The first time my son and I visited a local petting zoo, I watched a woman nearly dive into the duck pond when she lunged for the handles of a stroller rolling straight into the water. I saw no wagging fingers, shaking heads or concealed smirks—because we’ve all been there in some way or another.
Perhaps it’s not so surprising, then, that a recent study shows more than 17,000 young children end up in the ER each year as a result of strollers and infant carriers (both baby-wearing carriers and the kind that build upper arm muscle when switching between a stroller and a car seat).
Bumps and bruises are generally a rite of passage for all kids, but it’s a bit more surprising that a quarter of those stroller and carrier injuries were concussions or traumatic brain injuries.
“Traumatic brain injuries and concussions in young children may have long-term consequences on cognitive development,” said co-author Kristi Roberts, MPH, a research associate in the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. “These injuries have become the most common diagnosis associated with stroller- and carrier-related injuries.”
Brain injuries made up 79% of the carrier-related injuries and 65% of the stroller-related injuries that led to hospitalization. Over the study period, the rate of diagnosed concussions and traumatic brain injuries doubled for stroller-related injuries and tripled for those associated with carriers. The increase, however, may not be a true increase in proportions of injuries.
“It is likely that increased awareness of TBI/concussion has resulted in more conservative diagnoses of head injuries that previously may have been diagnosed as a less severe injury,” Roberts said.
Overall, the absolute risk of injuries from strollers and carriers in general remains very low: Injuries related to strollers, for example, declined slightly from 5.3 per 10,000 children a year in 1990 to 4.8 per 10,000 children per year in 2010. Further, about 95% of the injuries were not serious enough to warrant admission to the hospital. Still, the rate works out to two children every hour in public health terms. Although it’s impossible to eliminate all injuries associated with such common devices used daily by parents, Roberts noted that many of them can be prevented.
“We want parents to be aware of the ways children can get injured from these products so they know what they can do to prevent these injuries from happening,” she said.
Roberts and fellow researchers analyzed two decades’ worth of National Electronic Injury Surveillance System data, from 1990 through 2010, on stroller and baby carrier injuries in children age 5 and under. As a passive surveillance system, the data can only tell the number of injuries, not the denominator of total uses of strollers and carriers.
During those 21 years, a total of 360,937 children were treated in the ER for injuries resulting from stroller or carrier use, translating to an estimated 17,187 injuries a year. While the rate of injuries declined during that period, the rate of head injuries remained a substantial proportion of overall injuries.
Among nearly 262,000 stroller injuries, 42% of which occurred in children under 1 year old, 43% of the injuries were to the head, and 31% were to the face. Two in five of these involved soft-tissue injuries, but 25% were concussions or traumatic brain injuries—most often from simply hitting the ground.
Carriers had an even higher rate of concussions and traumatic brain injuries—35% of the approximately 99,000 injuries analyzed from carriers. As would be expected, the vast majority of these children (89%) were under a year old, and again, high rates of injury occurred to the head (62%) and face (25%). Soft-tissue injuries comprised almost half (48%) of the overall injuries.
Carrier injuries also had a hospitalization rate triple that of stroller injuries—6.5% compared to 2.4%. The authors note that the Consumer Protection Safety Commission issued 43 recalls related to strollers and 13 recalls related to infant carriers during the period studied. Reasons included risk of falls, entrapment, strangulation, choking hazards, amputations and lacerations.
Roberts provided a list of recommendations for reducing the risk of injuries from strollers, carriers and baby-wearing, reproduced fully below.
Stroller and Carrier Safety Tips
- Always buckle up. Make sure your child is seated and buckled at all times. Read and follow the manufacturer’s instructions. Choose a stroller with a five-point harness, and buckle the child into the stroller to ensure that the child remains seated at all times.
- Keep handles clear. Don’t add heavy bags or items to the handles of the stroller. Place these items the in basket underneath. Never allow children to climb on the stroller, as this could also cause the stroller to tip.
- Lock it. A stroller should be locked into position so it doesn’t accidentally close, and LOCK the brake when parked to prevent unexpected movement. Be careful using a stroller near a curb or in high-traffic areas if sidewalks are not available.
- Buy a stroller/carrier that fits your baby. Choose a stroller with a wide base and a seat that sits low to the frame to make it less likely to tip over. Make sure the product is appropriate for your child’s age and size. Furthermore, when shopping for a new stroller, parents should look for a stroller with a wide wheel base, and a child’s weight should not exceed the maximum weight limit of the stroller or carrier.
- Keep it low. Keep carriers low to the ground so the child has a shorter fall if the carrier tips over. Do not place the product on an elevated surface.
- Place carriers on a non-elevated surface to minimize impact if there is a tip-over, follow all manufacturers’ instructions, exercise caution when using a stroller near a curb or navigating high traffic areas where sidewalks are not available and do not leave a child unattended or only in the care of another young child.
- When using a carrier, take time to put it on properly. Sit down when placing your baby in or taking them out. Make sure you can always see your child’s face and that they can breathe easily. Follow manufacturer’s guidelines and make sure your carrier is appropriate for the age and size of your child.
- Check for recalls. Both stroller and carriers have had recalls in the recent years. Check recalls.gov to see if the model you use has been recalled.
Baby-wearing Safety Tips
- The CPSC also provides recommendations for safe baby-wearing here.
- Make sure you can see your baby’s face or eyes in the sling and that your baby can see you. Also, you should place the baby’s face at or above the rim of a sling or wrap so that their face is visible.
- After nursing your baby, change the baby’s position in the sling, so that the baby’s face is at or above the rim of a sling or wrap and that their face is visible and clear of fabric and the mother’s body. You should be vigilant about frequently checking the baby in a sling.
By Tara Haelle