Clinical recommendation Evidence rating Comments
All children younger than 13 years should be properly restrained in the back seat of motor vehicles. Children should sit in rear-facing seats until at least two years of age.11 C Expert opinion based on laboratory biomechanical testing
Infants should be placed on their backs in a crib in the same room as a caregiver for the first six to 12 months of life, without any soft bedding or toys.13 C American Academy of Pediatrics recommendations based on good-quality patient-oriented evidence
All children should have swimming lessons by four years of age, starting as early as one year. Fencing should completely enclose pools and separate them from the house and yard.3,4 B Expert opinion and case-control studies with systematic review of observational data in the absence of data from clinical trials
Caregivers should be counseled to contact poison control or emergency services immediately after a potential poisoning. Inducing vomiting with or without ipecac is not recommended.12 C Clinical review article and expert opinion
Parents should be encouraged to maintain functional smoke detectors and to educate children about what to do in the event of a fire.9 B Cluster randomized controlled trial
Guns should not be kept in the home. If there are guns in the home, they should be stored locked and unloaded, with ammunition stored in a separate locked location. Physicians should consider contacting legislators if local gun laws are not in the best interest of children's safety.10,37,41 B Case-control studies, expert opinion, and policy recommendations
Children and family members should be counseled about the importance of consistent helmet use when bicycling.2 B Systematic review of case-control studies