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PEDIATRICS Vol. 100 No. 2 August 1997, p. e1
Copyright ©1997 by the American Academy of Pediatrics

ELECTRONIC ARTICLE:
Babywalker-related Injuries Continue Despite Warning Labels and Public Education

Received Sep 13, 1996; accepted Feb 26, 1997.

Gary A. Smith, Mary Jo Bowman, Joseph W. Luria, and Brenda J. Shields

From the Division of Emergency Medicine, Department of Pediatrics, Ohio State University College of Medicine, Children's Hospital, Columbus, Ohio.

Objective.  To describe the epidemiology of babywalker-related injuries to children treated in a pediatric emergency department despite current prevention efforts, and to investigate the beliefs of parents regarding babywalker use.

Design.  A descriptive study of a consecutive series of patients.

Setting.  The emergency department of a large, academic children's hospital.

Participants.  Children treated for babywalker-related injuries during the 3-year period of March 1993 through February 1996.

Results.  There were 271 children treated for babywalker-related injuries. The mean age was 9.2 months, and 62% of patients were boys. Ninety-six percent of children were injured when they fell down stairs in their babywalker. The number of stairs that a child fell down was significantly associated with skull fracture and admission to the hospital, and a fall down more than 10 stairs had a relative risk (RR) of skull fracture = 3.28 (95% confidence interval, 1.35 < RR < 7.98). There were 159 children with contusions/abrasions (58.6%), 35 concussions/head injuries (12.9%), 33 lacerations (12.2%), 26 skull fractures (9.6%), 9 epistaxis (3.3%), 4 nonskull fractures (1.5%), 4 avulsed teeth (1.5%), and 1 burn (0.4%). Three of the skull fractures were depressed, and three also had accompanying intracranial hemorrhage. Ten patients (3.7%) were admitted to the hospital, and all had skull fractures resulting from falls down stairs. Supervision was present in 78% of cases, including supervision by an adult in 69% of cases. Forty-five percent of families kept the walker, and 32% used the walker again for the study patient or another child after the injury episode. Fifty-nine percent of parents acknowledged that they were aware of the potential dangers of babywalkers before the injury event. Fifty-six percent of parents favored a national ban on the sale of walkers, and 20% were opposed.

Conclusion.  Despite the currently used prevention strategies, including adult supervision, warning labels, care giver education programs, and stairway gates, serious injuries associated with babywalkers continue to occur to young children. The US Consumer Product Safety Commission should promulgate a rule, similar to the voluntary standard adopted in Canada, regarding design requirements for babywalkers that will prevent their passage through household doorways at the head of stairs. The manufacture and sale of mobile babywalkers that do not meet this new standard should be banned in the US. A recall or trade-in campaign should be conducted nationally to decrease the number of existing babywalkers.

Key words: babywalker, pediatric trauma, falls, injury prevention.


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