N O R T H C A R O L I N A

M illions of toys have been recalledin recent months. The reports oflead poisonings, finger

amputations, death and disability hardlybring forth images of happy children atplay. With all the recent recalls, knowingwhich toys are safe for children to playwith might seem confusing. Though thealarming number of recalls has raisedpublic awareness about the topic of toysafety, these issues are not new. In 2005,the CPSC (Consumer Product SafetyCommission) reported 20 toy-relateddeaths. More than 200,000 toy-relatedinjuries were treated in hospital emergency rooms.Most of the recently recalled toys wereproduced in foreign countries andcontained lead. Though there areregulations that govern the safety of toyssold in the US , toys are randomlyinspected or inspected when there is aconcern. Toys manufactured in othercountries may have different or lessstringent standards than those in the US. Itis more likely that toys made abroad couldcontain harmful levels of lead. Lead wasfound in paint in children’s toys and inchildren’s costume jewelry. Lead is a serioustoxin that can interfere with braindevelopment. It can cause lasting learningand behavior problems. In high enoughdoses is can cause death. Lead cannot beseen or smelled; it can only be detected ina lab. Providers cannot check for lead indonated toys, antique toys, or toys boughtat flea markets and thrift shops. Any toynot known to be safe should be removed.Providers can go to the CPSC web sitewww.cpsc.gov/ for recalls of new toys.Providing safe and appropriate toys isfundamental to healthy child care. Inaddition to checking for recalls, providerscan check to make sure all toys are sturdyand well constructed. Toys should bechecked frequently and repaired ordiscarded if they are broken. Providers canfind out the recommended ages for toysand how to use them by reading the labelson the packaging. Each child developsdifferently and the toys should match his or her developmental age and interest.

Play, an invaluable part of childhood, buildsimaginations, minds and bodies. It is theway children learn. Cooperative playpromotes social/emotional developmentand builds language skills. Dramatic playfosters confidence and creativity. Physicalplay builds large muscles, coordination andbalance. Working with art materials,puzzles and blocks develops small motorskills and promotes creativity and logic.

Providing a wide range of developmentallyappropriate toys ensures that children withdifferent abilities and interests will find toysthat are fun and stimulating. Offer enoughtoys so that each child can choose from avariety of toys, and offer duplicates offavorite toys. Providers can rotate toyswhen children seem ready for somethingdifferent to play with. When a favorite toyis rotated back into the classroom, it canfeel like an old friend returning after a longseparation!

The recent recalls remind providers to takea second look at the toys they offer to thechildren in their programs. When theyknow what to look for, providers canensure that the toys are safe andappropriate. Appropriate toys enhancechildren’s learning experiences and providehours of fun!

References:Choosing Safe Toys. Retrieved Oct. 10. 2007 from

www.kidshealth.org/parent/growth/learning/safe_toys.htm

Toy Injury, The Facts. Retrieved Oct. 10. 2007 fromwww.usa.safekids.org/tier3_cd.cfm?folder_id=540&conte

nt_item_id=1212

Toy Recall Update: Mattel Recalls 9 millions Toys.Retrieved Oct. 10. 2007 from

www.kidshealth.org/research/another_recall.html

The NC Child Care Health and SafetyResource Center is a project of theDepartment of Maternal and ChildHealth, School of Public Health, TheUniversity of North Carolina. ProjectDirector: Jonathan Kotch. Funding forthe Resource Center originates with theMaternal and Child Health Title V BlockGrant of USDHHS’s Health Resourcesand Services Administration/Maternal andChild Health Bureau, awarded to the University under a contract from theDivision of Public Health, NCDHHS.The development, translating, printing,web posting and mailing of the NC ChildCare Health and Safety Bulletin are supportedby funding from the Child Care andDevelopment Fund Block Grant of theChild Care Bureau, Administration onChildren and Families, USDHHS,through a contract between the Divisionof Child Development, NCDHHS, and the Department of Maternal andChild Health, School of Public Health,The University of North Carolina at Chapel Hill.

