Hidden Dangers and Child Safety

Child Safety Basics

Never leave the dropside down in a mesh playpen, which are popular to use when traveling.
Young infants can fall into the loose mesh pocket of a mesh crib with the dropside down, where they can be trapped and suffocate.. Photo © Vincent Iannelli, MD

Since accidents are the leading cause of death for children, it is not surprising that pediatricians often focus so much on educating parents about childproofing, the proper use of car seats, and encouraging kids to use helmets.

Many parents are unaware, however, of less common dangers that don't get as much publicity as drownings, car accidents, or house fires.

Learning about these other hazards can help you take simple steps to keep your kids safe.

Escalators

Most parents let their kids ride escalators without giving it a second thought. Unfortunately, the Consumer Product Safety Commission (CPSC) reports that there were about 11,000 injuries on escalators in 2007, mostly from falls. In addition, there have been at least 77 reports of entrapment -- when hands, feet, or shoes (mostly clogs and slide sandals) get trapped in the escalator -- since 2006.

Your kids can still ride the escalator, but be sure they do it safely. They should:

  • tie their shoelaces before getting on the escalator
  • stand in the center of the escalator, face forward, hold the handrail, and step off at the end
  • refrain from sitting or playing on the escalator -- it should not be treated as an amusement park ride

Perhaps most importantly, learn where the emergency shutoff button is so that you can turn off the escalator if someone gets entrapped while riding.

Shopping Carts

Shopping carts shouldn't necessarily be considered a hidden hazard anymore, as injuries from shopping carts have been well publicized in recent years.

There are even warnings about shopping cart injuries printed on most shopping carts these days.

Still, if you go to a grocery store or large department store, you will invariably see kids riding in and on shopping carts, putting them at risk for falls and head injuries. In fact, according to the Consumer Product Safety Commission, "falls from shopping carts are among the leading causes of head injuries to young children."

In addition to learning about shopping cart safety, keep in mind that the American Academy of Pediatrics states that "parents are strongly encouraged to seek alternatives to transporting their child in a shopping cart until an effective revised performance standard for shopping cart safety is implemented in the United States."

TV and Furniture Tip-overs

Young children like to climb. Unfortunately, when they climb on a large piece of furniture, such as a bookcase, television stand, or dresser, it can tip over on top of them. In addition to the danger of the heavy piece of furniture falling on them, children can also be injured when large items on top of the furniture tip over, especially large television sets.

According to the CPSC, there were at least 36 television tip-over deaths and 65 furniture tip-over deaths between 2000 and 2005; many more injuries were treated in emergency rooms.

To avoid this hazard, be sure to secure large appliances and pieces of furniture to the wall with an anchor or strap; one may be provided to you when you make your purchase, or you can pick one up at a furniture or home improvement store.

Also, be sure to place your television on a sturdy stand and secure it in place so that it can't tip over.

Bounce Houses

The CPSC reports that 4,900 injuries related to inflatable slides and bounce houses were treated in emergency rooms in 2004. This was an increase from 1,300 injuries in 1997 and likely reflects the increased availability and lower cost of bounce houses these days; you often seen them rented for backyard birthday parties, block parties, and festivals.

In addition, there has been about one death a year due to inflatable bounce houses, inflatable obstacle course slides, and inflatable climbing walls. These deaths have been almost exclusively in older teens and young adults and involve falls and head injuries. One child did die in a bounce house in 2007 though - a three-year-old at an indoor playground when two adults fell on him in a bounce house and crushed his skull.

Bounce houses can be fun, but children should be well supervised when bouncing and matched with children of a similar age and weight. Also, be sure that the bounce house is secured to the ground and that you can quickly get the kids out if the bounce house starts to deflate.

Parents

Parents? How could parents be a hidden hazard to their child's safety?

One way is that they often know the safe way to do things, but stop doing it too early because they think their child is too old to get injured. For example, they wouldn't think of letting their three- or four-year-old ride in the car without a car seat, but they let their five-year-old graduate from his booster seat. Or, they let their eight-year-old ride in the front seat of the car or ride his bike without a helmet.

