Halloween is an exciting time of year for kids, and to help ensure they have a safe holiday, here are some tips from the American Academy of Pediatrics (AAP). Feel free to use any part or all of these tips as a parent handout, with acknowledgment of the AAP as the source.

• Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
• If going out after dark, add reflective tape or striping to costumes and trick-or-treat bags.
• Use non-toxic makeup and well-fitting decorative hats instead of masks so children can see well.
• Use only flame resistant costumes, wigs etc.
• Avoid any accessory that could trip a child or injure a child who stumbles.
• Equip all children and escorts with flashlights with fresh batteries.

• Small children should never carve pumpkins. Children can draw a face with markers. An adult should do any cutting.
• Use a flashlight or glow stick instead candles.

• To keep homes safe for visiting trick-or-treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations.
• Parents should check outdoor lights and replace burned-out bulbs.
• Wet leaves or snow should be swept from sidewalks and steps.
• Restrain pets so they do not inadvertently jump on or bite a trick-or-treater.

• Remove trip hazards and provide good lighting on the path trick-or-treaters will use to your home.
• A parent or responsible adult carrying a cellphone should always accompany children on neighborhood rounds.
• If no sidewalk is available, walk at the far edge of the roadway facing traffic. 

• A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats.
• Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
• Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.
• Try to ration treats for the days following Halloween.
 ©2018 American Academy of Pediatrics - authorized for copying and distribution
- See more at: https://www.assuredhealthcare.com/speaking-of-healthcare/halloween-safety-tips Updated 7/2021

Hand hygiene is the cornerstone of infection prevention. Following correct hand hygiene techniques significantly reduces the spread of disease in all settings, especially where infants and children gather. Your hands can pick up disease-causing germs from any surface. If you then rub your eyes, touch your nose, put your fingers in your mouth or onto open skin, you can become ill. Cleaning your hands frequently and appropriately is the most important way to protect yourself and protect the people with whom you live and work.

Children need active play to be healthy and ready to learn. Playgrounds are an important part of vigorous outdoor play. They also pose a high risk for injury. Active supervision and equipment safety are necessary to prevent serious injuries, such as concussion or traumatic brain injury (TBI). Symptoms of TBI can be mild or severe and can include nausea or vomiting and problems with balance, vision, or thinking.
A recent report from the U.S. Centers for Disease Control and Prevention reveals that playground-related brain injuries have risen significantly over the past decade. Monkey bars, playground gym, and swing use cause the most injuries.

Children die in hot vehicles every year. Heatstroke begins when the core body temperature reaches about 104 degrees and the ability to maintain or control body temperature is overwhelmed. Vehicles heat up quickly – even with a window rolled down two inches.   If the outside temperature is in the low 80°s Fahrenheit, the temperature inside a vehicle can reach deadly levels   in only 10 minutes! Children’s bodies overheat easily, and infants and children under four years of age are among those at greatest risk for heat-related illness. When left in a hot vehicle, a young child’s body temperature may increase three to five times as fast an adult. High body temperatures can cause permanent injury or even death.

Warning signs of heatstroke include:

  • Red, hot, and moist or dry skin
  • No sweating, even though the child is warm
  • Strong rapid pulse or slow weak pulse
  • Throbbing headache
  • Dizziness
  • Nausea
  • Confusion, or acting strangely

If a child exhibits any of these signs after being in a hot vehicle, call 911 or your local emergency number immediatelyCool the child rapidly. Spray the child with cool water - do NOT place child in an ice bath.


  • Always check the back seat before you lock the vehicle and walk away.
  • Get in the habit of always opening the back door to check the back seat before leaving a vehicle. Put something you will need like your cell phone, handbag, or briefcase, etc., in the back seat to create a reminder to open the back door to retrieve that item every time you park.
  • Keep a large stuffed animal in the child’s car seat. When the child is placed in the car seat, put the stuffed animal in the front passenger seat as a visual reminder that the child is in the back seat.
  • Distractions and/or a change in routine increase the risk of forgetting a child in a back seat. If someone else is driving your child, or your daily routine is altered, always check to make sure your child has arrived safely.
  • Have a strict policy in place with the childcare provider about morning drop-off.
    • If your child will not be attending childcare as scheduled, the parent’s responsibility is to call and inform the childcare provider.
    • If the child does not show up as scheduled, and the child care provider did not receive a call, the childcare provider pledges to contact the parent immediately to ensure the safety of your child.
  • Never leave a child alone in a car.
  • Never let children play in an unattended vehicle. Teach children that a vehicle is not a play area.
  • Never leave a child in a parked vehicle, even if the windows are partially open.
  • Observe and Report: If you see a child alone in a car, call 911, especially on warm days!