1 Safe Toys for Children

2-3 Let’s Get Down and Play

4 Toy Safety

5 Come Play With Me!

6. Just Change It Up!

7 Alike - and Different

8 Ask the Resource Center

In This Issue

About TheResource Center

D E C E M B E R 2 0 0 7 / J A N U A R Y 2 0 0 8 VOLUME 9 , ISSUE 6

CHILD CARE HEALTH AND SAFETY BULLETIN

NORTH CAROLINA CHILD CARE HEALTH AND SAFET Y RESOURCE CENTER

Safe Toysfor Children

2 • HEALTH AND SAFETY BULLETIN • DECEMBER 2007 / JANUARY 2008

InfantsBirth to 3 monthsWith their fresh smiling faces and burbling coos, new babiesare a delight. Babies look intently at faces; their visualsystem is developing rapidly. Babies turn their heads towardsounds; they babble and imitate those sounds. Hands andfeet are endlessly fascinating; they kick their feet inexcitement as they reach for objects with their hands.• Toys: rattles, rings, squeeze toys, toys with bright

pictures, mobiles, high contrast pictures, unbreakablemirrors

• Books: board, cloth and vinyl books that have brightpictures, simple shapes and familiar faces or objects.

• Music: music boxes or CD players with soft music

4-6 MonthsBabies between the ages of 4 and 6 months enjoyinteracting with their caregivers. At this age babies listen toand imitate sounds; they smile, laugh and gurgle, and theybabble when “babbled” to! They are interested in mirrorimages and respond to expressions of emotions. Babies graspand bat at objects and, if the results are interesting, theyrepeat actions over and over again.• Toys: soft dolls, textured balls, toys that make noise when

batted or squeezed, pictures of faces, unbreakable mirrors• Books: board, cloth and vinyl books with photos of other

babies and familiar objects; books that include simplerhymes and poems

• Music: songs, large bells, tambourines, rattles and maracas

7-12 MonthsBabies between the ages of 7 and 12 months areincreasingly mobile. During this time, most will learn to sit,crawl and take their first steps. Babies can explore toys and

bang, grasp, and shake them. They can pick up objects andput them in and out of containers. Babies can usually find atoy hidden by an adult in play. During this time babiesbegin to remember simple events and understand simpleconcepts.• Toys: rag and baby dolls, stuffed animals, puppets,

containers of large beads, large plastic blocks, balls,stacking toys, nesting toys, plastic containers, cups, pails,toys that float or squirt, large building blocks, toy phones,push-pull toys, large soft balls, small wooden cubes, watertoys that float, rubber and plastic balls, rubber or softvehicles with wheels

• Books: photo albums of family and friends, touch and feelbooks, plastic/vinyl books for bath time, rhythmic poems

• Music: recordings of sounds and songs

Let’s Get Down and Play!Children learn about their world and their place within it through play, and toys are the tools of children’s play. Children need awide variety of toys to support different areas of development and individual interests.

Hands on toys• eye-hand coordination• understanding of how

things work • cooperation • problem solving• fine motor development

Books and recordings• language and vocabulary• appreciation of literature• early literacy skills• appreciation of music

Art and music• creativity • early literacy skills • early math skills• cultivation of artistic senses• fine motor development

Blocks• early math skills: shapes,

sorting, spatial relations• early science concepts • cooperation• problem solving

Construction items• muscle strength• early science concepts • math skills• problem solving• planning

Active play equipment• strong muscles• coordination• balance• physical confidence• early social skills

Experimental materials• early science skills• discovery• control over material• early literacy skills

Pret end play• emotional and social skills• experimentation with new

behaviors• expression of personal

concerns and conflicts • imagination• planning

Matching Toys with Developmental Age, Skills and InterestDevelopmental milestones are approximate guidelines to development. Each child develops at his or her own pace, somehitting milestones early, some a little later than others, and many within the typical age range. Consider the child’s individualdevelopment, language skills, physical skills, feelings and interests when selecting toys.

