Appletree Day Care, Inc

Health and Safety

Lead Poisoning Prevention

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Protecting children from exposure to lead is important to lifelong good health. No safe blood lead level in children has been identified. Even low levels of lead in blood have been shown to affect learning, ability to pay attention, and academic achievement. While the effects of lead exposure may be permanent, if caught early there are things parents can do [PDF – 234 KB] to prevent further exposure and reduce damage to their child’s health.

The most important step that parents and caregivers, healthcare providers, and public health professionals can take is to prevent lead exposure before it occurs.

CDC supports primary and secondary lead exposure prevention.

  • Primary prevention is the removal of lead hazards from the environment before a child is lead exposed. It is the most effective way to ensure that children do not experience harmful long-term effects of lead exposure.
  • Secondary prevention includes blood lead testing and follow-up care and referral. It remains an essential safety net for children who may already be exposed to lead.
Cover sheet of the How to Prevent Lead Poisoning Fact Sheet

How to Prevent Lead Poisoning in Children

A blood test is the best way to determine if a child has been exposed to lead. The amount of lead in blood is referred to as a blood lead level, which is measured in micrograms of lead per deciliter of blood (μg/dL). Most children with lead in their blood have no obvious symptoms. Talk to your child’s health care provider about getting a blood lead test.

Preventing childhood lead exposure is cost-effective.

According to an analysis from the Health Impact Project, [PDF – 7.5 MB] eliminating lead hazards from the places where children live, learn, and play could generate approximately $84 billion in long-term benefits per birth cohort. Additionally, permanently removing lead hazards from the environment would benefit future birth cohorts, and savings would continue to grow over time. CDC is committed to helping address this threat and improving health outcomes for our nation’s most vulnerable citizens—our children.

Adverse Childhood Experiences (ACEs)

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Adverse childhood experiences (ACEs) can have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. CDC works to understand ACEs and prevent them.

What are adverse childhood experiences?

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). For example:

  • experiencing violence, abuse, or neglect
  • witnessing violence in the home or community
  • having a family member attempt or die by suicide

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding, such as growing up in a household with:

  • substance use problems
  • mental health problems
  • instability due to parental separation or household members being in jail or prison

Please note the examples above are not a complete list of adverse experiences. Many other traumatic experiences could impact health and wellbeing.

ACEs are linked to chronic health problems, mental illness, and substance use problems in adolescence and adulthood. ACEs can also negatively impact education, job opportunities, and earning potential. However, ACEs can be prevented.

How big is the problem?

ACEs are common. About 61% of adults surveyed across 25 states reported they had experienced at least one type of ACE before age 18, and nearly 1 in 6 reported they had experienced four or more types of ACEs.

Preventing ACEs could potentially reduce many health conditions. For example, by preventing ACEs, up to 1.9 million heart disease cases and 21 million depression cases could have been potentially avoided.

Some children are at greater risk than others. Women and several racial/ethnic minority groups were at greater risk for experiencing four or more types of ACEs.

ACEs are costly. The economic and social costs to families, communities, and society totals hundreds of billions of dollars each year. A 10% reduction in ACEs in North America could equate to an annual savings of $56 billion.

What are the consequences?

ACEs can have lasting, negative effects on health, well-being, as well as life opportunities such as education and job potential. These experiences can increase the risks of injury, sexually transmitted infections, maternal and child health problems (including teen pregnancy, pregnancy complications, and fetal death), involvement in sex trafficking, and a wide range of chronic diseases and leading causes of death such as cancer, diabetes, heart disease, and suicide.

ACEs and associated social determinants of health, such as living in under-resourced or racially segregated neighborhoods, frequently moving, and experiencing food insecurity, can cause toxic stress (extended or prolonged stress). Toxic stress from ACEs can negatively affect children’s brain development, immune systems, and stress-response systems. These changes can affect children’s attention, decision-making, and learning.

Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. These effects can also be passed on to their own children. Some children may face further exposure to toxic stress from historical and ongoing traumas due to systemic racism or the impacts of poverty resulting from limited educational and economic opportunities.

