Childhood Falls

The type and severity of falls in children are often related to their age and developmental stage. 

Infants (birth to one year old)

• Most infant falls happen at home and are the result of falling from a raised surface, such as a bed, couch, chair, change table or down stairs
• During the first year, infants learn to roll and then progress to sitting, crawling, standing and eventually taking their first steps. These new skills require extra safety precautions, such as close supervision, creating a safe space, and the use of safety devices, like stair gates

Toddlers and preschoolers (two to four years old)

• Falls for toddlers usually happen at home and are commonly caused by slipping, tripping and falling out of bed, down stairs or from high places
• Toddlers begin to walk, run and climb but they do not have the balance and coordination of older children. They require close supervision, assistance and a safe place to play and explore

Primary school age (five to nine years old)

• Playgrounds are the most common area for falls for children in this age group
• Playground falls often cause upper extremity injuries, with arm fractures being the most common
• At this age, children try different activities, spend more time in new surroundings and become more independent. These changes are important for their growth and development, but also expose them to new risks. They are often not able to sense danger, or identify and avoid hazards and need adults to help them manage these new challenges

Many falls can be prevented. Parents and caregivers play a key role in protecting children from fall-related injuries.

Actively supervise

• Watch, listen and stay close to your child
• Infants and young children should never be left unattended
• If you need to step away, put the child in a safe place, like a crib or playpen free from hazards
• Supervise more closely as the level of risk goes up
• For older children, keep watch while giving your child the chance to explore and develop

Recognize risks and take precautions to create a safe environment

• Take the time to survey your home for things that may cause your child to fall
• Give your child a safe place to play
• Remove your child from danger

Anticipate new skills and be prepared

• A fall often happens when a child has learned a new developmental skill
• Learn about your child’s developmental stage and plan ahead for your child’s future skills and abilities

Teach and role model safe behaviours

• Teach and reinforce safety rules. Children may need reminders before changing behaviour
• Help school age children manage risk
• Do not assume a child understands safe practices and hazards
• Do not accept that falls and fall-related injuries are a way to teach children how to be independent or to avoid risk
• Always model safe behaviours for children

Take the time to survey your home for things that may cause your child to fall. Get down on your hands and knees to look at your home from a child’s point of view

Here are some recommendations to get started:

• Never step away from your baby when they are on a raised surface, like on a change table or a bed
• When changing your baby on a change table, keep at least one hand on your baby at all times
• Use safety straps when your child is in a stroller, high chair, car seat, infant seat or on a change table
• Place car seats and other carriers on the floor, not on top of counters or furniture
• Make sure your crib, infant and child equipment, and home safety devices meet Canadian safety standards
• Lock and raise the crib rail to its highest position when your baby is in the crib
• Move the crib mattress to its lowest level when your baby begins to push up on their hands and knees
• Once a child is taller than 90 cm (35 inches), move them out of the crib and into a toddler bed
• Install safety gates at the top and bottom of all stairways; the top must be anchored to the wall, not pressure mounted
• Keep pathways, hallways, stairs and exits clear of objects and toys, accessible and well-lit
• Use locks and guards on patio and balcony doors
• Install window stops or guards
• Prevent children from climbing to windows that open by moving furniture away
• Install child-resistant door knob covers for basement or exit doors
• Use a non-skid mat in the bathtub

Use the Preventing Harmful Childhood Falls: A Fall-Proof Checklist to complete a more thorough assessment of potential fall risks at home and at play.