References for pages 2 and 3:American Academy of Pediatrics. Caring for Your Baby and Young Child, Birth to Age 5. Bantom Books; 2004

NAEYC. Toys for Learning. National Association for the Education of Young Children: Washington, DC

DECEMBER 2007 / JANUARY 2008 • HEALTH AND SAFETY BULLETIN • 3

Young Toddlers1-2 YearsDuring thesecond yearof lifechildrenlearn towalk, climbstairs, run,kick balls,walk withpull toys,and standon tiptoe.Toddlersshow pride in their accomplishments as they experimentwith objects and solve problems. Toddlers can sort byshapes and colors. They understand common words andfollow simple instructions. Their understanding of languagehelps them to enjoy listening to stories. Children this agebegin to play side by side with their peers and often engagein pretend play.• Toys: balls of all sizes, surprise boxes, large pegboards,

large piece puzzles with knobs, large beads to string,large cardboard box to crawl in, toys that jingle, plasticmeasuring cups, boats, washable dolls for water play,geometric and unit blocks, stacking toys, containers, pushand pull toys

• Books: with just a few words on each page; that rhymeand have a predictable text; that say hello and goodbye,good morning and goodnight; that have shapes andanimals of all sizes; that have simple large colorfulillustrations

• Music: music box recordings with songs, bells, drum,musical tops, musical keyboards, songs with movement

• Art: soft play dough, clay, wide watercolor markers, fatnontoxic crayons, large blank pieces of art paper

• Pretend play: kitchen set, small broom, sponge, camera,wagon, riding toy, washable dolls of all sizes, playphones, people and animals made of wood or rubber

OlderToddlers2-3 YearsOlder toddlersare on the go,learning newskills, andgaining morecontrol overtheir bodies,fingers andhands. Theywalk independently, climb stairs, and pedal tricycles. Theycan hold a pencil and scribble, build a tower of 6 or moreblocks, turn pages of a book, and screw and unscrew jars.Language grows rapidly during this period; children usesimple phrases and follow simple instructions. Toddlers areeager to be with other children, playing make believe andother games with their friends.

• Toys: puzzles with knobs (4-20 pieces), pegboards,sewing cards, stacking toys, picture lotto, dominos, soundmatching games, wooden train set with large pieces, largerubber balls, Duplo® blocks, texture matching games,wagon or wheelbarrow, riding toys, beginning tricycle,wood block units with accessories, blackboard and chalk

• Books: with simple stories and rhymes children canmemorize; about counting, the alphabet or shapes andsizes; about animals, vehicles and playtime; pop-upbooks; books that are funny

• Music: classical, folk, and children’s music, triangle• Art: tempura paint, finger paint, brushes, blunt scissors,

white glue• Pretend play: hand puppets, washable dolls with a few

clothes, doll bed, dress up clothes (no hats – possiblelice) shawls, skirts, shirts, and shoes, tea party utensils

Preschoolers3-5 YearsPreschoolers areinterested in theworld aroundthem, and wantto experienceeverything firsthand. Theirphysical skillsare welldeveloped; theycan skip, gallop,throw ballsoverhand andpump themselves on a swing. Preschoolers’ language skillsare usually well developed and they use these skills to asklots of questions. Preschoolers’ attention spans areincreasing, allowing them to listen to complete stories.They participate in group activities where they oftenbecome boisterous and silly! Preschoolers often engage indramatic play where they develop social skills, exploredifferent roles, and sometimes work through difficultemotions.• Toys: puzzles with more pieces, simple card or board

games, Duplo®/ Lego® blocks, sorting objects, CD ortape player, unit blocks – shapes and accessories, realisticmodel vehicles, construction set, hammer, sand and waterplay equipment, egg beater, bats and balls, (plastic)balance board, bowling pins, ring toss, bean bags andtarget

• Books: children who are alike and different, counting andconcept books, science books, how thing work, trains,cooking, friends, doctor visits, going to school, sistersand brothers, and texts they can memorize

• Music: xylophone, maracas, tambourine, cymbals• Art: clay, easel, chalk, paste, tape, collage materials• Pretend play: child sized stove or sink, toy phone, play

food, cardboard cartons, dress up clothes, doll carriagesand accessories, airport, dollhouse, miniature settings,finger or stick puppets

4 • HEALTH AND SAFETY BULLETIN • DECEMBER 2007 / JANUARY 2008

December isSafe Toys and Gifts Month

December 2-8 National Handwashing Awareness Week

January isNational Birth Defects Prevention Month

Family Fitness MonthJanuary 24 Women’s Healthy Weight Day

January 14-20 National Folic Acid Awareness WeekJanuary 20-26 Healthy Weight Week

February isAmerican Heart Month

National Children’s Dental Health MonthKids E.N.T. (Ears Nose & Throat) Health Month

February 1 Give Kids a Smile DayFebruary 1 National Wear Red Day

(Awareness Campaign for Women about Heart Disease)February 1-7 National Women’s Heart Week

Bulletin BoardFind the Hidden Critter!

