Falls from household furniture
Detailed mechanisms for these falls included; falls from beds (146, 54.1%), falls from change tables (64, 23.7%), falls from chairs/couches/sofas (53, 19.6%) and falls from tables (6, 2.2%).
The most commonly mentioned precursor event for falls from household furniture, was the infant rolling off the furniture. This was mentioned 71 times within the 270 (26.3%) incidents related to furniture falls.
“Yesterday, my little girl (6 months) rolled off the bed. She hit her head … and screamed…”.
The next most common precursor event involved the infant being left alone on furniture. This was mentioned in 36 of the 270 (13.3%) incidents.
“I left her in the middle of my queen bed while I did some vacuuming. As I got closer to my bedroom … I could hear her screaming like she had never screamed before. I ran into the room and she was on the floor!... “
The caretaker falling asleep with the baby was another common precursor event, identified 18 times (6.7%).
“… I was breastfeeding him in bed and fell asleep with him on the outside. I woke up when I heard a thud and DS cry.”
It was clear from some discussions that the precursor event of falling asleep was often unintentional (10, 55.6%), while in others (6, 33.3%) it was intentional or intention was unclear (2, 11.1%).
For falls from change tables, a common precursor event was the caretaker reaching for something while nappy changing, identified 11 times within the 64 change table related incidents (17.2%).
“I was changing him on the change table and all I did was slip one hand down to put the dirty nappy in the nappy bag and ds launched himself off the table and landed on the floor…”
Unexpected or rapid changes in motor development was the most common influencing factor for furniture falls. This was identified 29 (10.7%) times.
“…when he had started to move - I underestimated how quick he was. I used to put him on our bed every morning while I got dressed. One day I turned my back for a second and in that time he pulled himself to the edge then did a somersault off the bed!”
Lapses in caretaker attention was the next most common influencing factor for this fall mechanism. This was identified 20 times (7.4%).
“… honestly it can happen in the blink of an eye. Similar to your DH I looked away from the table, and over he went. It was so quick”
Falls when carried or supported by someone
This was the second most common fall mechanism in the discussions (n=92). These commonly occurred when the child was carried or supported by the mother (39, 42.4%), or an unidentified parent (28, 30.4%); when the child was carried or supported by an adult caretaker other than a parent (19, 20.7%); and less commonly, when carried or supported by an older child (6, 6.5%).
The most common precursor for these falls was the caretaker tripping/slipping (29 of 92 incidents, 31.5%) and this often occurred on steps or stairs (18/29 incidents, 62.1%). Other environmental hazards within the home included slippery floors (2/29, 6.9%) and tripping hazards on the floor (2/29, 6.9%).
“I dropped my ds he was about 10 months triped up the back step he screamed has a giant bump … “
Another common precursor event for these falls was the person falling asleep while holding the infant (mentioned 15 times/ 92 incidents, 16.3%) and often involved the child’s mother falling asleep while feeding (12/15 incidents, 80.0%).
“…I was totally sleep deprived. Sat down on the couch to nurse her, dozed off with her snuggled low in my arms (basically in my lap) our dog barked and I startled awake - DD rolled down my legs and into the coffee table.”
A tired caretaker is also a likely influencing factor; however, this was only overtly discussed a few times (2/15). Other commonly discussed influencing factors were inadequate holding of the child (13 times/92 incidents, 14.1%) and sudden unexpected movements of the child (9/92 incidents, 9.8%).
“A friend was holding my 6 month old he had his arm tucked behind his legs holding him up right and wasn't supporting his back when my LO flung back …”
Fall from baby products
The most common products involved in falls were strollers/prams (21, 38.2%); bouncers (10, 18.2%); high-chairs/baby chairs (9, 16.4%); and bassinets/cots (9, 16.4%). Less commonly involved were baby carriers/capsules (3, 5.5%); child car restraints (2, 3.6%); and portable baby beds (1, 1.8%).
Improper use was the most common precursor event for these falls. Non-use or misuse of safety straps was common for many baby products (particularly for strollers/prams, baby bouncers, high chair/baby chair, child car restraints, baby capsules/carriers). This was identified 30 times (55%, 15 not using safety strap and 15 cases of apparent improper use of straps)
“Mother of the Year here took a few months to really internalise the 'strap them in' message and DD1 bounced herself face first out of the bouncer at about three months old”
Some other critical misuses identified were: cot base in high position (5, 9.1%), unbalancing the stroller (3, 5.5%), not using strollers’ brakes (2, 3.6%) and carrying the infant while in bouncer/portable baby bed (2, 3.6%). Falls from cots were influenced by rapid motor development.
“…like he was balancing on the cot railing with his feet off the mattress suspended in mid air by piece of wood- … “
Falls on the same level
Four different types of falls on the same level were mentioned. Most common was a fall while the infant was standing (20, 71.4%). Falls while the infant was sitting, falls while the infant was crawling and other falls due to being pushed by another person each had <five identified incidents.
The common influencing factor for this fall mechanism was the child’s under-developed motor skills (13, 46.4%).
“…Now that both are easily pulling themselves up against furniture to stand, they are doing it every chance they get. The only problem is once they get up they don't know how to get down or lose concentration, let go and fall...a lot of the time hitting their heads on the tiles.”
Fall on or from stairs
Falls on or from stairs were relatively uncommon (5 incidents). Two influencing factors for these were lapses in caretaker attention (3, 60%) and unexpected/rapid infant motor development (2, 40%).
“DS1 fell down the stairs - all 8 of them - when he was 4 months. He was lying at one end of the room, well away from the stairs. I put a book on the shelf and when I turned back he'd rolled across the room and I was just in time to see him disappear, screaming, down the stair well”
Other fall mechanisms
Other mechanisms identified from the discussions included falls from playground equipment or playmats and falls from shopping carts (10 incidents). Precursor events relating to falls from shopping carts was non-use of straps (3, 30%).
“…didn't bother to buckle him in. I was squatting down looking at something when I heard a horrible splat sound, he had fallen face first onto the cement floor …”
There were no detailed discussions to identify causal factors for falls from playground equipment and playmats. Also, there were no discussions of falls between levels e.g. from windows
Table 2 summarises pre cursor events and influencing factors for different fall mechanisms.