Preventing Falls in Babies
Infants are at risk for falls, even before they begin to walk. Important points to consider include the following:
- Always place infant seats on a hard surface with the seat belt fastened. Never put a baby in an infant seat on a soft surface (e.g., couch) or an unstable surface (e.g., running washing machine).
- Falls from changing tables are relatively common. Even with a safety strap, infants should never be left alone on a changing table, even for a moment. If there is no safety strap, parents and caregivers should keep one hand on the baby at all times. Changing table guardrails should be at least 2 inches high. Hinged adapters designed to be used to convert a chest of drawers to a changing table should be used with caution. The infant's weight can unsteady the chest, causing a fall and possibly bringing the chest of drawers down on top of the baby.
- Windows are dangerous, especially once babies start crawling and climbing. Keep furniture away from windows and consider installing window guards over the panes. (Adults should be able to remove the guards easily in case of fire.) Remember that screens are not strong enough to prevent a fall.
- Furniture and other objects that can be used for climbing (e.g., step stools, stairs, railings) can pose a fall risk. These items should be removed or the infant should be prevented from climbing. Use L-brackets to secure larger items, such as shelving units and entertainment centers to the walls. Be sure that shelving is not top heavy and that individual items on shelves cannot fall onto the infant.
- Gates can be effective for keeping babies out of harm's way; however, they must be selected carefully. When installed, gates should not be more than three quarters of the child's height or more than 1 to 2 inches from the floor. They should be attached to the door frame (rather than pressure-mounted, which can come loose) and should be made of material that won't cut or trap a baby's hand, head, or limbs. Gates should be placed at the top and bottom of each staircase and in the doorway of any room that the baby should not enter.
- The American Academy of Pediatrics (AAP) discourages the use of baby walkers. Walkers are not always steady and a simple twist or an object on the floor can cause them to tumble over, causing injury. Walkers also can flip onto a hot surface, down a staircase (even through a gate), or into a pool.
- When choosing a high chair, be sure that the base does not wobble and that all hardware is in intact. Restraining belts should be connected to the chair and not to the tray. The tray should lock properly to prevent falling. A folding high chair should lock to prevent it from folding accidentally when the baby is seated. Rounded edges can prevent injuries as well.
- Baby swings should have a stable base that won't wobble or tip over. The seat should be well-padded with a seat belt and crotch post to prevent the baby from falling out. Parents and caregivers should always make sure that the seat belt is fastened before starting the swing and should never leave a swinging baby unattended. Keep in mind that swings usually are intended for babies 6 months of age or younger who are below 15 to 20 pounds. When a baby is able to climb out of the swing, discontinue using it.
- Infants should be belted securely into strollers to prevent them from falling out or slipping into a leg opening. The stroller should be sturdy with effective brakes controlled by a mechanism that actually stops the wheels. Parents and caregivers should make sure that the stroller cannot tip over and should not hang a diaper bag or purse on the handlebars, as this can make the stroller unsteady. Never leave a baby alone in a stroller.