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For all the dangers lurking in this world, it's ironic that infants and toddlers face the greatest physical peril in the sanctity of their own homes.

Injury is a leading cause of death among children, accounting for more than a third of all deaths among children ages 1 to 4, according to the National Center for Health Statistics (NCHS).

For infants, the leading causes of death are congenital, SIDS or attributable to premature birth or low birth weight. However, once children survive that first year, "unintentional injuries," as the healthcare industry classifies accidents become the No. 1 cause of death.

"Injuries are not 'accidents;' they're preventable," said Fred Rivara, M.D., a professor of pediatrics and former director of Harborview Injury Prevention and Research Center at the University of Washington. "It is up to parents and caregivers to safeguard children from accidents that can hurt, maim or kill."

How preventable are serious accidents? NCHS numbers show that between 1980 and 2003, the annual number of deaths from unintentional injuries in children ages 1 to 4 dropped nearly 50 percent, from 3,313 to 1,717.

"As a society, we've become more safety conscious," Dr. Rivara said. "We're mandating the use of car seats and now car booster seats. We put bicycle helmets on our kids."

More Can Be Done to Protect Kids

Despite our growing safety awareness and safety laws, millions of children are still being taken to emergency rooms every year for injuries. The top three causes according to the Centers for Disease Control and Prevention (CDC) — falls, being struck by an object or a person, and motor vehicle-related injuries. The rankings change, depending on age.

Falls are the No. 1 reason for ER visits for the youngest children, peaking at age 1 and staying on top until age 9 or 10. That's when kids are likely to become involved in sports and being struck by a person or object is most likely to send a child to the ER. At least until age 17, when motor vehicle traffic-related injuries claim the highest spot.

Motor vehicle traffic-related injuries, however, aren't exclusive to those with driver's licenses. They are the third most-common injury requiring emergency care for children under age 15, and of particular concern to Harborview Injury Prevention and Research Center.

"Young kids need to be in a proper vehicle restraint," Dr. Rivara said. "If they're under 8 years old they should never be in a seatbelt. Ages 1 and under need to be in a rear-facing car seat. From ages 1 to 3, they should be secured in a forward-facing car seat. And between ages 4 and 8 they should be sitting in a booster seat."

Inevitably, some parents will question whether all this precaution is absolutely necessary. After all, they tell Dr. Rivara, there were no car seats — or bicycle helmets or baby monitors — when they grew up and they turned out just fine.

"Yes, many of us made it," he responds, "but a lot of kids didn't survive childhood and died. We all love our children and want to protect them from harm, and these are ways to do just that."

Dangers Vary from Room to Room

Another injury that's caught the attention of Harborview is fire pit burns. Grills and fireplaces have long been hazards to children but it's only in the last 10 years that fire pits have become popular additions to porches and backyards.

"The problem is that even after the fire goes out the coals are still burning," said Betsy Titus, a safety expert with Underwriters Laboratories (UL), the not-for-profit product safety testing and certification organization. "Coals can last for several hours and contact with the skin can result in up to third-degree burns. Pouring water on the coals will help extinguish them completely."

Yet, for every unforeseen danger based on recent trends, there are scores more that have plagued households for generations. Choking, poisoning, drowning, fire and burns, suffocation, firearm injuries and falls, all of them preventable and yet all too common an occurrence in American homes each year.

"Kids are not a constant. They grow so fast, they gain strength and agility," said Sandy Jones, who co-authored "Great Expectations: Your All-In-One Resource for Pregnancy and Childbirth" with her daughter, Marcie. "They're inquisitive and curious, and there's no better place for them to express these qualities than at home. Parents might be slow to recognize that home is not a child's haven, and that's when the hazards come into play. Literally."

Each room of the home, along with the garage and backyard, holds particular peril for children ages 6 and younger. Some are specific, such as ovens and stovetops in kitchens, toilets and tubs in bathrooms or lawn equipment in garages. Others share a list of common threats — electrical outlets, dangling cords, furniture with sharp corners, blinds or drape cords, or cabinets containing cleaning products or medicine.