In the 2008 NC Child Care Health and Safety Calendar there will be ahidden critter on one of the pages. To find out what the hidden critterlooks like, check the back page of the calendar. Read the content of thecalendar carefully to locate the hidden critter.

Be one of the first 100 callers in your region to• Call us at 800-367-2229• Tell us where you found the critter hiding• And receive a free gift!

MRSA (methicillin-resistant Staphylococcus aureus)MRSA is a type of staph that is resistant to methicillin and other morecommon antibiotics. MRSA infections in the community usually occurin healthy people and show up as skin infections such as red, swollenand painful pimples or boils that contain pus or other drainage. MostMRSA infections are treatable with antibiotics. Prevent the spread ofMRSA by practicing good hygiene:

1. Wash hands thoroughly with soap and water.2. Keep cuts and scrapes clean and covered with a bandage until healed.3. Avoid contact with other people’s wounds or bandages.

If a person has MRSA symptoms he or she should see a health careprovider. For information about Controlling MRSA in Child Care visit:www.nrms.k12.nc.us/departments/staff_wellness/PDF/child.care.MRSA.pdf

Toy Safety

Choose toys wisely when setting thestage for how and what children willlearn. Before buying new toys checkproduct recalls at www.cpsc.gov/cpscpub/prerel/category/toy.html. Read andfollow the warning labels. Offer toys thatmatch with the child’s abilities and alwaysprovide close supervision of childrenplaying with toys.

Prevention of Injuries from Toy HazardsChoking: Choking on balloons,small parts, small toys and ballsremains a leading cause of toy-

related deaths and injuries. Items thatfit in a choking tube or an unused rollof toilet paper are too small for childrenunder 3 years of age. Latex balloonscause more childhood deaths than anyother toy and should be kept out ofreach for children under 8 years of age.

Strangulation: Check lengthof cords or elastics on pull toysused by children under 3 years

of age. Remove knobs or beads iflength is longer than 12 inches. Checkthe cords or elastics on toys in theinfant and toddler rooms. If they cantangle or form a loop, the lengthshould be less than 14 inches.

Hearing loss: Almost 15percent of children ages 6 to17 show signs of hearing loss.

Decrease the sound from loud toys byremoving batteries or covering thespeakers with tape.

Exposure to Toxic Chemicals:Some toys expose children todangerous chemicals. Choose

wooden or cloth toys over toys madewith PVC plastic.

Swallowed Magnets: Avoidmagnetic toys for children lessthan 6 years of age. If a child

swallows more than one magnet, seekimmediate medical attention.

Reference:www.uspirg.org/issues/toy-safety

In addition tobeing safe, toysfor youngchildren shouldmatch thechildren's stagesof developmentand emergingabilities. Eachchild developsat her or hisindividual pace.

Children learn through play and toys invite children toplay. Look for toys that are both within the child’sability and understanding, and that represent theirworld. Avoid toys that are too simple or too hard for achild. This can cause frustration and may expose thechild to a safety hazard.

Provide a variety of toysto stimulate interest andencourage learning. Thenjoin in the fun!• Encourage social and

language development.Read board books andnursery rhymes to infantsand toddlers to help themlearn words.

• Encourage creativity andimagination. Offer artsupplies for preschoolersand toddlers: crayons andmarkers, paintbrushes andfinger paint, modeling clayand playdough, differentpapers for collages. Set thestage for imaginary playwith cooking utensils anddress-ups.

• Encourage development ofeye-hand coordination and large and small motorcontrol. Play ball with toddlers and infants: kick,catch, throw and chase balls of all sizes.

• Encourage the learning of cognitive concepts likecolor and shape identification, matching and causeand effect. Provide items for preschoolers likematching games, magnifying glasses, measuring cups,and block play.

• Encourage physical activity. Riding toys and climbershelp toddlers and preschoolers explore and developgross motor skills. Push and pull toys do that forbeginning walkers.

• Encourage literacy and a love of thearts. Young children of all ages enjoy music. Offerchimes, music boxes, books with music and pictures,recordings of lullabies and simple songs.

