Falls: 1 - 2 years

Falls

How big a problem is it?

A fall-related injury is the leading cause of non-fatal injuries to children aged 0 - 14 years. At least one child aged 1 -2 years is admitted to hospital for a fall related injury every day in New Zealand. 

Small children are naturally inquisitive and minor slips and falls are a normal part of their development. While most falls may not be serious, some can result in broken bones, cuts or head injuries. Falls-related injuries from falls at home are the number one cause of hospitalisation for babies and young children aged up to 4 years of age. 

Serious falls from climbing on furniture, tumbling from an open window, and playing at home are just some of the reasons why children require hospitalisation.


Who does it affect?

Young children are especially at risk because they're inquisitive and just beginning to get mobile. So too are older toddlers who are becoming very mobile. They need supervision as they have no judgement about risk.


Top Tips

The severity of a fall injury depends on the height a child falls, if they hit anything on the way and what they land on.

 

At home

  • Use approved safety gates at the top and bottom of stairs and attach them securely to the wall, if possible.

  • Properly install window guards and stops to prevent window falls. Windows above the first floor should have an emergency release device in case of fire.

  • Bunk beds encourage climbing so they should only be used by children over nine years of age. Make sure there are guardrails on the top bunk and that the opening for entering and exiting is no more than 40cm wide. Other furniture should be kept away from bunk beds and if younger kids want to play in a room where there are bunk beds, make sure you are free to supervise them.

  • Take a look around your house and move any objects and furniture away from windows that could be used by children to stand or climb on.

  • Keep young kids strapped in when using high chairs, infant car seats, shopping trolleys, swings and strollers. And remember, if your toddler is in a car seat out of the car, place it on the floor, rather than on a table or other furniture.

In the kitchen

  • Before you start to cook, organise your child with activities so that you know where they are and what they are doing, or place them somewhere safe such as in a playpen or highchair for a short time.

  • Wet floors are very slippery and become a potential crash hazard for young children. Wipe up spills immediately and encourage children to sit when eating and drinking to reduce spills.

At play

  • Talk to your children about how to be safe on a trampoline, because overconfidence can lead to serious falls. Remember it’s ‘one at a time’. Children under six years can run into trouble on a trampoline so it’s best to find another activity to keep them entertained.

  • Choose a time to go to the park and playground when you are not distracted by other commitments. That way you can supervise your children on the play equipment at all times.

  • Find playgrounds with shock-absorbing surfaces, such as wood chips, mulch, rubber or sand and steer your children to age-appropriate activities to help prevent falls from equipment.

  • High porches, decks, stairs and balconies have a high fall risk, so try and find alternative play areas at home for your children. If that’s not possible, make sure you keep an eye on them at all times.


First Aid

If your child has had a serious fall they may have bone fracture or a serious head injury and are in pain or for any of the following reasons, call 111 immediately. Do this if your child:

  • is, or has been, unconscious (can’t be woken up)

  • is being sick or seems sleepy

  • has trouble breathing

  • bleeding and you can’t stop the bleeding

  • there is bleeding from an ear.

There are also some things you can do straight away:

Fractures First Aid

  • Keep the injured arm or leg still. Someone who knows how to might use a splint to keep it still.

  • You can support the injured arm or leg with a pillow or sling.

  • Raise the arm or leg higher than the heart to help reduce swelling.

  • Your child will need pain relief.

  • If your child does not need ambulance-level care, take them to the nearest hospital Emergency Department.

Brain injury/loss of consciousness First Aid

Follow Drs ABCD for start CPR

D Dangers? Check for any dangers to yourself such as electricity or traffic.
R Responsive? Check responsiveness by calling loudly and shaking the child's arm.
S Send for help. Dial 111 and confirm an ambulance is on its way. Use the appropriate emergency number in other countries.
A Airway. Open the airway by moving the head into a neutral position and lifting the chin. Do not tilt the head back too far.
B Breathing. Look and feel for movement of the lower chest and stomach area. Listen and feel for air coming from the nose or mouth.
C CPR. If the child is not breathing, start CPR - 30 compressions to 2 breaths. Put the child on a firm surface. Place 2 fingers of one hand (for a baby) or the heel of one hand (for a child) in the centre of the chest just below the nipples. Push down hard and fast 30 times in about 15 seconds (push down one-third of chest depth).
Once you have completed 30 compressions (pushes) on the chest, breathe into the baby's mouth 2 times. Seal your lips around the baby's mouth and nose. For a child over 1, you may need to breathe into their mouth and pinch their nose closed. Gently puff into the child until you see their chest rise.
Continue with the cycle of 30 chest compressions and 2 breaths until the ambulance arrives.
D Defibrillator. Attach defibrillator as soon as it is available and follow prompts.


Link to Safekids' resources

Download Falls reference card

Reference Card Sources

Falls Injury Prevention Resources

Links to other organisations' resources

Falls Injury Prevention Resources 

Safekids International TV 

Ministry of Education information on Playgrounds and Equipment 

CDC - Falls, Playground Safety

Safekids Worldwide - Playground Safety