BABYWALKER-RELATED INJURIES CONTINUE DESPITE WARNING LABELS AND PUBLIC-EDUCATION

Objective. To describe the epidemiology of babywalker-related injuries to children treated in a pediatric emergency department despite curre nt prevention efforts, and to investigate the beliefs of parents regar ding babywalker use. Design. A descriptive study of a consecutive seri es of patients. Setting. The emergency department of a large, academic children's hospital. Participants. Children treated for babywalker-re lated 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 stair s in their babywalker. The number of stairs that a child fell down was significantly associated with skull fracture and admission to the hos pital, 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). Th ere were 159 children with conlusions/abrasions (58.6%), 35 concussion s/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 depresse d, and three also had accompanying intracranial hemorrhage. Ten patien ts (3.7%) were admitted to the hospital, and all had skull fractures r esulting from falls down stairs. Supervision was present in 78% of cas es, including supervision by an adult in 69% of cases. Forty-five perc ent of families kept the walker, and 32% used the walker again for the study patient or another child after the injury episode. Fifty-nine p ercent of parents acknowledged that they were aware of the potential d angers of babywalkers before the injury event. Fifty-six percent of pa rents favored a national ban on the sale of walkers, and 20% were oppo sed. Conclusion. Despite the currently used prevention strategies, inc luding adult supervision, warning labels, care giver education program s, and stairway gates, serious injuries associated with babywalkers co ntinue to occur to young children. The US Consumer Product Safety Comm ission should promulgate a rule, similar to the voluntary standard ado pted in Canada, regarding design requirements for babywalkers that wil l prevent their passage through household doorways at the head of stai rs. The manufacture and sale of mobile babywalkers that do not meet th is new standard should be banned in the US. A recall or trade-in campa ign should be conducted nationally to decrease the number of existing babywalkers.