March 14, 2006

Dramatic drop seen in baby walker-related injuries

By Clementine Wallace

NEW YORK (Reuters Health) - A combination of public
education and re-design of infant walkers has resulted in a 76
percent decrease in emergency room visits for walker-related
accidents between 1990 and 2001 in the United States, according
to researchers from the Children's Hospital in Columbus, Ohio.

The drop occurred mostly between 1994 and 2001, the
investigators report, with the introduction of stationary
activity centers as an alternative to walkers for infants, and
with improvements to walkers such as adding integral braking
systems or making them too large to go through doors.

"These interventions have led to a public health success
... Such dramatic declines in such a short period of time are
rare in the area of consumer related-injuries," Dr. Gary Smith,
director of the hospital's Center for Injury, Research and
Policy, told Reuters Health.

In their article in the medical journal Pediatrics, Smith
and colleague Brenda Shields note that the use of baby walkers,
which give infants mobility beyond their natural capabilities,
has been associated with numerous types of injuries -- mostly
fractures resulting from falling down stairs.

"We used to tell parents to get rid of walkers, because
even the best parent in the world can't watch their child 100
percent of the time," said Smith. "But year after year, despite
education, despite warning labels, we still saw 20,000 to
25,000 children treated in the emergency department for
walker-related injuries -- this was the wrong approach."

Looking through the National Electronic Injury Surveillance
System data for 1990 to 2001, Smith and Shields found 197,200
reported cases of baby walker-related injuries among children
younger than 15 months treated in US emergency departments.

The data show that the number of injuries started
decreasing after the introduction of stationary activity
centers, and dropped dramatically after the 1997 revised
American Society for Testing and Materials voluntary infant
walker standard. In 2001, only 5100 injuries were recorded,
compared with 20,900 in 1990.

Head trauma occurred in 91 percent of cases, and skull
fractures were the most common type of fractures observed, the
authors report. Falling down stairs was the mechanism of injury
in 74 percent of cases.

"We should try to learn from this approach -- there are
many examples where this type of prevention strategy would work
and we are simply not doing it," said Smith, who cited, for
example, the dangers related to shopping carts and lawn mowers.

SOURCE: Pediatrics, March 2006.