Falls

Simple things you can do to lessen the chances of your child falling

By constantly supervising your child, buying safe products and making modifications to your home can help reduce the likelihood of your child falling and suffering related injuries. The following are tips from the Centers for Disease Control and Prevention (CDC) and the National Safety Council:

Furniture

Babies who are left unsupervised on top of beds, changing tables, and even couches, can roll off unexpectedly.

• Never leave your baby alone on any furniture, such as beds, tables, sofas, cribs with the guardrails down or changing tables.
• Choose baby products that meet required safety standards. Use all safety straps and features. Look for special safety features on high chairs, cribs and other equipment.
• Install padding on sharp corners.

Windows

Young children are naturally curious and will explore an open window. Windows that are open just five inches pose a danger to children under the age of 10. Falls from windows tend to be the most severe and/or fatal. In addition, even a closed window can be dangerous if your child can get near it - falling through glass can cause serious and often fatal injuries.

• Install window guards on all windows above the first floor.
• If you must open windows for ventilation, makes sure your child cannot reach the open window.
• Set rules with your child about playing near windows.
• Remove furniture near windows that children can climb on.
• Do not rely on insect screens to keep children from falling out of windows.

Stairs

Your infant or toddler doesn't realize the danger of falling down stairs. Even your older children who are running up and down stairs can trip and injure themselves. Clutter on stairs poses an increased risk of falling.

• Remove clutter from floor and stairs.
• Use safety gates to prevent infants and toddlers from falling down stairs. Don't use accordion gates with large openings, because children can get trapped.

Floor surfaces

Area rugs that are not secure, especially on bare floors, can cause your child slip and fall. Mats that are not slip-resistant and tubs without slip-resistant stickers can increase the risk of falling.

• Modify slippery surfaces and remove hazards on floors wherever possible.
• Secure area rugs with foam carpet backing, double-sided tape or a rubber pad.

Playgrounds

Although playgrounds can provide your child with exercise and an enjoyment of the outdoors, they also pose safety hazards. Faulty playground equipment, not using proper equipment for different sporting activities, and careless behavior leads to nearly 20 child fatalities ages 14 and under each year.

• Always supervise your child during trips to the playground. Young children, and even older ones, often do not have the proper judgment to identify unsafe situations that proper supervision can help prevent. In case there are injuries, an adult should be on hand to administer first-aid immediately.
• Make sure playground equipment is age-appropriate. Most equipment manufactured today is made for two age groups: children from 2 to 5 years old, and children from 5 to 12 years old. Since 1994, manufacturers are required to have a sticker placed on each piece of equipment indicating the appropriate age group it's designed for. Looking for this sticker can help you judge whether it's age-appropriate for your child.
• Play areas for younger children should be separate from those of older children. To reduce the risk of injury, children under the age of 5 should not play on equipment taller than four feet. Equipment for 5 to 12-year-olds should not be taller than eight feet.
• Surfaces under playground equipment should be soft enough to absorb falls. Recommended surfaces include wood chips or mulch, sand, pea gravel, rubber, and rubber-like materials that are maintained at a depth of 12 inches. Other safe alternatives include rubber mats, synthetic turf, or other artificial materials. Concrete, grass, blacktop, and packed surfaces are considered unsafe.
• Surface materials should cover "fall zones" surrounding equipment. This usually requires a minimum of six feet in all directions from the equipment.
• Playground equipment should be adequately spaced apart from one another to prevent overcrowding.
• Swings, seesaws, and other equipment with moving parts should be located in areas that are separate from the rest of the playground in order to prevent children from having to cross directly in front of or behind swings to reach them.
• Make sure equipment has been specifically designed for playground use.

An important warning about baby walkers

Baby walkers cause more injuries than any other nursery products. In 2003 alone, an estimated 3,200 children were treated for baby-walker related injuries. Consider these statistics:

• Baby walkers have killed more than 34 children since 1974.
• Most children that sustain injuries from baby walkers are between the ages of 5 and 15 months.
• Most baby walker-related injuries are caused by falls down stairs (76 percent) or tipping over (12 percent).

In addition to increasing the risk of falls down stairs, baby walkers give small children access to hot substances on tables and stoves, as well as poisonous substances. Based on these alarming statistics, the American Academy of Pediatrics (AAP) and the National Association for Children's Hospitals and Related Institutions (NACHRI) have called for a ban of baby walkers. Even with close adult supervision, baby walkers are not safe.

Alternatives to baby walkers

Safe alternatives to baby walkers include the following:

• stationary "walkers," which allow the child to rotate and bounce
• play pens
• high chairs

Injury and death rates

• More than two and a half million children ages 14 and under are treated annually at hospital emergency rooms for fall-related injuries.
• More than half of fall-related injuries among children occur among ages 5 and under.
• About 18 children ages 10 and under die annually from falls from windows. Another 4,700 children ages 14 and under will require treatment each year for window fall-related injuries.

Where and when

• Infants are more likely to fall from furniture, baby walkers and stairs.
• Toddlers tend to fall from windows.
• Older children fall more often from playground equipment.
• Most falls occur during common play times for children: noon to early evening.
• The majority of falls (more than 80 percent) among children ages 4 and under occur in the home.
• Falls from windows tend to be the most severe or fatal.
• Window falls most often occur in urban, low-income neighborhoods and in deteriorated and overcrowded housing.

Who

• Preschoolers are at greatest risk for falls.
• Children ages 10 and under sustain fall-related injuries twice as often as other children.
• Boys are twice as likely to die from fall-related injuries than girls.
• Most often, children who fall from windows are boys under the age of 3 who are playing unsupervised.
• Children who live in apartment buildings are five times more likely to fall from a window.
• African-American children are one and a half times more likely to sustain fall-related injuries than Caucasian children.

Playgrounds

• Playground falls cause more than 230,000 children, ages 14 and under, to require emergency room treatment. Of those, approximately 70 percent are between the ages of 5 and 14.
• Most playground-related injuries occur when children fall to the ground (70 percent).
• The most severe playground-related injuries are due to falls (90 percent). One-third of playground-related fatalities are due to falls.
• Children ages 4 and under tend to suffer injuries to the face and head from playground-related injuries, while older children are more likely to injure arms or hands.