Home Fall Prevention, Children Ages One to Four Years

Each day in New York State, an average of 120 children ages one to four years are treated for an injury at a hospital because of unintentional falls; an average of three children are injured severely enough to require hospitalization. Falls are the leading cause of injury-related hospitalizations and hospital emergency department visits for children ages 14 and younger in New York.

The good news is that you, as a parent or caregiver, can play a major role in preventing home fall injuries.

What are the most common causes of falls and why?

  • The majority of child falls occur at home. The most common causes of fall-related injuries for children at this age are slipping, tripping, stumbling, and falling out of bed or down stairs or from another high surface.
  • Toddlers quickly begin walking and climbing. They will be able to go up and down stairs independently, but they still do not have the balance and coordination of older children.

Is direct supervision always necessary at home?

  • The best way to prevent injury is to watch, listen and stay near your child. While there is no equal substitution for direct supervision, if you do need to step away from your baby for a short time, put him or her in a safe place, like a crib or playpen.
  • Never leave your child alone while he/she is on a high surface like a changing table or bed. Always keep one hand on your child while you change him/her.

Are baby walkers safe to use?

  • No. Baby walkers should not be used. Babies using them may tip over, fall out, or fall down stairs.

What are the alternatives to using baby walkers?

The American Academy of Pediatrics recommends the following alternatives to baby walkers:

  • Stationary walkers: These devices have seats that rotate and bounce but do not have wheels.
  • Playpens: These enclosed areas are great safety zones for children as they learn to sit, crawl, or walk.
  • High chairs: Older children often enjoy sitting up in high chairs and playing with toys on the tray.

How can I protect my child from falling down the stairs?

  • Properly install safety gates in your home. Anchor safety gates to the wall at both the top and bottom of stairs.
  • Do not use accordion-style or tension gates in your home. They are very hazardous because your baby can get his or her head caught in it and become strangled.

What types of features can help make windows safer?

  • All windows above the first floor should have locks and operable window guards. Window screens alone are not strong enough to keep a child from falling out a window.
  • Window guards prevent the window from being opened more than four inches. They can be removed in case of fire. It is possible for a child to fit through an opening as small as five inches.

How can I make my bathtub safer?

Place slip-resistant mats or stickers on the bottom of your bathtub and shower so the floor is not as slippery.

What are some other safety tips?

  • Child safety devices, like safety belts and straps, should always be used when available. This will reduce the risk of children falling out of their car seat, high chair or carrier.
  • Crib sides should be kept up and firmly secured while your baby is in a crib.
  • Teach your child important home safety rules, like using handrails when walking up or down stairs and keeping their shoelaces tied.
  • Secure area rugs so your child cannot trip on them.
  • Children should wear footwear that fits properly and is slip-resistant, such as sneakers.
  • Teach your child not to climb on furniture and counters as well as hazards outsides the home, such as trees.
  • Place furniture away from windows and anchor pieces to the wall (especially television sets). As your infant begins to crawl and walk he or she may pull and lean on furniture to balance him or her, causing it to fall.
  • Toddlers love to climb on furniture and use drawers and shelves as steps. Do not put toys or items that may interest children on the top of furniture.

Where can I find more information about home safety?

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