning at a phenomenal rate.  Just as your learning her cues and the best responses, she’s learning yours as well.  Stick with it and you can become adept at handling the situation on your own, too.

Poison Control and Child Safety

Poison Control and Child Safety

You experience abject fear and relentless guilt.

The former grabs you when you realize that your kid has swallowed or drunk something potentially dangerous.  What is it?  When did this happen?  Could she die?

Then the latter hits.  How could I be such a god-forsaken, ignorant, lazy fool for letting this happen?

So what do I do?  Who do I call?  911?  Not necessarily, because the people that they’ll call are at a regional Poison Control Center.

So Just What Is Poison Control?

As a parent, your first introduction to them is probably through the bright green “Mr. Yuk” stickers that came from your pediatrician or maternity ward.  And if you’re paying attention – and fortunate – that will be your last

Created to provide toxicology information for medical emergencies, there are more than 60 Poison Control Centers in the country and each is responsible for a particular region.  Each is staffed by trained specialists, frequently nurses or pharmacists, and has access to a computerized database of natural and toxicological substances.  It is surprising that there is no automatic government funding for these Centers.  Each must obtain its individual funding separately through applications for federal and state grants, medical center affiliations and individual donations.

What You Need to Know About Poisons and Your Child

Trust me, a poisoning event – either through chemical or natural substances – can happen to your child.  It’s happened to my family twice in 13 years.

First, there is only one phone number for all the Centers and it isn’t 911.  Mark this:


Several years ago, the Centers adopted phone technology which reads the incoming area code and automatically routes the call to the appropriate Poison Control Center.  While all have the same toxicology information available, each has a better grasp of what local hospitals and resources are available in their particular region.

According to Dr. Allison Muller, Clinical Director of the Poison Control Center at the Children’s Hospital of Philadelphia, her center alone averages 80,000 exposure calls annually for the region of Delaware and Eastern Pennsylvania.  In her experience at the Children’s Hospital of Philadelphia, there are three key things for parents to understand.

First, do not underestimate the speed and resourcefulness of your small child.  A toddler is eminently able to reach high places and enter remote cabinets when he puts his mind to it.  Having all of the prescriptions and other medications in a separate cabinet simply isn’t sufficient.

Second, even a child-proof/resistant cap can be beaten and might only provide a few minutes of difficulty before your child is into it.  Knowing these facts, Dr. Muller keeps her home medicines stored in a locked toolbox.

Third, keep all liquids in their original marked containers and don’t store excess of refills in other containers.  Dr. Muller cited a call in which a toddler was unwittingly served dilute windshield washer fluid as a snack drink when it was stored in a juice bottle and inadvertently placed in the refrigerator.  The child fortunately survived.

So What Should You Expect When You Call Poison Control?

Most bottle warnings tell you to either contact your physician or Poison Control if the contents are ingested.  According to Dr. Muller, a Doctor of Pharmacy and toxicologist, the first call should be to the Poison Control Center as time is essential and you’re already there with the bottle or material.  If however, you believe that immediate medical attention is required, call 911.

You can expect such questions as your child’s age and condition at the moment, what was ingested, when it was ingested and how much was ingested.  Dr. Muller outlined a scenario for a child who drank from an adult formula Dimetapp bottle.

Q:  How much did she drink?

A:  I don’t know.

Q:  Okay, what’s the size of the bottle?  How much does it contain at purchase?

A:  The label says 4 ounces.

Q:  How much is in the bottle now?

A:  Umm, maybe a third?

Q:  Alright then, how much was in it to begin with?

A:  I don’t know.  I’m not sure.

Q:  I want you to add a teaspoon of water to the bottle – count the number that it takes – to bring the level back to where you thought it was.

A:  (After a pause) Five teaspoons.

With this, the specialist can estimate how much the child drank and outline whatever course of action is appropriate.  If you’re directed to a physician or hospital, be sure to take along the bottle for the staff to review.

Practical Home Tips for Kids and Poison Safety

1.       Keep all medications secured in a locked place.

2.       Keep all liquids in their original containers.

3.       Know what’s planted in your yard.

       a.       If you plant something, keep the identifying tag available in case it’s eaten.

       b.      If you move into a new home and have small children, identify what’s planted in your yard.  I removed a vine plant growing from under a corner bush after a neighbor identified it as Nightshade.

4.        Let  your kids only use paints marked as non-toxic and keep them separate from adult paints.  Keep model-kit paints (oil-based) and supplies in a separate box from other children’s art supplies.

5.       If you’re using cleaning supplies and are called away to the door or phone, take your child with you or gate them away from the supplies.  Never leave a child alone with cleaning supplies.

Watch, watch, watch.  And good luck.

Thanks to Dr. Allison Muller, Director of the Poison Control Center, Childrens’ Hospital of Philadelphia, for her assistance.

For further information, visit the Childrens’ Hospital of Philadelphia Poison Control site at