To keep kids safe:

  • Keep your home well-childproofed until your child is old enough to understand the hazards you are trying to protect him from. That means keeping locks on drawers and cabinets, gates on stairs, and covers on electrical outlets, etc.
  • Avoid glass-topped tables, especially if they aren't made with tempered glass, because they pose a risk if kids climb or fall on top and break through the glass.
  • Remember to keep your hotel childproofed when traveling, including using a travel crib and other baby products properly.
  • Move kids to a booster seat when they have outgrown their forward-facing car seat with harness straps, and keep them there until they are ready for regular seatbelts when they are about 4'9" tall.
  • Keep kids in the back seat of the car until they are 13 years old.
  • Childproof your pool, if you have one, by enclosing it in a fence with a self-closing and self-latching gate.
  • Supervise kids around water, even if they know how to swim.
  • Encourage kids to wear a helmet whenever they ride a bike, scooter, skateboard, or use Heelys.
  • Remember not to leave your child home alone until he or she is really ready.
  • Take kids to a public fireworks display, instead of letting them play with fireworks, including sparklers, which can reach over 1000 degrees and cause half of the fireworks-related injuries to children under age five (10% of fireworks-related injuries overall).

Can your child be too safe?

You don't want your child to live in a bubble or walk around wearing a helmet at all times, but remember that the more chances you take, the more likely your child will be injured or killed by an accident.

In addition to obvious safety steps of using a car seat correctly, installing a smoke detector, and childproofing your home, beware of other hidden dangers that can compromise your child's safety:

  • the upper bunk of a bunk bed, which should be avoided until children are at least six years old
     
  • musical instruments, such as a guitar, that can hurt a young child that is playing with the strings (for example, trying to over-tune them), if one of the strings that is under high tension breaks, flying into his eye or scratches his face, etc.
     
  • high water, storm drains, and ditches when flash flooding occurs during and after severe thunderstorms
     
  • parade floats, which can run over a child along the parade route; kids can also fall while riding on a float
     
  • recalled or broken toys
     
  • toys that are not age-appropriate, especially toys with magnets and small parts, which pose a choking hazard for younger children
     
  • home exercise equipment, including stationary bikes, treadmills, and stair climbers, which lead to about 25,000 child injuries each year
     
  • ride-on lawn mowers, which should not be used by children under age 16 years of age; walk-behind lawn mowers, which should not be used by children under age 12
     
  • hot cars, especially when infants or toddlers are left in a car seat, toddlers or preschoolers sneak into the car to play and can't get out, or kids get trapped in the trunk
     
  • drawstrings on clothing hoods, which can be a strangulation hazard; extra buttons, ribbons, or decorative items on baby clothes and clothing for infants or toddlers, since they can come off and be a choking hazard
     
  • paper shredders, which can cause finger amputations and lacerations, especially to younger children
     
  • older (sold before November 2000) window blinds and cords, which can form loops and strangle young children.
     
  • Roman shades and roll up blinds that have looped pull cords or exposed inner cords.
     
  • falls from windows, which can be prevented by installing a window guard or window stop (prevents the window from opening more than four inches)
     
  • a garage door that does not automatically reverse and can trap a child underneath the door (mainly a problem for garage doors made before 1993 and newer ones that no longer work properly)
     
  • balloons, which cause more choking deaths than balls, marbles, or small toy parts (In addition to choking or aspirating on broken balloon pieces, some children suck in uninflated balloons while trying to blow them up, which is why adults should supervise children under age eight who are playing with balloons. Kids under age three shouldn't be allowed to play with balloons at all.)
     
  • older pool, spa, and hot tub drains; their powerful suction and older covers can lead to hair entanglement or body part entrapment
     
  • home trampolines, motorized cycles and all-terrain vehicles (ATVs), nonpowder guns (BB guns, pellet guns, air rifles, or paintball guns), or loud toys, which the AAP considers to be unsafe toys for children
     
  • home trampolines, motorized cycles and all-terrain vehicles (ATVs), nonpowder guns (BB guns, pellet guns, air rifles, or paintball guns), or loud toys, which the AAP considers to be unsafe toys for children
     
  • be sure to secure the liquid nicotine that goes into e-cigarettes, as poison centers across the country are noting a large increase in kids getting exposed by ingestion, inhalation or absorption through the skin or eyes.
     
  • laundry detergent pods, which the AAP states "pose a serious poisoning risk to young children," including over 17,000 calls to poison control in one year from children who ingest or aspirate the pods.
     
 

Sources:

AAP Policy Statement. Shopping Cart–Related Injuries to Children. PEDIATRICS Vol. 118 No. 2 August 2006, pp. 825-827

Amusement Ride-Related Injuries and Deaths in the United States: 2005 Update

CDC. National Vital Statistics Reports. Volume 53, Number 17. March 7, 2005.

CPSC. Shopping Cart Safety Alert. Falls from Shopping Carts Cause Head Injuries to Children. CPSC Document #5075

National Center for Injury Prevention and Control. WISQARS Fatal Injuries: Mortality Reports

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