Getting hurt is part of being a kid — and we all want to stick to minor bumps and bruises worthy of a Band-Aid and not a hospital stay. Injury is the number one cause of death in kids and teens in the U.S., according to the Centers for Disease Control and Prevention. The good news is you can prevent many serious injuries.
“The way I think about injury prevention in broad terms is there are two parts,” says Megan Marino, a pediatric emergency medicine physician with Ochsner Health System in New Orleans. “There’s preparation: making sure kids are in a safe space. If we’re talking about a home, doing applicable things to childproof a home… In the moment, it’s about supervision, making sure there’s an adult available to supervise, not distracted by the phone or on the computer and not intoxicated. If you’re somewhere that’s not been childproofed, keep both eyes on the kids and both hands close.”
Knowing which injuries are most common can help you understand how to best childproof and what to look out for while you’re supervising, adds Jill Creighton, assistant professor of clinical pediatrics and medical director of ambulatory primary care pediatrics at Stony Brook Medicine in Stony Brook, New York.
These are the top causes of injury in kids, according to the National Institutes of Health (NIH) and the best (as well as the most surprising) ways to prevent them.
1. Motor vehicle accidents
Toting kids to and from play dates, sports practice and dance lessons comes with risks. In fact, motor vehicle accidents are the number one injury-related cause of death. Every hour, around 150 children visit emergency departments due to serious injuries from these accidents, according to the NIH.
“Sadly, many of these happen to be related to lack of seat belts or using seat belts incorrectly,” says Christina Johns, senior medical advisor at PM Pediatrics in Annapolis, Maryland.
How to protect babies and toddlers: Use the correct car seat for the child’s height and weight, and don’t be in a rush to turn the car seat forward-facing as they grow. Rear-facing is safer until you hit the maximum height and weight the seat allows. The American Academy of Pediatrics recommends kids ride rear-facing until at least age 2, even if their legs seem a bit scrunched up.
“Three out of four car seats are installed incorrectly,” says Creighton. “Car seats can reduce the risk of death during a car accident by greater than 70 percent, but if not installed correctly, this benefit is greatly reduced.”
Read the seat’s manual carefully, and look for local hospital or community programs where safety pros can check that your seat is installed correctly.
How to protect bigger kids: Keep kids seated in the back seat, which is always safer than the front. And use a booster until the car’s seat belt fits them properly, which is at about a height of 4’9″ and age 8 to 12, according to the AAP.
“The crash data is really compelling,” Johns says. “Incorrect seat belt positioning can create pretty significant abdominal and spinal injuries.”
Did you know? “If your car seat has been in an accident, you need a new car seat,” says Marino.
2. Suffocation
It’s every parent and caregiver’s worst nightmare: A child who’s unable to breathe. Sleep, food and toy safety are important in preventing suffocation.
How to protect babies and toddlers: Infants are most likely to suffocate while they sleep. Keep the baby’s crib free of toys, puffy blankets, pillows and any other objects. Baby bumpers may be cute, but both the AAP and the CPSC (U.S. Consumer Product Safety Commision) deem them unsafe. All the crib really should have is a fitted sheet on the mattress and perhaps one receiving blanket — or you can dress the baby in a sleep sack instead.
The AAP says babies should always sleep on their backs in their own, separate sleep space. It can be hard not to co-sleep, especially if you’re doing overnight care and the baby cries each time you put him down. But “130 babies die each year just from co-sleeping,” says Marino. “These are healthy babies that otherwise would have been fine.”
For toddlers, choking is the biggest cause of suffocation. Cut all foods into very small bites, especially those that can be tough to chew. Avoid common choking hazards, such as whole grapes, nuts, raisins and popcorn for kids under age 4.
How to protect bigger kids: “Don’t allow kids to run around with food in their mouth of any sort,” says Johns.
Did you know? Don’t let small children play with balloons, since they tend to put things in their mouths.
“They can get stuck in the wind pipe and turn it into a one-way valve that doesn’t allow them to breathe,” says Johns.
