The parents were in tears, holding each other while the nurse and paramedic were securing their almost 4 month old baby girl onto the transport carrier on a stretcher that would take her to the pediatric trauma center.

About 3 hours earlier, the family had just come home from grocery shopping. The parents set the infant carrier to which their baby was secured on the kitchen countertop while they put their groceries away. The baby leaned forward and with a blink of an eye, the carrier toppled over the kitchen countertop. She struck her forehead onto the tiled kitchen floor. She seemed stunned for a few minutes, then started crying, and became difficult to console. The parents rushed her to their neighborhood emergency department.

A CT scan of the baby's head showed a skull fracture and small amount of brain bleeding. She needed an intravenous line, a cervical collar, and x-rays of her neck, and now an ambulance ride to the children's hospital. She will need to be observed at least overnight at the intensive care unit of the pediatric trauma center.

Unfortunately, the scenario above is not that uncommon. Roughly 50 children a day, or about two every hour, aged 5 years or younger, were treated in American EDs for a carrier or stroller-related injury from 1990 through 2010, based on a recent study published in Academic Pediatrics.

The researchers collected data regarding carrier or stroller-related injuries among children 5 years of age or younger recorded in the National Electronic Injury Surveillance System between 1990 and 2010. The rate of injuries declined during the study periodm but remained high with a total of 360,937 children treated in U.S. EDs during that time.

There were an estimated 99,057 carrier-related injuries, with a rate of 1 per 10,000 children. More than half of the patients treated were male, and the majority (89 percent) were younger than 1 year of age, and injured at home (78 percent). Almost two thirds of the patients fell from the carrier, and the carrier tipped over in more than one fourth of the situations . Soft tissue injuries (48 percent) and traumatic brain injuries/concussions (35 percent) were the most common diagnoses. About 6.5 percent of the injured patients were hospitalized, and 79 percent of the hospitalizations were for TBIs/ concussions.

An estimated 261,879 young children were treated for stroller-related injuries, with a rate of 4.8 per 10,000 children. Similarly, more than half were male, 42 percent were younger than 1 year of age, and 61 percent were injured at home. Most patients (67 percent) fell from strollers, and in 16 percent of patients, the stroller tipped over. Almost 40 percent had soft tissue injuries and 25 percent had TBIs/ concussions. Most injuries were minor. Only 2.4 percent required hospitalization, and TBIs/ concussions accounted for more than two thirds of the hospitalizations.

Carriers and strollers, designed to safely transport young children, are widely used by young families. In spite of regular improvements in product design, updates in manufacturing standards, and product recalls issued by the US Consumer Product Safety Commission, carriers and strollers are frequently associated with injuries in young children, requiring ED visits. In 2010, carriers and strollers were the first and third most common "nursery" product-related injuries in children 5 years of age or younger. Cribs and mattresses were second.

Even a single trip with a young child requires multiple transfers, and fastening and unfastening from one product to another. The need to sometimes transport multiple young children makes the task even more complex. It is therefore not surprising that injuries occur during the process. The rate of carrier and stroller-related injuries reported in this study underestimates the true incidence since injuries treated in other settings besides the ED were not captured.

We live in an environment when almost everyone is hustling and bustling to get from one place to another. When the hustling and bustling involve transporting young children, parents and care-givers need to be hyper-aware of the potential risks associated with the use of carriers and strollers. Here are some injury prevention tips:

  • Properly secure children to carriers or strollers every time.
  • Do not place these products on elevated surfaces to minimize the impact of tip-overs.
  • Even when young children are securely fastened to a carrier or stroller, do not leave them unattended or under the supervision of another child.
  • Exercise caution when using a stroller in a curb or in high traffic areas especially when there is no sidewalk.
  • Make sure children remain seated on the stroller at all times.
  • Do not hang heavy purses or bags on the stroller handles to prevent tipping it.
  • Always lock parked strollers.

Have a question for the Healthy Kids panel? Ask it here. Read more from the Healthy Kids blog »