How can we prevent adverse childhood experiences?

ACEs are preventable. To prevent ACEs, we must understand and address the factors that put people at risk for or protect them from violence.

Creating and sustaining safe, stable, nurturing relationships and environments for all children and families can prevent ACEs and help all children reach their full potential. CDC has produced a resource, Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidencepdf icon, to help states and communities use the best available evidence to prevent ACEs. It features six strategies from the CDC Technical Packages to Prevent Violence.

Strategy

Strengthen economic supports to families
Promote social norms that protect against violence and adversity
Ensure a stron start for children
Teach skills
Connect youth to caring adults and activities
Intervene to lessen immediate and long-term harms

Approach

  • Strengthening household financial security
  • Family-friendly work policies
  • Public education campaigns
  • Legislative approaches to reduce corporal punishment
  • Bystander approaches
  • Men and boys as allies in prevention
  • Early childhood home visitation
  • High-quality child care
  • Preschool enrichment with family engagement
  • Social-emotional learning
  • Safe dating and healthy relationship skill programs
  • Parenting skills and family relationship approaches
  • Mentoring programs
  • After-school programs
  • Enhanced primary care
  • Victim-centered services
  • Treatment to lessen the harms of ACEs
  • Treatment to prevent problem behavior and future involvement in violence
  • Family-centered treatment for substance use disorders

Raising awareness of ACEs can help:

  • Change how people think about the causes of ACEs and who could help prevent them.
  • Shift the focus from individual responsibility to community solutions.
  • Reduce stigma around seeking help with parenting challenges or substance misuse, depression, or suicidal thoughts.
  • Promote safe, stable, nurturing relationships and environments where children live, learn, and play.

Let’s help all children reach their full potential and create neighborhoods, communities, and a world where every child thrives.

See Adverse Childhood Experiences Resources for publications, data sources, and prevention resources for adverse childhood experiences.

 
Page last reviewed: April 6, 2022
Content source: National Center for Injury Prevention and Control, Division of Violence Prevention

Picky Eaters and What to Do

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An older infant grimacing.

Your child might not like every food you give him or her on the first try. Give your child a chance to try foods again and again, even if he or she does not like them at first. Children may need to try some foods many times before they like them. Here are some tips that might make trying foods again and again easier.

  • Try freezing small bites of different foods. You can use these later and it avoids throwing a lot of food away.
  • Wait a week before you try the new food again.
  • Try mixing the new food with a food your baby likes, such as breast milk.

As your child gets older, he or she may start refusing foods he or she used to like or he or she may start showing signs of picky eating. Favoring just a couple of foods or not wanting foods to touch each other on the plate are normal behaviors. These behaviors often go away by the time your child is about 5 years old.

To learn more about picky eaters and what to do, watch Tips for Feeding Picky Eaters from the American Academy of Pediatrics.

Tips to Help

  • Try again: Wait a couple of days before offering the food again. It can take more than 10 times before you toddler might like it.
  • Mix it up: Mix new foods with foods you know your child likes.
  • Be silly: Make funny faces with the foods on your child’s plate. It might help your child get excited to eat it.
  • Me too: Try eating the food first to show your child you like it. Then, let your child try it.
  • Choices: Give your child a choice of different foods to try. Let your child decide which one to try today.

Choking Hazards

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Your baby is learning how to chew and swallow foods. This means your child may choke. By 12 months old, your child is getting better at eating and may even be feeding themselves. Even though your child can now eat most foods, some are still choking hazards. The way food is prepared may increase the risk for choking. For example, some foods that are served uncooked, whole, or in certain shapes or sizes can be choking hazards. Cutting up food into smaller pieces and mashing foods can help prevent choking.

Here are ways to help prevent your child from choking.

Foods and preparation

  • Cook and prepare food to the right shape, size, and texture for your child’s development.
  • Avoid small, sticky, or hard foods that are hard to chew and swallow.