Many safe and appropriate play materials are free itemstypically found at home. There is no need to “break thebank” when everyday objects can offer hours of creativeplay.

• Sturdy plastic cups, plates, and wooden or plasticspoons

• Small saucepans and their non-glass lids • Empty plastic bottles. Add water and food coloring to

change the weight, feel, and color.• Plastic jars and freezer containers with lids • Paper and fabric of various textures and colors to

crumple, tear, and handle• Every possible variety of

“ball”: ping pong balls,beach balls, balls of stringor yarn, pieces of fruit

• Things that roll but arenot spherical: large threadspools, wrapping papertubes

• Flat hard things: a ruler ora sandpapered strip ofwood

• Things that are squishy:foam rubber or a cleansponge

• Things with lumps, dipsand holes: empty sodabottles, muffin tins,strainers

• Something big and heavybut safe: a loaf of bread ora cushion

• Large cardboard boxes can become tunnels, playhouses and more

Creative and appropriate toys not only occupy andeducate children – they are just plain fun!

1 - 8 0 0 - 3 6 7 - 2 2 2 9DECEMBER 2007 / JANUARY 2008 • HEALTH AND SAFETY BULLETIN • 5

N O R T H C A R O L I N A C H I L D C A R E H E A L T H & S A F E T Y R E S O U R C E C E N T E R

We e

ncoura

ge y

ou t

o c

opy p

age 5

and

dis

trib

ute

it

to f

am

ilie

s.

FAMILY

F O C U SCome Play with Me!

Toy safety considerations� Sturdy and Safe Construction – No small pieces,

sharp edges, or easily breakable parts

� Washable – Remember, babies put everything intheir mouths.

� Non-toxic finish – Lead-free paint

� Safe Size – Choking can occur if a toy is lessthan 5/8 inch in diameter or has small breakableparts. No latex balloons for children under 8years old.

� No Strings Attached – Strings, cords or ribbonsare a strangulation hazard for babies. Attachtoys to cribs or playpens with plastic, colorful links.

� Safe Sound – Sharp, loud sounds can damageyoung, delicate ears.

References:Good Toys for Young Children

National Association for the Education of Young ChildrenRetrieved Oct. 4, 2007 from www.naeyc

Everyday Objects For PlayUniversity of Utah Hospitals and Clinics, Office of Patient Education

Retrieved Oct. 4, 2007 fromhttp://uuhsc.utah.edu/pated/handouts/handout.cfm?id=634

6 • HEALTH AND SAFETY BULLETIN • DECEMBER 2007 / JANUARY 2008

Toys for OutdoorsOutdoor spaces that inspire children, invite them to play.Many outdoor environments have permanent featuressuch as playground equipment, trees, and sheds or playhouses. These features do not need to be the only thingsthat define the outdoor space. Varying the choices foroutdoor play encourages children to adapt and becreative. Bring out loose parts, prop boxes, and activitiesthat typically take place indoors. Outdoor projects andresearch add a new purpose to being outdoors.Magnifying glasses, tape measures, and paper bags aretools of exploration. Add crayons and paper to documentobservations. Simple tools for complex learning.

Large playground structures offer children a wide range ofphysical challenges: climbing, navigating a slide, wigglingacross a suspended bridge. Children also need spaces torun, ride, and practice skills like throwing, balancing andhopping. Rotate in loose parts (moveable equipment) andchallenge the children to use them in a variety of ways.How many ways can hula hoops be used? Or large snaptogether blocks? What about blankets, zoo animals andvehicles? Or tubs for bathing baby dolls? Add a clothesline on laundry day.

Virtually anything that can be done indoors can also bedone outdoors and often with surprising results. Anoutdoor arts center allows items like stones, leaves, seeds,pine cones and needles to be added to clay sculptures orcollages. And children experience great freedom outdoorswhere they can really make a mess! Provide the materialsand the opportunity and see what the children can do.

The outdoors can also offer quiet time for one or two. Afavorite tree can become a reading nook. Place a basket ofbooks nearby and sit a stuffed bear against the tree. Soona child will be snuggled up with the bear and a book. Orplace two trays of manipulatives under the tree. Add a boxof small vehicles or animals and see what happens. Sandplay can be both soothing and very creative, especiallywhen there are pails, measuring cups, sieves, shovels,trucks and dinosaurs to add to the fun.

