In this paper we take a broad look at child sexual exploitation concerns on decentralized social media, present new findings on the nature and prevalence of child safety issues on the Fediverse, and offer several proposals to improve the ecosystem in a sustainable manner. We focus primarily on the Fediverse (i.e., the ecosystem supporting the ActivityPub protocol) and Mastodon, but several techniques could also be repurposed on decentralized networks such as Nostr, or semi-centralized networks such as Bluesky.