Falls are the most common cause of injuries treated in hospitals in all age groups. Even from birth, babies are always at risk of falling. Children are naturally curious and they often have the desire to climb in and on everything they see. 

Slips and falls are a normal part of a child’s development. For instance, when a child is learning to walk, stumbling is part of the process. To avoid injuries, the aim is to provide a safe environment where they can practise their new skills.

Many falls are not serious and may simply result in a bump or bruise, others may result in fractures, cuts or head injuries. There are many actions you can take to prevent more serious injuries.

Main causes of fall injuries

The most common falls in children 14 years old and younger include falls:

• involving playground equipment
• on the same level e.g. from slipping, tripping and stumbling
• involving ice skates, skis, rollerskates or skateboards.

Children under five were also likely to fall from chairs or highchairs.

There are three important factors that influence the seriousness of a fall.

• The height the child can fall from: the lower the height, the lower the danger. Children under five should not have access to heights over 1.5 metres. Older children should not have access to heights over two metres.
• What the child falls onto: hard surfaces such as concrete, ceramic tiles and even compacted sand are more hazardous to fall onto than softer surfaces. 
• What the child may hit as they fall: landing on sharp-edged furniture or glass can cause serious injuries.
  

Preventing falls at different ages

Babies

Place babies where they cannot fall. Babies wriggle from the time they are born and it is not long before they learn to roll over. When babies are able to roll, they can easily move across an area into danger.

• Babies may unexpectedly fall from a bed or change table. If there is no safety strap, always keep one hand on your baby when using a change table. Whenever feasible, consider using the floor when changing your baby.
• Never carry your baby around in a bouncer or rocker chair, and never place these products on tables or raised surfaces when your baby is using them. An active baby may move a bouncer, causing it to fall from a table or bench top.
• Do not use baby walkers. They give a young child the mobility to place themselves in danger quickly and unexpectedly. 
• Whenever your baby is in a pram or pusher, make sure their five-point safety harness is on. Whenever you are not holding onto the pram or pusher, make sure the brakes are on, and be sure not to overload the handles with bags or other items that could cause it to tip backwards.

Toddlers

A standing and toddling baby has frequent minor falls. To minimise these, look at the environment from their level.

• Create a clear area by removing rugs and tripping hazards (e.g. electrical cords).
• Pad sharp corners of benches and tables, or remove them from the play area.
• Use a safety gate at the top and bottom of stairs.
• Use a full body (five-point) harness in high chairs, strollers and shopping trolleys.
• Remove any toys from the cot that your toddler could use to climb on and fall out.
• When your child is ready to move from a cot to a bed, place a mattress on the floor to soften a fall.
• Be aware that falls are more common when a child is tired or unwell. Plan quiet activities for these occasions.

Children

Once a child has learnt to walk, they quickly manage to climb. Pre-school aged children have the physical ability to reach heights, but have no fear or understanding of the consequences of a fall. 

• Bunk beds are not recommended for children under nine years of age. Do not let children play on bunk beds, and ensure the top bunk has a guardrail.
• Lock windows in multi-storey buildings so that children cannot climb out, or ensure that the windows can only open less than 100 mm.
• Scissors, knives or glassware are some of the sharp objects that may cause serious injury if a child falls. Discourage children from walking or running with these objects, and teach them not to walk or run with anything in their mouths.
• Shopping trolleys can be very dangerous for children – do not allow your child to stand in the trolley or ride on the sides.

Preventing falls around the home 

Slippery areas

When wet, some surfaces become extremely slippery for all age groups.  A wet kitchen floor can become a potential crash scene for young children. It is safest to wipe up spills immediately. Encouraging children to sit when eating and drinking will help to reduce spills. 

Fall injuries are common in the bathroom due to the combination of water and potentially slippery surfaces. Make sure you have a slip-resistant bath/shower surface and slip-resistant flooring; rubber mats may be useful.

There are anti-slip flooring products commercially available to assist with indoor and outdoor areas. Products such as safety walk tape, rubberised paint, slip-resistant concrete spray and lock matting are examples of some of the products available. 

Glass

Falling onto windows or glass doors may result in serious injuries to children.

• Make glass doors and full-length windows visible by placing stickers at a child’s eye level.
• Consider using safety glass or a shatter-resistant film. Whenever glass is replaced in existing homes, have safety glass installed.
• Place furniture so children cannot run into windows or fall from furniture into glass.

Balconies

• Supervise children at all times when on balconies, and keep entrances to balconies locked to avoid them being used as a play area.
• Ensure the balcony surface is non-slip and that all tripping hazards are removed to prevent falls.
• Position balcony furniture away from railings to stop it being used for climbing. Use heavy balcony furniture that is harder for children to move, rather than light plastic furniture.
• Refer to your state's building code for details on required balustrade heights and railing gaps when building a new balcony.

For more information, see our fact sheets Safety: Backyards and playgrounds and Safety: Around the home.

Key points to remember

• Falls are a common cause of injuries and may result in fractures, cuts or head injuries.
• The severity of the injuries is affected by the height a child falls from, what they land on and what they can hit as they fall.
• Use safety harnesses on babies and toddlers in prams and pushers, high chairs, and shopping trolleys.
• Bunk beds are not recommended for children under nine years of age.
• Take steps around the home to prevent falls in relation to slippery surfaces, glass and balconies.

For more information

• Kids Health Info fact sheet: Safety: Backyards and playgrounds
• Kids Health Info fact sheet: Safety: Around the home
• Kids Health Info fact sheet: Head injury – general advice
• Kids Health Info fact sheet: Cuts, grazes and lacerations
  
• The RCH National Child Health Poll: Summer safety
  
• Product Safety Australia: Kids equipment
  
• Consumer Affairs Victoria Toy and Nursery Safety Line, ph. 1300 364 894

• Download our Falls Prevention poster in these languages: Arabic, Burmese, Chin (Hakha), Chinese, Dari, English, Karen, Khmer, Persian, Punjabi and Vietnamese

Developed by The Royal Children's Hospital Safety Centre. We acknowledge the input of RCH consumers and carers. 

Reviewed July 2018. 

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.