Infants & children

  Population considerations

  • Access to open windows. Children often suffer injuries from falling out of windows in apartment buildings, especially during summer months when windows are left open (Pressley, 2005). 
  • Unsafe living conditions: Children in low-income neighborhoods suffer more falls from buildings due to substandard housing under circumstances of overcrowding, family instability, tensions and pressures (Pressley, 2005, Rivara, 1998).  
  • Recreational hazards. Bike riding is associated with the highest number of injuries from falls for children (Britton, 2005).  Skateboard riding, roller skating, trampoline use, scooter riding, horseback riding and ice skating also put children at high risk for injury from falls (Britton, 2005). 
  • Structural hazards. Falling down stairs is the most common fall from height injury followed by playground-related falls and bed-related falls (Britton, 2005).  Some of the more popular playground structures produce more injuries than any other piece of equipment (Nixon, 2004). Fall from height injury also results from grocery or shopping cart-related falls (Britton, 2005).
  • Baby walker hazards. Children can fall down stairs and off porches while left unsupervised in unsafe baby walkers (Rivara, 1998).  Walker use is the most common cause of injury for children under 18 months (Conners, 2002).
  • Household hazards. Spilled liquid, furniture, objects placed near windows, stairways, rugs, debris, clutter and cribs can cause children to fall (Ulione, 1997).

  Strategies to address these considerations

  • Increase knowledge. Education campaigns directed towards parents can prevent injuries (Rivara, 1998). Educating children about the consequences of risky behavior can significantly decrease self-reported risky behavior in young children (Gresham, 2001).
  • Improve caregiver modeling. Caregivers should model safe behaviors for children (Ulione, 1997).
  • Involve health care providers. Health care providers should counsel families on fall prevention (Britton, 2005).
  • Restrict child access. Children should not be allowed to play on balconies, roofs or fire escapes (Britton, 2005).  Young children should not sleep in the top bunk of the bed (Britton, 2005).  Children should only sit in the seat of shopping carts and should wear a seat belt (Britton, 2005). 
  • Improve the physical environment. Make environments safer by putting up window guards, using gates or doors around stairs, securing area rugs with double-sided tape or a rubber pad to prevent tripping, keeping areas clutter free, putting protective padding on furniture with sharp edges, cleaning up liquid spills immediately and using non-skid surfaces in bathtubs (Britton, 2005, Pressley, 2005, Ulione, 1997). 
  • Improve playgrounds. Installing softer, more energy absorbent surfaces on playgrounds can minimize the seriousness of injuries (Britton, 2005, Rivara, 1998). Routine inspections of the playground area and equipment can help to promote safety (Rivara, 1998, Ulione, 1997). Lowering the height of playground equipment can increase safety (Hsiao, 2001) along with ensuring the equipment is appropriate for the specific age/size of children (Ulione, 1997). 
  • Modify shopping carts. Install seat belts in shopping carts (Rivara, 1998). 
  • Avoid high-risk situations.  Complete avoidance of very high risk equipment such as infant walkers and trampolines may be the safest option (Britton, 2005).
  • Replace walkers.  Walkers, if used, should be replaced by walkers that meet the U.S. Baby Walker Standard. The U.S. Baby Walker Standard requires a walker base too large to fit through standard doorways and friction strips to prevent tipping on the edge of stairs.  Stationary walkers with a platform for infants to move their feet around in are a better alternative (Rivara, 1998).
  • Improve supervision. Active and diligent supervision of young children can prevent falls (Britton, 2005, Rivara, 1998, Ulione, 1997, DHSS, 2006).
  • Use safety equipment. Children should wear helmets while riding a bike, skateboarding, scooter riding and horseback riding to prevent head injury (Britton, 2005).
  • Incorporate training.  Appropriate training and conditioning for children involved in sports increases strength, coordination and experience which can reduce the frequency and severity of sports injuries (Britton, 2005, DHSS, 2006). 
  • Raise awareness. Increase awareness of injury from falls as a community issue. Education campaigns directed towards parents living in apartment buildings about the hazards of children falling out of windows may decrease falls (Pressley, 2005).

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