Meals and snacktime

  • Have your child sit up while eating (no lying down, crawling, or walking).
  • Have your child sit in a high chair or other safe place.
  • Avoid letting your child eat in the car or stroller.
  • Keep mealtimes calm. Avoid distractions, disruptions, and rushing when eating.

Always

  • Pay close attention to what your child puts in his or her mouth.
  • Watch your child at all times while he or she is eating.

Be ready

  • Talk to your child’s doctor or nurse to learn what to do if your child chokes.

Potential Choking Hazards for Young Children

The United States Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) put together a listexternal icon of foods to avoid because these foods could cause a child to choke. This list may not include all foods which could cause choking. For helpful tips to prevent choking, print this handout pdf icon[PDF-896KB]external icon from the United States Department of Agriculture.

Fruits/Vegetables

  • Cooked or raw whole corn kernels
  • Uncut cherry or grape tomatoes
  • Pieces of hard raw vegetables or fruit, such as raw carrots or apples
  • Whole pieces of canned fruit
  • Uncut grapes, berries, cherries, or melon balls
  • Uncooked dried vegetables or fruit, such as raisins

Proteins

    • Whole or chopped nuts and seeds
    • Chunks or spoonfuls of nut and seed butters, such as peanut butter
    • Tough or large chunks of meat
    • Hot dogs, meat sticks, or sausages
    • Large chunks of cheese, especially string cheese
    • Bones in meat or fish
    • Whole beans

Grain Products

    • Cookies or granola bars
    • Potato or corn chips, pretzels, popcorn, or similar snack foods
    • Crackers or breads with seeds, nut pieces, or whole grain kernels
    • Whole grain kernels of cooked barley, wheat, or other grains
    • Plain wheat germ

Sweetened Foods

    • Round or hard candy, jelly beans, caramels, gum drops, or gummy candies
    • Chewy fruit snacks
    • Chewing gum
    • Marshmallows

Foods and Drinks to Avoid or Limit

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Healthy eating is all about balance. There is no need to add salt or sugar to your child’s food. There are also some foods and drinks that are not safe for your child to eat and others that are not as healthy choices as other foods.

  • A generic can of soda being held in a pour position, with sugar flowing from it. Children younger than 24 months old should not be given foods or drinks with added sugar.

    Honey before 12 months may cause a serious type of food poisoning called botulism. Before your child is 12 months old, do not give him or her any foods containing honey, including yogurt with honey and cereals and crackers with honey, such as honey graham crackers.

  • Unpasteurized drinks or foods (such as juices, milks, yogurt, or cheeses) may put your child at risk for a harmful bacteria that can cause severe diarrhea. Do not give your child unpasteurized drinks or foods such as juice, milk, yogurt, or cheeses. Unpasteurized milk can also be called raw milk.
  • Foods with added sugars, low-calorie sweeteners, or no-calorie sweeteners are not recommended. Foods with added sugars can include muffins, flavored yogurts, or cookies. Children younger than 24 months old should avoid added sugars. Check the Nutrition Facts Labelexternal icon to find foods with no added sugars.
  • Sugar-sweetened drinks (such as soda, pop, soft drinks, flavored milks, sports drinks, flavored water with sugar, and juice drinks) contain added sugars. These drinks are different than 100% juice. Children younger than 24 months old should avoid added sugars.
  • Foods high in salt (sodium), such as some canned foods, processed meats (e.g., lunch meats, sausages, hot dogs, ham), and frozen dinners should be avoided. Some snack foods and store-bought packaged toddler foods are high in salt. Check the Nutrition Facts Labelexternal icon to find foods with less salt.
  • Fish high in mercury, such as king mackerel, marlin, orange roughy, shark, swordfish, tilefish (from the Gulf of Mexico), and bigeye tuna should be avoided. Before serving fish caught by family and friends, check for fish and shellfish advisories.external icon Mercury can be harmful to the brain and nervous system if a person is exposed to too much of it over time. While it is important to limit mercury in the diets of children, many types of fishexternal icon are lower in mercury, have important nutrients that support brain development and the immune system, and support a healthy diet. Learn moreexternal icon about which types of fish to avoid and which types of fish to choose to best support your child’s brain and nervous system development.
  • Did You Know?
    A small bowl of honey. Do not give children younger than 12 old honey because it may cause a type of food poisoning called botulism.

