Kids Health Info

Preventing Falls

  • Falls are the most common single cause of injuries treated in hospitals in all age groups. From the time your child starts to roll, crawl and climb, there is an ever-present risk of falling.  Children are naturally curious and they often have the desire to climb in and on everything they see. 

    Slips and falls are a normal part of a child’s development.  For example, when a child is learning to walk, stumbling is part of the process. To avoid injuries, the aim is to provide a safe environment where they can practice their new skills.

    Many falls are not serious and may simply result in a bump or bruise; others may result in fractures, cuts or head injuries and there are many actions you can take to prevent more serious injuries.

    There are three important factors which influence the seriousness of a fall:

    1. The height the child can fall from.  The lower the height, the lower the danger.  Children under five should not have access to heights over 1.5 metres. Older children should not have access to heights over two metres.
    2. What the child falls onto.  Hard surfaces such as concrete, ceramic tiles and even compacted sand are more hazardous to fall onto than softer surfaces. Impact absorbing or soft fall materials under play equipment are recommended to provide a softer landing.   A depth of 300mm is required and this needs to be maintained.
    3. What the child may hit as they fall.  Place sharp edged furniture such as coffee tables to the side of the room, where a child is unlikely to fall on to them.

    Glass may cause serious injury, therefore consider using safety glass or a shatter resistant film.  Make glass doors and full length windows visible by placing stickers at a child’s eye level.  Place furniture so children cannot run into windows or fall from furniture into glass.  Low-level glass should be replaced with safety glass whenever glass is replaced in existing homes.

    Main causes of falls

    Fall injuries are common in the bathroom due to the combination of water and potentially slippery surfaces.

    For children less than five years of age, most falls occur:

    • from nursery furniture including baby walkers and high chairs;
    • onto furniture and down stairs;
    • on the same level (as compared to falls on steps and stairs).

    In the older age group (five to 14 years of age), most falls occur:

    • from playground equipment;
    • from bunk beds and other furniture;
    • in sports-related activities such as using trampolines, in-line skates, rollerskates, skateboards and bicycles.

    Preventing falls with babies:

    Place babies where they cannot fall.  Babies wriggle from the time they are born and it is not long before they learn to roll over. When babies have learned to roll, they can easily move across an area into danger. Babies may unexpectedly fall from a bed or change table.  Always keep one hand on your baby when using a change table.  Whenever feasible, use the floor when changing a baby. 

    An active baby may move a bouncer, causing it to fall from a table or bench top. Do not place a bouncer above floor level.

    Never carry your baby around in a bouncer or rocker chair or place these products on tables or raised surfaces when your baby is using them.

    Preventing falls with toddlers:

    A standing and toddling baby has frequent minor falls.  To minimise these, look at the environment from their level.

    • Create a clear area, remove rugs and tripping hazards such as electrical cords. Pad sharp corners of benches and tables, or remove them from the play area.
    • Use a full body (five point) harness in high chairs, strollers and shopping trolleys.
    • Do not use baby walkers. They give a young child the mobility to place them in danger quickly and unexpectedly.
    • Be aware that falls are more common when a child is tired or unwell.  Plan quiet activities for these occasions.
    • Use a safety gate at the top and bottom of stairs.
    • Use a sensor light.

    Preventing falls with children:

    Once a child has learnt to walk they quickly manage to climb. The pre-school aged child has the physical ability to reach heights but has no fear or understanding of the consequences of a fall. 

    Lock windows in multi-storey buildings so that children cannot climb out, or ensure that the windows can only open less than 100mm.

    Scissors, knives or glasses are some of the sharp objects that may cause serious injury if a child falls.  Discourage children from walking or running with these objects, especially in their mouths.

    Suggested ways to protect your child from falls 

    Furniture

    Children can sustain serious harm including head injuries after falling from nursery furniture.

    If your child is continually trying to climb out of the cot leave the sides down. When your child is ready to move from a cot to a bed, place a mattress on the floor to soften a fall.

    Bunk beds are not recommended for children under nine years of age.  Do not let children play on bunk beds and ensure the top bunk has a guardrail.

    Place sharp-edged furniture such as coffee and bedside tables where a child is unlikely to fall on to them.

    Remove any toys from the cot that your baby could use to climb on and fall out.

    Ensure moving equipment such as prams have workable braking devices and locks.

    Slippery areas

    Where slippery surfaces are walked on, use:

    • nightlight in passageways, bathrooms and toilets;
    • slip resistant bath/shower surface;
    • slip resistant floor surfacing.

    When wet, some surfaces become extremely slippery for all age groups.  A wet kitchen floor can become a potential crash scene for a toddler.  It is safest to wipe up spills immediately. 

    Encouraging children to sit when eating and drinking will help to reduce spills. 

    Bathroom floors are often hard, wet surfaces.  Use rubber mats to help reduce slipping.  There are anti-slip flooring products commercially available to assist with indoor and outdoor areas.  Products such as safety walk tape, rubberised paint, slip resistant concrete spray and lock matting are examples of some of the products available. 

    Playground equipment and outside

    The older child may have an understanding of danger but still take risks. Playgrounds are great fun for children.  They can be designed for adventure and safety. Good design, placement and maintenance of play equipment will reduce the likelihood of severe injury, whether this is at home, at school or in a public playground. Carefully-placed playground equipment will discourage children from walking in front of a swing or falling from one piece and hitting another.

    Play areas can be made safer by the choice of equipment at an appropriate height, the provision of safety rails, the size of the bars and the layout of the equipment. 

    Good under-surfacing for play equipment kept at a depth of 300mm is of utmost importance. 

    Children should use playground equipment that is suitable for their size and age in a fenced backyard or a park. Trampolines are not recommended for children under six years of age. Use trampolines with enclosed nets to prevent children from falling off the trampoline and ensure constant supervision by a responsible adult.  

    For children under five years, it is safer to use play equipment that is less than 1.5 metres in height and for older children, less than two metres.

    An Australian Standards approved bicycle helmet must be used by children when riding a bike. It is also advisable for a young child to wear a helmet when using a tricycle in the backyard. When older children use in-line skates, roller skates, skateboards and scooters, they should wear a helmet as well as protective clothing such as elbow and knee pads.

    Balconies

    Keep entrances to balconies locked to avoid them being used as a play area.

    Supervise children at all time when on balconies.

    Position balcony furniture away from railings to stop it being moved and used for climbing.  Use heavy furniture that is harder for children to move, rather than light plastic furniture, on balconies.

    Use vertical railing on balconies to stop children climbing up a horizontal railing like a ladder.  Gaps between railings should be no wider than 100mm (10 cm).

    The vertical railing should be a height of at least 1000mm (one metre).  If the balcony is more than three metres from the ground, the vertical railing height must be at least 1200mm (1.2 metres).

    Ensure the balcony surface is non-slip and that all tripping hazards are removed to prevent falls.

    For more information

    See the Falls Prevention website for more details and ideas on how to prevent falls that are common in the different age categories.

    Falls Prevention

    Consumer Affairs Victoria: 1300 558 181      www.productsafety.vic.gov.au  
    The Australian Competition and Consumer Commission   www.accc.gov.au 
    Toy and Nursery Safety Line: 1300 364 894

    The Royal Children’s Hospital Safety Centre factsheet “Backyard & Playground Safety” www.rch.org.au/safetycentre


    Reviewed 17/6/15



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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.