Join the children and invent, experiment, expand andenjoy the opportunities for active and quiet play.

Adapting ToysMany toys and materials used by typically developingchildren can be adapted easily for children withdisabilities. Tips for making items easier to grasp and manipulate:

• Add wooden knobs or spools to puzzle pieces.• Attach plastic rings to toys.• Attach small squares of weather stripping or small felt

pads to the top right corner of book pages to separatepages.

• Modify paint brushes, markers, crayons, or pencils bywrapping clay, foam or cloth around them to make themthicker.

• Attach one side of Velcro® to children’s gloves orsweatbands and the other side to children’s toys.

• Stabilize toys by attaching magnetic strips to them sothe toys can be positioned upright on a cookie sheet.

• Secure toys to surfaces using suction cups, c-clamps,non-skid matting, Velcro® and sandbags.

• Suspend toys from appropriate surfaces.• Add adaptive switches to toys with “on/off” functions.• Use chenille sticks or stiff lacing instead of shoestrings

for stringing beads.

Increasing sensory input may enhance learningopportunities. To encourage the child to explore a toyor use one differently, consider these ideas:

• Add familiar smells by rubbing food extracts or otherscents on toys. Try adding vanilla extract to play dough.

• Add new textures to toys or activities. Mix sand infinger paint or put Velcro dots on blocks.

• Vary temperatures to create new interest in toysand activities. Freeze the playfood or change the temperatureof the water in the water table.

• Increase visual contrast to helpchildren see the different partsof a material or activity. Usedifferent colors of paint ormarkers to color spaces for each puzzle piece. Selectpaper for drawing, coloring or painting that is adifferent color from the table or easel.

References:

Greenman,J. Caring Spaces, Learning Places: Children's EnvironmentsThat Work. Redmond, WA: Exchange Press; 1988.

McGinnis, J. Children's Outdoor Environments. A Guide to Play andLearning. NC Partnership for Children; 2000

Wesley, P. W., Dennis, B. C., & Tyndall, S. T. QuickNotes: Inclusion resources forearly childhood professionals. Chapel Hill: University of North Carolina, FPG

Child Development Institute; 2007. Adapted with permission fromPartnerships for Inslusion.

Just Change It Up!

DECEMBER 2007 / JANUARY 2008 • HEALTH AND SAFETY BULLETIN • 7

Alike – and Different

Imagine a world where everyone looks the same or celebrates specialoccasions in the same way. Sounds boring, doesn’t it? Differences in peoplemake the world a more interesting place. Many early childhoodprofessionals wonder how they can embrace the cultures represented by allchildren. They consider which holidays to celebrate in their program orclassroom. As young children begin to form their identity and self-concept,they question the world around them. Who are the people who celebrate aspecific holiday? Where do they live? How are they like me? How arethey different?An environment in which children learn about similarities and differencespromotes awareness and acceptance of both them selves and others.Remember that children are naturally curious about the differences – andshould be recognized for their own and their family’sunique qualities.

Activities That Support Understanding of Alikeand Different!• Place a full-length mirror (acrylic) in the dramatic

play center. Encourage children to look atthemselves. Discuss their appearance and how theyare alike or different from the other children. Helpthem see that no one is exactly alike. Extend the activity by creatinggraphs of how many in the group have brown eyes, red hair, etc.

• Make hand and foot prints. Whose fingers are the longest? Who has thewidest foot?

• Gather holiday or seasonal music that familiesin the program enjoy. Teach children songsand dances from different cultures. Childrenwill begin to see that all people like tosing and dance, but every group has itsown special ways of doing it. Invitefamily members to talk with childrenabout what is being celebrated.

It's a small world after all, it's a small world after all,It's a small world after all, it's a small, small world.

There is just one moon and one golden sunAnd a smile means friendship to everyone

Though the mountains divide and the oceans are wide,It's a small world after all.

• During circletime, talk withchildren abouthow people arethe same,especially when itcomes to feelings.Use props to demonstrate how wemay be different on the outside butthe same on the inside. One idea is touse brown and white eggs. Ask thechildren to tell you how they aredifferent in color, size, and shape.Then, using clear bowls, break theeggs open and ask the children to tellyou what they see. Like the eggs,despite the obvious differences, we areall built the same on the inside, whichis what makes us human beings.