Resource: National Highway Traffic Safety Administration

It’s unsafe and bad practice to leave a child unattended in a car for any reason, even for a quick stop – e.g. in a parking lot or elsewhere to pick up food from a restaurant. In PA, it is a summary offense as specified in PA Statute Title 75 3701.1 Leaving an unattended child in a motor vehicle.

For heatstroke prevention information cited above, click here. For other traffic injury prevention information, contact the PA Traffic Injury Prevention Project of the PA Chapter of the American Academy of Pediatrics (PA-TIPP) at      1-800-CARBELT, 484-446-3008 or see their website and resource page. Updated 6/2021

Deciding when to exclude a child who is ill from early learning and education programs can be confusing for staff. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, clarifies the decision-making process. A child who is ill but does not require immediate medical attention should be excluded if the staff member determines the illness:
a. Prevents the child from participating comfortably in activities as determined by staff
b. Results in a need for care that is greater than the staff can provide without compromising the health and safety of other children
c. Poses a risk of spread of harmful diseases to others based on the list of specific excludable conditions
If any of the above criteria are met, the child should be excluded, regardless of the type of illness.

Immunization is a key component of early childhood development and health. Remember – early childhood and school readiness begin with good health! It is important for early childhood education staff to make immunization a priority. Foster an environment of health with:
• Immunization tracking
• Staff education and adult vaccination as needed
• Parent education
Early childhood education (ECE) programs are prone to disease outbreaks. Recent outbreaks of measles, flu and pertussis (whooping cough) have occurred in ECE settings. Unvaccinated children are at increased risk for disease and can spread disease to others. Babies are at high risk since they are too young to be fully vaccinated.

 National Immunization Awareness Month (August)       

Staying up-to-date with immunizations provides the best protection against disease and is essential to health. Getting vaccinations on time is still important during the COVID-19 pandemic. It is crucial that everyone—children, staff and parents—receive their regularly scheduled vaccines.

Due to the COVID-19 pandemic, parents and guardians should schedule immunization appointments early. Some health care providers may have delays in scheduling and decreased appointment windows. Health care providers are taking every precaution to ensure the safety of patients, families, and staff. Call your health care provider if you have any questions or concerns about a scheduled well-child visit or immunizations in general. The Pennsylvania Departments of Education, Health, Human Services, and Insurance remind parents to ensure their children’s immunizations are up to date as part of back-to-school preparations.

Early Childhood Education staff should make immunization a priority. Foster an environment of health with:

  • Immunization tracking
  • Staff education and adult vaccination as needed
  • Parent education

Unvaccinated children are at increased risk for disease and can spread disease to others. Babies are at high risk since they are too young to be fully vaccinated. Un- and under-vaccinated people are a threat to children and adults who might not be able to receive certain vaccines due to other health conditions. Children who are not up-to-date with vaccines recommended for their age may be excluded from child care and schools if an outbreak occurs.

For more information to educate staff and parents, visit the following websites:

PA Partnerships for Children Fact Sheet - Pediatric Visits and Childhood Immunizations: Getting PA Kids Back in School and Back on Schedule (August 2021):  https://www.papartnerships.org/report/fact-sheet-pediatric-visits-and-childhood-immunizations-getting-pa-kids-back-in-school-and-back-on-schedule-august-2021/

Posted 8/2021

As you prepare for fall enrollment, now is a good time for early care and education programs to make sure all staff are up-to-date with recommended immunizations.  Getting vaccinated is an important part of staying healthy.  Routine immunization of adults is the best way to protect yourself against vaccine-preventable diseases.  Several of the vaccines routinely recommended for adults will prevent diseases that can be spread to children in the child care setting, including pertussis (whooping cough), varicella (chicken pox), measles, mumps, rubella and influenza.

Start your influenza vaccine efforts now too!  All children 6 months of age and older and staff should get influenza vaccine.   

Fall means cooler weather and is a good time to remind infant caregivers of safe sleep recommendations and the prohibition of use of blankets. The Centers for Disease Control and Prevention (CDC) offers the following guidance to promote safe sleep. Take these steps to help babies sleep safely and reduce the risk of sleep-related infant deaths, including sudden infant death syndrome (SIDS).