"Through a baby's or toddler's eyes, lamp cords, electrical outlets and other common household items become fascinating playthings that may possibly be touched, grabbed, poked, yanked or chewed," UL safety expert Titus said. "That's why it's important for parents of small children to conduct frequent and regular surveys of their homes to spot potentially dangerous materials. Are your outlets exposed? Seal them with a UL-approved electrical outlet cover. Dangling lamp cords? Carefully route them away from traffic areas."

The threats vary on whether you're trying to protect an infant or a toddler. An infant's point of view and ability to grab and clutch will be much lower to the ground than a toddler's, similar to the perspective of an adult lying on his or her stomach. A toddler's point of view is about the same as an adult on hands and knees.

Physically lowering yourself to a child's point of view and looking around each room for child-attracting objects is highly recommended by child-safety experts and commonly is known as "babyproofing."

The Art of Babyproofing

Babyproofing should be done before an infant begins to crawl — about 6 months old — and continue until around age 2½, when the child is able to follow parent commands, babyproofing expert Jones said.

"Parents can be highly vigilant but kids are fast and often it is very difficult to anticipate what your child is going to do next," Jones said. "Babyproofing is only designed to slow babies down and give moms and dads a few minutes to figure out what the baby is doing."

Putting gates up at the top of stairs, for example, could prevent a catastrophic tumble during those seconds when a toddler scampers away after a parent is distracted. Securing cabinets where toilet cleaner and rubbing alcohol are stored will keep the child from getting into it after he or she has somehow eluded adult supervision.

Unused electrical outlets should be covered with UL-approved safety plugs where accessible to babies, particularly in family rooms, kitchens, dens and the baby's own room. Titus recommends that swimming pools have fences completely surrounding them that are at least 4 feet high; there should be no direct access to a pool from the home's rear door.

Other babyproofing measures require no additional equipment, only behavioral changes. Pot handles should be turned inward on the stove, power cords should be wrapped up so they're not dangling from lamps, and drapery and blinds cords should be tied up. Nothing that is small enough to fit through a toilet paper tube (coins, buttons, pieces of toys) should be left on the floor where a child could try to swallow and then choke on them.

"Young children are unable to respond to 'no' very well," Jones said. "It's very difficult for them to put on the brakes just because you say so. Parents need to be ready to jump up and physically intervene if necessary."

No Substitute for Supervision

If you have a small child, UL also promotes the "10/20 second rule" for enhanced pool safety. Parents are advised to scan the pool for their children every 10 seconds and never be any more than 20 seconds away from the water in case of emergency.

Titus said a similar philosophy could be adopted by parents with small children on a everyday basis. As a rule, they should scan for their kids every 10 seconds and never let them be any more than 20 seconds away from reach.

"Babyproofing is no substitute for adult supervision," Titus said. "As a society we've become more aware of child safety and safety products, but there's still no better way to keep kids out of harm's way than to keep an eye on them."

For parents already stressed by the demands of work and, perhaps, additional family members, all this can seem overwhelming. So how do the pros out in the trenches help parents — particularly first-time parents — keep it together?

"First of all, every child should have a 'medical home,' a primary care pediatrician or family physician who can discuss the parents' concerns," said Joseph Zanga, M.D., president of the American College of Pediatricians. "Your physician can explain the risks and why or why not a parent should be concerned."

Beyond that, parents need to realize that accidents happen, Dr. Zanga said. "Play is the work of childhood and injuries may sometimes occur. This is rarely a cause for panic, and certainly children must be allowed to enjoy their childhood. Common sense and attention to reasonable precautions will make raising a child a safe and pleasant experience for all."

Babyproofing expert Jones agreed. "There's no need to be paranoid about it. If you manage for the big things, the little things are going to take care of themselves. The truth is, there are going to be bumps and falls during childhood that are unavoidable. You can't beat yourself over the head when something like that happens."