Window blind cords can cause strangulation — keep them tied up way out of reach, or better yet, get rid of them completely. Other long cords, such as jump ropes, can also be turned into a hazard.
3. Drowning
Three children die each day from drowning in the U.S, and drowning is the most common cause of death from injury in kids ages 1 to 4, according to the NIH.
How to protect babies and toddlers: Never leave a child in a pool area unattended, even for a second. And if there’s a pool — or any body of water on the property — follow all the safety rules recommended by the AAP, including having a four-sided fence and a child-proof latch on the gate that only an adult can reach.
“Small children can drown in 2 inches of water,” says Marino, so practice extra caution if there’s a pond or stream nearby, as well.
How to protect bigger kids: “It’s not just enough to have an adult beside the pool assigned to watching the kids,” says Johns. “You need to be within arm’s reach of the child. People think wearing water wings are OK, but they’re not. A Coast Guard-approved flotation device is the way to go. Get the child swim lessons really early in the game, too.”
A U.S. Coast Guard-approved flotation device will be marketed as such and will have an approval number printed on it.
Any time a child goes missing, always check the bottom of the pool first — even if you think the child is probably in their bedroom or somewhere else safe. If she’s in the pool, every second is crucial.
Did you know? “Most people worry about kids drowning in pools, but children more commonly drown in their own bathroom or house (in places such as a) tub, toilet or bucket,” says Creighton. “Using toilet seat locks, cabinet locks and safety gates and ensuring toys are big enough not to cause choking could save a child’s life.”
4. Poisoning
Each day, more than 300 children in the U.S. go to emergency departments because of poisoning. Two die each day. Household chemicals, cleaners and medicines are often the culprits, says the NIH.
How to protect babies and toddlers: Babyproof your home by removing all medications and chemical cleaners and putting them high out of reach. Even kids’ medications, such as Tylenol or gummy vitamins, can be damaging or life-threatening when taken in large doses — and they’re tempting to kids because they taste sweet. Also, dishwashing and laundry pods look a lot like candy but can cause burns in the esophagus if a child bites into them.
“Always call Poison Control if you think the child ingested something they shouldn’t,” says Marino. “If you’re not sure what it was, you should come to the emergency room.”
How to protect bigger kids: Unfortunately, older kids get curious and may take medications knowingly. So take the childproofing a step further and put meds in a locked box with the key in a separate, secret location, as kids tend to figure out almost anything.
Did you know? Your purse or handbag should be medication-free too. Children tend to go into purses and think they’re getting candy or a mint but are really grabbing medication, some of which can be fatal to small bodies.
5. Burns
More than 300 children go to emergency departments every day to be treated for burns, according to the NIH, and two children die every day from serious burns.
How to protect babies and toddlers: The younger set tends to get burnt by hot liquids or steam, but there are a few precautions you can take to cut down on their risk. First, set the water heater to 120 degrees or lower.
“That means that even if child is having bath and knocks the faucet handle, we know that they will not have second- and third-degree burns,” says Marino.
When cooking, turn pot handles toward the stove, so little hands can’t pull them, and get childproofing safety items like knob covers for the stove and a locking latch for the oven. Keep an eagle eye on kids in the kitchen in general.
How to protect bigger kids: Older kids are more likely to be burned from direct contact with fire. Keep any lighters — whether for cigarettes, candles or outdoor grills — well out of reach of kids.
“A lot lighters have a safety mechanism but will still allow a spark,” Marino says. “Just a spark can cause a burn in a child.”
Did you know? Always seek medical care to burns on the face, hands, feet, genitals or located near a joint. Also visit a doctor anytime clothing is stuck to the burn, if the child has a fever, if you don’t know if they’re up to date on their tetanus shots or if they have a medical condition that could inhibit the healing process, says Johns.
6. Falls
Falls are the most common cause of nonfatal injuries for children. Each day in the U.S., about 8,000 children visit emergency departments due to injuries from falls, according to the NIH.
How to protect babies and toddlers: Babies can fall from changing tables and beds, so clip the baby into the changing pad and handle her as if she can roll over, even if she hasn’t done it yet. They tend to roll when we least expect it. Car seat carriers have been known to fall off tables and other surfaces, so never rest them above the ground. Second floor and higher windows should have safety window guards installed, too.