    There are certain foods and drinks you should avoid giving your child.

    To learn more, watch these videos from 1,000 Days.

    Cow’s milk before 12 months old may put your baby at risk for intestinal bleeding. It also has too many proteins and minerals for your baby’s kidneys to handle easily and does not have the right amount of nutrients your baby needs.

  • Juice before 12 months old is not recommended. Children should not drink any fruit or vegetable juice before they are 12 months old. Juice after 12 months old is not necessary, but 4 ounces or less of 100% juice a day can be provided. Check Nutrition Facts Labels to make sure it is 100% juice. Juice drinks, fruit drinks, and fruit-flavored drinks have added sugars and should be avoided. Whole fruits are healthier options for your child than fruit juices.
  • Caffeinated drinks, such as soft drinks, tea, coffee, and sports drinks, should be avoided for children younger than age 2. There is no established safe limit for caffeine for young children.

These are just examples of foods and drinks and do not include all possible foods and drinks to avoid or limit. Talk with your child’s doctor or nurse if you have more questions about which foods to avoid or limit.

Child Passenger Safety: Get the Facts

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In 2019, 608 child passengers age 12 and younger died in motor vehicle crashes,1 and more than 91,000 were injured.2 Of the children 12 and younger who died in a crash (for whom restraint use was known), 38% were not buckled up.1 Parents and caregivers can make a lifesaving difference by checking whether their children are properly buckled on every trip.

  • Of the children who died in a crash:
    • Restraint use (like car seat, booster seat, or seat belt use) varies by age. In 2019, 43% of 8–12-year-olds were not buckled up, compared to 41% of 4–7-year-olds and 27% of children less than 4 years old (for whom restraint use was known).1
    • Black and Hispanic children have higher proportions of unrestrained child deaths compared with White children. A study of data from 2009–2010 indicated that 45% of Black children and 46% of Hispanic children were not buckled up, compared with 26% of White children (among children 12 and younger).3
  • Alcohol-impaired driving is a threat to the safety of child passengers. In 2019, 23% of child passenger deaths among children age 14 years and younger in the United States­­­ involved alcohol-impaired driving (blood alcohol concentration ≥0.08 g/dL); 64% of the time, it was the child’s own driver who had been drinking.1
    • Among children who died in alcohol-impaired driving crashes, a higher proportion of those riding with impaired drivers were unrestrained (58%) compared with those riding with sober drivers (37%).1
  • Restraint use among young children often depends on the driver’s seat belt use. In 2019, 67% of fatally injured children riding with unbelted drivers were also unrestrained (based on known restraint use).1
  • Child restraint systems are often used incorrectly. An estimated 46% of car seats and booster seats are misused in a way that could reduce their effectiveness.4,5
  • Of the children who died in a crash:
    • Restraint use (like car seat, booster seat, or seat belt use) varies by age. In 2019, 43% of 8–12-year-olds were not buckled up, compared to 41% of 4–7-year-olds and 27% of children less than 4 years old (for whom restraint use was known).1
    • Black and Hispanic children have higher proportions of unrestrained child deaths compared with White children. A study of data from 2009–2010 indicated that 45% of Black children and 46% of Hispanic children were not buckled up, compared with 26% of White children (among children 12 and younger).3
  • Alcohol-impaired driving is a threat to the safety of child passengers. In 2019, 23% of child passenger deaths among children age 14 years and younger in the United States­­­ involved alcohol-impaired driving (blood alcohol concentration ≥0.08 g/dL); 64% of the time, it was the child’s own driver who had been drinking.1
    • Among children who died in alcohol-impaired driving crashes, a higher proportion of those riding with impaired drivers were unrestrained (58%) compared with those riding with sober drivers (37%).1
  • Restraint use among young children often depends on the driver’s seat belt use. In 2019, 67% of fatally injured children riding with unbelted drivers were also unrestrained (based on known restraint use).1
  • Child restraint systems are often used incorrectly. An estimated 46% of car seats and booster seats are misused in a way that could reduce their effectiveness.4,5
  • The Community Preventive Services Task Force recommends child restraint laws to increase restraint use and decrease injuries and deaths among child passengers, based on strong evidence of effectiveness.10
  • Child restraint laws require children riding in vehicles to use approved restraint devices such as car seats, booster seats, or seat belts that are appropriate for their age, height, and weight.10,11
  • Strengthening current laws with booster seat provisions that require children who have outgrown car seats to use booster seats until at least age 9 helps reduce injuries and deaths.12–16
    • Children age 4–8 years in states with booster seat laws were over four times as likely to be using age-appropriate restraints and were 20% less likely to die than children in states without booster seat laws.12
    • A study among children involved in crashes found that restrained children were 66% more likely to be buckled in appropriate restraints if their state law followed best practice recommendations.13
    • Observed booster seat use among children age 4–7 years increased by 19 percentage points after booster seat laws were implemented in Milwaukee County, Wisconsin.14
    • The death rate among 7-year-olds was 25% lower for the children in states with booster seat laws compared to states without booster seat laws.15
    • The rate of children using car seats and booster seats increased nearly three times in five states that increased the booster seat use age requirement to 7 or 8 years. The rate of children who sustained fatal or incapacitating injuries decreased by 17% in these states.16
  • Car seat distribution plus education programs also are recommended for increasing restraint use.10,17 Distribution plus education programs help parents and caregivers obtain new, unused car seats and learn how to properly use and install them.10,17 These programs often include hands-on demonstrations, which can help increase proper use and installation.
  • Short-term, high-visibility enforcement of child restraint laws are similar to those used for seat belt use (such as Click It or Ticket). Effective programs are short-term, highly visible in the community, and advertised widely in the media.11
  • Incentive and education programs reward parents or children with coupons or other prizes for correctly using car seats. Programs offer print materials, videos, or other instructional aids for parents and caregivers.11

