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Infant Carrier-Related Falls: An Unrecognized Danger

Objective: Our objective was to describe young children injured through the use of infant carrier car seats, comparing them with children injured through other fall mechanisms. Methods: We performed a retrospective chart review of children 18 months or younger with a fall mechanism of injury presenting to the emergency department of a tertiary care level 1 pediatric trauma center from August 2004 to December 2005. The primary outcome measure of the study was to determine the pattern of injuries sustained by infants falling from infant carrier seats. Results: Eight hundred three children were identified. There were 62 patients (7.7%) with infant carrier falls with a mean age of 4.4 months. Of these patients, 87.1% were not buckled into their carriers. Infant carrier-related falls resulted in 22 hospitalizations (35.5%), including 6 pediatric intensive care unit admissions (9.7%). Thirteen patients in the group with infant carrier-related falls sustained intracranial injuries (ICIs; subdural hematoma, 8; epidural hematoma, 3; cerebral contusion, 1; and subarachnoid hemorrhage, 1); 1 patient required a craniotomy. Ten patients had isolated skull fractures, and 11 of the 13 patients with ICIs also had skull fractures. The 62 carrier patients were compared with 741 children with other fall mechanisms. The carrier group had more ICIs (P < 0.001) and hospitalizations (P < 0.001). When carrier injuries were compared with falls down stairs, there were more ICIs (13/62 vs. 2/68, P = 0.002) resulting from carrier injuries. Conclusions: Falls from infant carriers are common, often involve children unbuckled in their car seats, and represent a significant source of morbidity. Injury prevention measures such as education and manufacture labeling may be effective strategies.