There are about 3,500 sleep-related deaths among US babies each year. CDC supports the 2016 recommendations issued by the American Academy of Pediatrics (AAP) to reduce the risk of all sleep-related infant deaths, including SIDS. See How to Keep Your Sleeping Baby Safe: AAP Policy Explained to learn more about these recommendations and other actions.

Recommendations for prevention of sleep-related infant deaths by the American Academy of Pediatrics (AAP) are as follows. Infants should be put to sleep on their backs for the first year of life. Comfortable rolling over from back to front and back to back again should be observed by the person/people who put the infant down to sleep to influence that person's decision about whether to return the child to back positioning if the child rolls over onto his/her tummy. Infants should sleep on a firm and flat sleep surface, without any loose bedding, and not in any type of seating device. Infants should not be placed to sleep on soft bedding or soft furniture. Overheating and head covering should be avoided.

A recent study in Pediatrics, “Infant Deaths in Sitting Devices,” reviewed the safety of infant sitting devices. The study found over 300 sleep-related infant deaths from 2004-2014 happened in car seats, strollers, bouncers, swings, and other infant seats.

Follow the American Academy of Pediatrics policy about preventing sleep related deaths in group care settings. Standards,, and of the updated, HTML version of Caring for Our Children, say what should be done. Many early childhood programs must change some common practices.

Infants need opportunities for physical activity many times a day just like toddlers and preschoolers. Tummy time is a great way to provide physical activity. This practice is an important way to help infants develop good neck and upper body strength and control. Infants need tummy time daily to reach these developmental milestones.

Outbreaks of influenza can be stopped by requiring that most child care workers and children who are over 6 months of age get flu vaccine. The CDC reported low influenza vaccination rates among child care workers in a national sample. The most common reasons for not getting the vaccine were mistaken ideas. The respondents didn't understand that they needed to get the vaccine, that the vaccine does prevent or reduce the severity of the flu, and that the vaccine is safe. Those who got the vaccine had the facts and felt some external pressure to receive the vaccine. Strong promotion of flu vaccine is associated with significantly decreased rates of emergency department visits for flu-like symptoms.

The influenza (flu) virus is common and unpredictable. It can cause serious complications – even in healthy children. The Centers for Disease Control and Prevention (CDC) reports 136 influenza-related pediatric deaths for 2018-2019. The 2018–2019 influenza season was the longest-lasting season reported in the United States in the past ten years. Certain people are more at risk for serious flu-related complications. These include:
• Children younger than 5 years of age, especially those younger than 2 years
• Preterm infants
• Children of any age with certain long-term health problems, for example, asthma or other lung disorders, heart disease, or a neurologic or neurodevelopmental disorder
• Pregnant women
• Older adults age 65 years and older: Immune systems decline as adults age.

The influenza vaccine is on the recommended Advisory Committee on Immunization Practices (ACIP) schedule and is mandatory for children 6 months of age and older in child care. Children enrolled in a before or after-school program at a licensed child care facility are required by the PA Department of Human Services / Office of Child Development and Early Learning (DHS/OCDEL) to follow the ACIP schedule. Child care programs must have documentation on file for each child that flu vaccine was given. DHS permits written exemptions from immunization for religious belief or strong personal objection equated to a religious belief or medical exemption. If flu or other vaccines cannot be given due to severe allergic reaction or other medical exemption, the child must have a written, signed and dated statement from the child’s physician, physician’s assistant or certified registered nurse practitioner on file at the child care program. If a child's appointment for flu vaccine is scheduled, have documentation in the child’s file at the child care program with the date.
The flu vaccine helps reduce serious illness and deaths that occur every year from influenza. For the 2019-20 flu season, the national American Academy of Pediatrics (AAP) advises that any licensed, recommended, age-appropriate vaccine available can be administered. Flu mist is an approved form of the vaccine for this season. Some children may need two doses of flu vaccine. Get flu vaccine as soon as it is available for the current season.

In August 2010, the American Academy of Pediatrics released a policy statement about the management of head lice infestations in typical K – 12 school settings. (Pediatrics 2010;126:392–403) The statement made some news headlines. It said no healthy child should be excluded or miss any time from school for lice.  Also, the policy said “no nit” policies in schools should be abandoned.   The AAP statement only applies to school age children in typical K-12 classrooms, not child care settings. However, the AAP book, Managing Infectious Diseases in Child Care and Schools, 4th edition (2017), echos this policy for child care too.