CDC provides guidance to ensure children are properly buckled in a car seat, booster seat, or seat belt— whichever is appropriate for their age, height, and weight.

  • Rear-facing car seat: Birth until age 2–4.
    Infants and toddlers should be buckled in a rear-facing car seat with a harness, in the back seat, until they reach the maximum weight or height limit of their car seat. This offers the best possible protection. Check the car seat manual and labels on the car seat for weight and height limits. Never place a rear-facing car seat in the front seat. Front passenger air bags can injure or kill young children in a crash.
  • Forward-facing car seat: After outgrowing the rear-facing car seat and until at least age 5.
    When children outgrow their rear-facing car seats, they should be buckled in a forward-facing car seat with a harness, in the back seat. They should stay in the forward-facing car seat until they reach the maximum weight or height limit of this seat. Check the car seat manual and labels on the car seat for weight and height limits.
  • Booster seat: After outgrowing the forward-facing car seat and until the seat belt fits properly.
    When children outgrow their forward-facing car seat, they should be buckled in a belt-positioning booster seat with a seat belt, in the back seat, until the seat belt fits properly without a booster seat. A seat belts fits properly when the lap belt is across the upper thighs (not the stomach) and the shoulder belt is across the center of the shoulder and chest (not on the neck/face or off the shoulder). This typically does not occur until children are age 9–12.
  • Seat belt: When the seat belt fits properly without a booster seat.
    Children no longer need to use a booster seat when the seat belt fits them properly. A seat belt fits properly when the lap belt is across the upper thighs (not the stomach) and the shoulder belt is across the center of the shoulder and chest (not on the neck/face or off the shoulder). This typically does not occur until children are age 9–12. Seat belt fit can vary by vehicle so check belt fit in all vehicles to make sure the child no longer needs to use a booster seat. It could be that a child might need a booster seat in one vehicle but not another.  Keep children properly buckled and in the back seat through age 12 for the best possible protection.
  • Install and use car seats & booster seats properly.
    Install and use car seats and booster seats according to the car seat/booster seat manual, or get help installing them from a certified child passenger safety technicianexternal icon.
  • Find a child passenger safety technicianexternal icon.
  • Don’t seat children in front of an air bag.
    Air bags can kill young children riding in the front seat. Never place a rear-facing car seat in front of an air bag.
  • Buckle children in the back seat.
    Properly buckle all children age 12 and younger in the back seat.
  • Always buckle older children who use booster seats or seat belts with a lap and shoulder belt. Both the lap and shoulder belt are needed for proper protection.
  • Buckle children in the middle of the back seat.
    Properly buckle children in the middle seating position of the back seat when possible, because it is the safest position in the vehicle.18
    • If the middle seating position contains only a lap belt, older children using booster seats or seat belts should sit in a different seating position in the back seat where they can use both a lap and shoulder belt.
    • Most rear-facing and forward-facing car seats can be safely installed in the middle seating position using the lap belt only, so younger children using these types of seats can be safely positioned in the middle.
  • Use proper restraints on every trip.
    Buckle children in car seats, booster seats, or seat belts on every trip—no matter how short the trip.
  • Parents and caregivers: Always wear a seat belt.
    Set a good example by always using a seat belt.

