Rock-A-Bye Baby -- But Never on the Counter Top

Falls in elevated chairs, car seats linked to head injuries in infants

WEDNESDAY, Feb. 20, 2002 (HealthDayNews) -- Infants demand attention almost around the clock. And busy parents trying to keep an eye on their babies while handling chores around the house learn to bring them along from room to room.

But if the baby is strapped into a removable car seat or bouncy chair, where that seat or chair is placed is critical to the baby's safety, says a new study. Placing a seat on an elevated surface, like a kitchen table or counter top, could be disastrous.

The findings appear in the March 2002 issue of the Archives of Disease in Childhood.

Dr. Tim Wickham, a specialist registrar in pediatrics at University College Hospital in London, led the study while at the Chelsea and Westminster Hospital pediatrics accident and emergency department in London.

He and his colleagues noticed that they were treating head injuries in infants who had fallen while strapped into either car seats (detachable infant carriers) or bouncy chairs (also known as "bouncers" or "bouncer seats"). In many cases, the seats had been resting on an elevated surface, such as a kitchen counter.

But it wasn't clear how common these accidents were, so Wickham decided to track the causes of all head injuries in infants who came to the emergency room over the course of one year.

A common scenario, says Wickham, was that parents would put their baby in the chair. But to keep an eye on their child while they worked in the kitchen, for example, they would place the chair on the kitchen table or counter.

"As the baby sits there, happily googling away, it quietly is jiggling and bouncing the chair," says Wickham. "The babies move and the chair gradually moves imperceptibly. As soon as the edge of it slips off the [counter], the whole lot goes onto the floor."

"They tend to tip forward, so babies go head first," says Wickham. Since kitchen floors are not usually carpeted, the baby lands on wood, tile or linoleum.

The same scenario occurred with car seats set on a counter or table, says Wickham.

During 1996, Wickham collected information on 131 cases of head injury in infants. Falling from a bed was the cause of 40 percent of the injuries, but 17 cases involved falls while in car seats or bouncy chairs. The injuries ranged from bruises to skull fractures, but although some infants were admitted to the hospital, none required intensive care.

"It's still significant," says Wickham. "Parents don't seem to realize that it is a risk to put the chair on the counter rather than on the floor."

Only one parent knew that placing the chair on an elevated surface was not safe. But Wickham points out that other parents in the study might not have admitted they knew it was unsafe because they felt upset or guilty that their baby had been injured in their care.

British manufacturers of car seats and bouncy chairs say that placing the products on an elevated surface is dangerous, but there are no warning stickers on the product.

Wickham stresses that the seats themselves are safe, so long as they're used safely. He suggests that a pictorial representation showing a seat on the floor, rather than on an elevated surface, might be helpful.

Nychelle Fleming, a spokesperson for the U.S. Consumer Product Safety Commission, says that placing such a label on infant carriers or bouncers is a voluntary standard in the United States. The label warns against leaving a child unattended in the seats or failing to use the restraint system.

The commission also notes that a child's movement can slide the product, and warns parents not to place the product near the edge of counter tops, tables or other elevated surfaces.

"It's always a good idea to look for products that meet the voluntary standard," says Fleming.

What to Do: You can find infant carrier safety tips from the Consumer Product Safety Commission, or check out this article on bouncer safety from the Department of Consumer and Employment Protection of the Government of Western Australia.

SOURCES: Interviews with Tim Wickham, M.D., specialist registrar, University College Hospital, London, U.K.; Nychelle Fleming, spokesperson, U.S. Consumer Product Safety Commission, Washington, D.C.; March 2002 Archives of Disease in Childhood
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