• All year-round classroom photos,books, and materials should reflectvarious cultures, skin colors, and wayspeople celebrate. Avoid the "tourist"approach. This approach emphasizesthe "exotic" differences betweencultureswithoutreflectingcurrent day-to-day lifeand howpeople arealike.

Celebrate Alike andDifferent!

Different Just Like Meby Lori Mitchell 1999

It’s Okay to Be Differentby Todd Parr 2001

Kids Around the World Celebrate!: The BestFeasts and Festivals from Many Landsby Lynda Jones 1999

The Big Orange Splotby D. Manus Pinkwater 1993

The Colors of Us by Karen Katz 2002

We Are All Alike . . . We Are All Differentby the The Cheltenham ElementarySchool Kindergartners 2002

= Infant-Toddler =Preschool-School Age

Nonprofit Org

US Postage

PAIDChapel Hill, NCPermit No. 177

8 • HEALTH AND SAFETY BULLETIN • DECEMBER 2007 / JANUARY 2008

NC Child Care Health & Safety Resource Center1100 Wake Forest Road, Suite 100Raleigh, NC 27604

POSTMASTER: Please deliver as soon as possible – time dated material enclosed

HEALTH BULLETINEDITOR: VOL. 9 ISSUE 6Jacqueline Quirk

CONTRIBUTORS:Lucretia Dickson, Jeannie Reardon,Suzanne Meek

DOWNLOAD:You may download a copy of this publication from our website at:www.healthychildcarenc.org

REPRINTING:Articles may be reprinted without permission if credit is given to the bulletin and the material is not reproduced for commercial purposes.This publication is produced by theNorth Carolina Child Care Health andSafety Resource Center and distributedto licensed child care facilities, CCR&Ragencies, DCD child care licensing consultants, and child care healthconsultants throughout North Carolina.10,000 copies of this document were printed at a cost of $.46 per copy

We’d like to hear from you…

Call us at 1-800-367-2229to share your comments and request

articles or information.

Q: I heard that children under 6 years of age should not be givennonprescription cold or cough medications. How can a parent or aprovider help a child with a cold or cough feel better if they can notgive cough syrup or cold medications?

A: In October 2007, the Food and Drug Administration’s (FDA)Nonprescription Drugs and Pediatric Advisory Committees met and discussed thesafety and effectiveness of cough and cold drug product use in children. They notedthere is a lack of proven effectiveness when the products are used with children.They also noted the need for clinical trials. For both those reasons the committeesrecommended that the ingredients in cough and cold medications not be used inchildren younger than 6.

Though there is no cure for a cold virus, thereare ways to relieve the symptoms of a cold. Fora stuffy nose parents can try using saline nosedrops to loosen the mucus. Only saline nosedrops, NOT nonprescription nose dropscontaining medication, should be used. For aninfant under 6 months of age, an adult canclear a stuffed up nose by using a suction bulb.The bulb should be squeezed, inserted in onenostril and then released slowly to draw out themucus. The process should be repeated in theother nostril.A cool-mist humidifier adds moisture to the air

and to the nasal passages. This helps thin the mucus. Humidifiers need to be cleanedand disinfected according to the manufacturer’s instructions. Humidifiers should befilled just before each use and emptied when they are turned off. Acetaminophen or ibuprofen will help relieve a fever. Follow the recommendationson the packaging for children more than 2 years of age. For children under 2 years ofage, ask a health care provider for the dose that is best for the child’s age and weight.Aspirin should not be given. It is associated with the life threatening Reye syndrome. A stuffy nose sometimes makes it hard to drink fluids. A person with a fever oftenloses body fluids from sweating. Offer small amounts of breast milk, formula, water orother clear liquids to help hydrate the body. If the symptoms do not get better or if they get worse, contact a health care providerfor advice. References:

American Academy of Pediatrics. 3/07. Parenting Corner Q&A: Childhood Infections. Retrieved Nov. 4, 2007from www.aap.org/healthtopics/commonillness.cfm.

FDA News. Vol. 2, Number 43. Oct. 25, 2007. Advisory Committees Recommend Against Cough and ColdMedications in Children Under . Retrieved Nov. 4, 2007 from

www.fdanews.com/newsletter/article?articleId=100166&issueId=10904.

Ask the Resource Center