Kiddie gates, rules help prevent falls off furniture
By Kathryn Doyle
(Reuters Health) - Kids who get hurt in falls from furniture often live in homes without safety gates or weren't taught rules about climbing in the house, a new study found.
The researchers only looked at common aspects of home life when kids fall, not at what actually caused the falls. But this is the first study to compare safety behavior and safety equipment between families with versus without these kinds of accidents, said lead author Denise Kendrick of the University of Nottingham in the U.K.
In the U.S., more than a million children under age five have a fall resulting in a visit to the emergency room each year, most involving furniture, baby walkers or changing tables - and these falls account for half of the ER visits for kids this age, according to the Centers for Disease Control and Prevention and the National Center for Injury Prevention and Control.
Kendrick and colleagues at four centers in the U.K. studied 672 children who had fallen from furniture and went to the hospital between 2010 and 2012, at an average age of almost two years old. Most kids had minor head injuries, cuts or fractures.
Researchers didn't include children who fell from play equipment, like trampolines.
Parents filled out questionnaires about safety behaviors, equipment and home hazards within a short time after their child's fall.
Compared to parents of more than 2,000 similar children who had not suffered a fall injury and who also filled out the questionnaire, parents of kids who had fallen were more likely to say they did not use safety gates in the home and that they had not taught their children rules about not climbing on objects in the kitchen, the researchers reported December 1 online in JAMA Pediatrics.
Parents of children who had fallen were also more likely to have left their child on a raised surface.
"Most of these types of falls result in arm fractures that are relatively straightforward to treat," but some can result in serious head injuries, said Mariana Brussoni of the Child & Family Research Institute BC Injury Research & Prevention Institute in Vancouver who was not involved in the new study.
Adequate, constant supervision is the best way to prevent these injuries, she said. Young children should not have access to bunk beds, she noted.
"Risk factors amenable to modification are important to understand to reduce preventable morbidity and mortality in children," said Dr. Kieran J. Phelan of Cincinnati Children's Hospital Medical Center, who was also not part of the new study.
"Falls from windows are particularly dangerous," said Dr. Andrea C. Gielen, director of the Johns Hopkins Center for Injury Research and Policy in Baltimore, Maryland. She recommends window guards.
"Many parents don't realize that screens are designed just to keep insects out and not to prevent kids from falling out," Gielen told Reuters Health by email. "It is also important to keep furniture away from windows so that kids don't have access to the window."
The findings suggest some falls may be prevented by using safety gates across doorways and on stairs for kids up to the age of two and by not leaving children on raised surfaces, not placing car seats or bouncing cradles on raised surfaces and not changing diapers on raised surfaces, Kendrick told Reuters Health by email.
Children develop and learn to do new things very quickly," she said. "It is important to anticipate what a child is likely to be able to do in the near future and adapt the home to suit them."
Kids can pull out drawers and climb on them, and even young babies may wriggle off a bed or raised surface if left there, she said.
"There is useful advice about preventing falls at home from a range of agencies and charities such as CDC, Safekids Worldwide, the Child Accident Prevention Trust, the Royal Society for the Prevention of Accidents," Kendrick said.
SOURCE: http://bit.ly/1tF51t2
JAMA Pediatrics 2014.
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