“A baby that falls should absolutely be evaluated for a head injury in the ER,” says Marino.
How to protect bigger kids: Make sure kids are wearing helmets when riding their bikes, skateboards, scooters and anything else with wheels. Elbow and knee pads are a good idea, too. Choose playgrounds based on the recommended age, often posted on a nearby sign.
“Moving injuries are more likely to occur if children too young are allowed to play on equipment not indicated for their age group,” says Creighton.
Did you know? “Good sleep — for everyone in the house — can help prevent injuries,” says Creighton. “Children are more likely to fall and have more serious injuries when tired.”
Adults are much less accident prone when well rested, too.
Other injury causes
Our experts flag a few other important ways you can prevent injuries:
- Guns: If there’s a gun in the home, it should be secured in a locked case, with the ammunition stored far away. According to AAP research from 2017, nearly 1,300 children die and 5,790 are treated for gunshot wounds each year.
- Small magnets: These aren’t just choking hazards. If swallowed, tiny magnets — which can come as part of older kids’ playsets — can become attracted to each other inside the body and cause perforation of the intestines and other serious injuries. Keep them far away from small kids. If you think the child has swallowed one, head to the ER, says Marino.
- Button batteries: Button batteries are inside some toys, remote controls and other devices. The batteries are caustic and can do serious internal damage and even cause death if swallowed. Keep anything with a button battery out of the reach of small kids, and if a toy breaks, take it away from the child immediately.
- Hot cars: Never leave a child in a car unattended, even if it doesn’t seem hot outside and even if a window is cracked. The temperature can quickly rise to a fatal level.
Important numbers and locations
Every parent and caregiver should have these phone numbers programmed into their contacts and written down. Also, know where the closest ER is.
- 911: We all know 911, but it’s important to know when to use it. If the child was submerged in water or if the child is having trouble breathing — if they’re breathing faster than 60 times a minute, turning blue, has stopped breathing — or they’ve fallen and are unconscious, call 911 right away, says Marino. (See more reasons here.) If you’re around other adults, ask one of them for help, either to call 911 or to tend to the hurt child.
- Emergency room: Go to the ER if the child is in a car accident where the airbag was deployed, where someone else was injured or where they weren’t in the car seat, says Marino. Also go to the ER if a child has a seizure that lasts more than five minutes, she says, adding, “If you’re wondering if the child needs to see a doctor that day, the answer is yes. Call a pediatrician, go to urgent care, go to the ER — never worry about overreacting.”
- Child’s pediatrician or nurse practitioner: Find out how the child’s primary physician handles calls for minor injuries in which case you might need immediate advice. Some will put questions through to the doctor personally. Others have a nurse practitioner line, where you can receive advice, such as whether you should take the child to urgent care or how you can treat the wound yourself.
- Urgent care center: If the injury is minor but you think the child should be checked by a medical professional or might need a minor procedure, such as stitches, you may be able to bring them to an urgent care facility. Know in advance what urgent care center is nearest that specializes in pediatrics and accepts the child’s insurance. In some cases, you can call ahead to request a timeslot for the child to be seen.
- Poison Control, 800-222-1222: This is a national number that will connect you with a Poison Control Center near you. Call immediately if you suspect the child has ingested anything they shouldn’t, and you’ll get expert advice on what to do.
- Parents’ emergency line: If you’re a caregiver, you definitely have the child’s parents’ cell phone numbers, but what if they’re not available via cell and you need to contact them immediately? This can be tricky if they have an occupation where they’re unreachable for long periods or if they’re somewhere loud or where they don’t get a mobile signal. Some cell phones can be programmed with Emergency Bypass or Bypass Mode, where certain phone numbers can get through in an emergency, even in airplane or “do not disturb” mode. Know the restaurant or theater they’ll be at, the main landline to their office or their assistant’s contact information. Arranging a plan B with the parents in advance ensures that if it’s a life or death situation, you can get through to them. Hopefully, you’ll never need to use it.
