Preventing Falls in Babies, Toddlers, and Children

Falls are the number one cause of non-fatal injuries in children. Every year, millions of children are treated in emergency rooms for fall-related injuries. While you can't prevent every tumble, you can significantly reduce the risk of serious falls with the right precautions and supervision.

Understanding Fall Risks by Age Safe Kids

Fall hazards change as your child grows:

Newborns to 6 months:

• Falling from changing tables, beds, couches
• Falling from car seats or bouncy seats placed on elevated surfaces
• Rolling off surfaces (even before they "can" roll)
• Being dropped

6 months to 1 year:

• Falling from high chairs
• Falling down stairs (once mobile)
• Falling from furniture they're learning to pull up on
• Walker-related falls (baby walkers cause thousands of injuries annually)

Toddlers (1-3 years):

• Stair falls
• Climbing on furniture and falling
• Playground falls
• Tripping while running
• Window falls

Preschoolers and older (3+ years):

• Playground equipment falls
• Bike, scooter, and wheeled toy falls
• Sports-related falls
• Climbing trees, fences, structures

Home Fall Prevention AAP

Your home environment can be modified to reduce fall risks:

### Stair Safety

• Install safety gates at the top AND bottom of stairs
• Top gates should be hardware-mounted (not pressure-mounted)
• Ensure gates are at least 3/4 the child's height
• Teach safe stair climbing when developmentally ready
• Keep stairs clear of clutter and toys
• Ensure adequate lighting
• Install handrails on both sides

### Window Safety

• Keep furniture away from windows
• Install window guards or window stops
• Window screens do NOT prevent falls
• Open windows from the top, not the bottom, when possible
• Never rely on screens to keep children in
• Keep windows locked when not in use

### Furniture Safety

• Anchor tall furniture to the wall (dressers, bookcases, TVs)
• Don't place tempting items on top of furniture
• Remove knobs or use dresser drawer locks
• Choose cribs with proper slat spacing and lowered mattresses

### Changing Tables

• NEVER leave a baby unattended on a changing table
• Keep one hand on the baby at all times
• Have all supplies within reach before starting
• Consider floor-level changing as a safer alternative

### High Chairs

• Always use the safety straps
• Don't allow children to climb in or out alone
• Push high chair away from tables and counters (to prevent pushing off)
• Choose chairs with a wide, stable base

Stairs and Baby Walkers AAP

Baby walkers are dangerous and NOT recommended:

• Walkers cause thousands of injuries annually
• They don't help babies learn to walk—they may actually delay walking
• Babies in walkers can move fast (up to 4 feet per second)
• Most injuries occur from falling down stairs

AAP recommendation: Do not use baby walkers with wheels. Use stationary activity centers instead.

Teaching stair safety:

• Teach children to go down stairs backward (on knees) initially
• Practice with supervision on just 2-3 steps
• Remove gates once child can safely navigate stairs (usually around age 2-3, depending on the child)
• Always supervise until you're confident in their ability

Playground Fall Prevention CPSC

Playgrounds are the second most common location for fall injuries:

### Surface Matters Most

• Look for impact-absorbing surfaces: rubber mulch, wood chips, sand, rubber mats
• Grass and packed dirt are NOT safe fall surfaces
• Surfacing should extend at least 6 feet around equipment
• Check that surfacing is maintained (not compacted, moved, or sparse)

### Age-Appropriate Equipment

• Use playgrounds designed for your child's age group
• Equipment for ages 2-5 differs from equipment for ages 5-12
• Supervise younger children closely—don't let them use big-kid equipment

### Supervision Guidelines

• Stay within arm's reach of toddlers
• Actively supervise (not on your phone)
• Watch for crowding on equipment
• Check equipment for hot surfaces in summer

### Equipment Safety

• Check for broken, loose, or missing parts
• Avoid equipment with gaps that could trap heads (3.5-9 inches)
• Ensure there are guardrails on elevated platforms
• Check for protruding bolts or sharp edges

Beds and Sleep Surfaces AAP

Crib safety:

• Lower the mattress before baby can pull to stand
• Remove bumpers, pillows, and toys that could be used as stepping stools
• Transition to a toddler bed when child can climb out (or is 35 inches tall)

Toddler beds:

• Use guardrails on both sides
• Place bed away from windows and blinds
• Keep bedside area clear

Bunk beds:

• Not recommended for children under 6
• Top bunk must have guardrails on all sides
• Gap between guardrail and mattress should be less than 3.5 inches
• Use night lights so children can see to use the ladder

Adult beds:

• Never leave infants unattended on adult beds
• Babies should not sleep in adult beds
• If co-sleeping is chosen, follow safe sleep guidelines

Sports and Wheeled Activities Safe Kids

Bikes, scooters, skateboards:

• Helmets are essential—every ride, every time
• Ensure proper helmet fit
• Use appropriate protective gear (knee pads, elbow pads, wrist guards)
• Start in safe, traffic-free areas
• Teach rules of the road before street riding

Trampolines:

• AAP discourages home trampolines due to injury rates
• If used: only one person at a time, no flips, adult supervision, safety nets
• Most injuries occur with multiple users

Sports:

• Use proper protective equipment
• Ensure appropriate coaching and supervision
• Follow league safety guidelines
• Allow proper rest and recovery

When Falls Happen AAP

Despite best efforts, children will fall. Know when to seek help:

Call 911 for:

• Loss of consciousness
• Difficulty breathing
• Seizures
• Severe bleeding that won't stop
• Obvious broken bone (bent at strange angle)
• Fall from significant height (second story or higher)

Go to the emergency room for:

• Head injury with vomiting, confusion, or behavior changes
• Possible broken bone
• Deep cuts that may need stitches
• Significant swelling
• Child cannot bear weight on limb

Call your pediatrician for:

• Any head injury (for guidance)
• Persistent pain
• Limping that doesn't improve
• Concerns about the fall

Watch for delayed symptoms (24-48 hours):

• Increasing headache
• Vomiting
• Confusion or irritability
• Unequal pupils
• Extreme sleepiness
• Balance problems

The Bottom Line

Falls are common but serious injuries are often preventable. Focus on the highest-risk areas: stairs, windows, changing tables, and playground surfaces. Always supervise actively, especially around heights. Make your home safer with gates, anchored furniture, and window guards. And remember—children develop quickly, so what was safe last month might not be safe today.

Clara can help you evaluate your home safety and answer questions about preventing falls at any age!