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March 12th, 2012
12:01 AM ET

Doctors: Still too many stair-related injuries among children

Between 1999 and 2008, the number of children younger than age 5 treated in the emergency room for stair-related injuries declined, according to research published in the journal Pediatrics this week.

Yet experts say the number is still too high.

"The staggering statistic is that we continue to see a child, on average, every six minutes in this country rushed to a hospital emergency department with a stair-related injury," said Dr. Gary A. Smith, study author and director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

Researchers looked at data from the U.S. Consumer Product Safety Commission, which shows almost 932,000 children were treated for these injuries during those 10 years.

About 3% of the children were hospitalized from concussions and hemorrhages in the brain. Most had injuries to the head and neck region, including bumps and bruises; however, sometimes an accident resulted in a cut or scrape, or a fracture to the thigh or arm.

The greatest number of injuries were seen in patients at the age of one. More than half were male.

Most were injured without reporting the use of a specific object, yet some were using a baby walker or stroller.

Among the more seriously injured children were those being carried by a parent or caretaker.  Smith speculates that multi-tasking played a role.

"For children younger than one, about one-quarter of them were injured while being carried on the stairs by an adult," he said.

The less frequent use of baby walkers and an updated design of the walkers since the mid-90s has played a role in the overall injury decline, he said.

Smith gives this advice to parents and others who care for a child:  "If you have to take the child up and down stairs, take only the child in your arm and leave that other arm free to hold onto the railing so if you do stumble or slip, you can help prevent the fall," he said. "But the best thing to do if you're taking a trip up and down the stairs, [is] just leave your child in a safe place - put them in the crib."

He also offers these suggestions as layers of protection for child safety:

-Have a practical handrail that your entire hand can grip, in the event that you lose your balance.  If you have a decorative one, you can install a second railing opposite it.

-Use hard-mounted baby gates.  Pressure-mounted gates may work themselves loose over time and should only be used at the bottom of the stairs.

-Homeowners can mark the edge of each step with paint to make it clearer where the edge is.

He advises builders to consider stair-related injuries during new construction.

"We need to design environments that have safety in mind," he said. "Every home when it is constructed should have a gate, because in the lifetime of the home, it's exceedingly common to have a child live or visit. So the default should be to build with it, then parents can remove it later if they wish."

In addition, Smith says the lack of uniformity on the stair design causes people to stumble and fall. He says this huge problem is a simple, cheap and easy fix for builders.

"The take-home message is to try to design and engineer the problem out of existence so that kids don't get put in harm's way," he noted. "Kids at this age are changing and developing very rapidly. That's why that age group is often getting into trouble- because they're developing so quickly that parents are having a hard time anticipating it and they're very curious."

"We want them to challenge themselves, we want them to explore - that is how they're going to learn, develop and grow," he continued. "We need to provide a safe environment so that they can do that without paying the price of a broken bone."

Dr. Young-Jin Sue, an emergency room pediatrician at the Children's Hospital at Montefiore in the Bronx, agrees.

"You feel like you know what your child is capable of one moment, but in the next days or weeks that can change," she said. "There's really no substitute when it comes to constant supervision when it comes to young children."


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