Original Article and Additional Resources from the CDC

What is Autism Spectrum Disorder?

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Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.

A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified (PDD-NOS), and Asperger syndrome. These conditions are now all called autism spectrum disorder.

Signs and Symptoms

People with ASD often have problems with social, emotional, and communication skills. They might repeat certain behaviors and might not want change in their daily activities. Many people with ASD also have different ways of learning, paying attention, or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life.

Children or adults with ASD might:

  • not point at objects to show interest (for example, not point at an airplane flying over)
  • not look at objects when another person points at them
  • have trouble relating to others or not have an interest in other people at all
  • avoid eye contact and want to be alone
  • have trouble understanding other people’s feelings or talking about their own feelings
  • prefer not to be held or cuddled, or might cuddle only when they want to
  • appear to be unaware when people talk to them, but respond to other sounds
  • be very interested in people, but not know how to talk, play, or relate to them
  • repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language
  • have trouble expressing their needs using typical words or motions
  • not play “pretend” games (for example, not pretend to “feed” a doll)
  • repeat actions over and over again
  • have trouble adapting when a routine changes
  • have unusual reactions to the way things smell, taste, look, feel, or sound
  • lose skills they once had (for example, stop saying words they were using)

Learn more about symptoms »

Learn about developmental milestones that young children should reach

Information provided by the Center for Disease Control – cdc.gov

Keeping Children Safe

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School is back in session. As you stock up on pencils, take first-day pictures, and adjust to new bus schedules, take a few, quick steps that can keep your child safer during an emergency.

From tornadoes to water main breaks, emergencies can occur with little or no warning—even during the school day. As children head back to school, take a few steps to help protect your child from an emergency and to reunite with your child quickly and safely.

Protecting Your Child Is as Easy as A-B-C

Ask how you would be reunited with your child in an emergency or evacuation

  • If students had to evacuate, where should you go to pick them up?
  • How would the school notify you in the event of emergency?

Bring extra medication, special foods, or supplies your child would need if you were separated overnight

  • What essential supplies would your child need if separated from you overnight? (Medications? Inhaler? Milk? Diapers? Battery pack for special equipment?)
  • Does the school have an emergency stockpile of these items or could you bring extras to be kept at school?
  • What is the school policy for how and when medicine can be administered to your child?

Complete a backpack contact information card and tuck one in your child’s backpack and your wallet

  • Emergencies are chaotic! Make sure your child or their school knows how to reach you, and who should be called if your phone isn’t working.
  • Download and complete your own backpack card.

Follow these A-B-C’s so that emergencies are less chaotic, children can be kept safe, and families can be reunited safely as soon as possible.

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