Each year, hundreds of children in the United States younger than age 1 year die of injuries, most of which could have been easily prevented.

In 2009, the CDC recorded 1,181 deaths caused by events falling under the heading of “unintentional injury” among children younger than age 1 year. The majority of deaths (n=907) were caused by suffocation, followed by motor-vehicle traffic accidents (n=91). In the same year, a total of 1,466 youths aged 1 to 4 years died from causes including drowning (n=450), motor-vehicle traffic accidents (n=362) and burns (n=169) among other injuries.1

Primary-care clinicians need to educate parents of young children on dangers such as suffocation, car safety, falls, burns and choking. Specific prevention strategies exist for children in each age group. For instance, parents who have a child younger than age 6 months should receive instruction on the proper installation of car seats and stairway gates, and be reminded to never carry a baby and hot foods or hot drinks at the same time.

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The CDC notes in its report that the high incidence of infant suffocation underscores the importance of a safe sleeping environment as recommended by the American Academy of Pediatrics (AAP), including supine positioning, a firm sleep surface, room-sharing without bed-sharing and avoidance of loose bedding. In addition, the agency has developed the Sudden Unexpected Infant Death (SUID) Case Registry, aimed at better understanding and ultimately preventing SUID deaths, which include suffocation in bed.

Car seats for babies should be installed according to the product’s instructions and the recommendations found in the automobile owner’s manual. Be sure the parent also knows whether the car seat should be rear-facing or front-facing.

A 2007 report in Injury Prevention concluded that rear-facing child-safety seats are more protective than front-facing seats for children up to age 23 months.2 A 2011 policy statement from the AAP advises parents to keep children in rear-facing car seats until age 2 years or until the child reaches the maximum height and weight for the seat.3

The Mayo Clinic provides some excellent suggestions for fall prevention in the home, such as never leaving a baby alone on a bed, a changing table or a piece of furniture; discouraging  play near windows and patio doors, which could lead to a fall through glass; and using night-lights in the child’s bedroom, in the bathroom and in hallways to prevent falls at night.

One easy way to educate new parents is by cell phone. Text4baby is a program that sends educational text messages at no charge, starting from the mother’s pregnancy and continuing throughout the baby’s first year of life.

The cell-phone messages are timed to the mother’s due date or the baby’s date of birth, so the tips and information the mother receives are coordinated with the baby’s prenatal and postnatal growth and development. Some topics covered are birth-defect prevention, developmental milestones and immunizations.

Debra Clements Coats, RN, BSN, CRNP-FNP, student, who recently completed a pediatric rotation, works in an internal-medicine practice and an infectious-diseases practice. 


  1. MMWR.Morb Mortal Wkly Rep. 2012 Apr 20;61:270-6.
  2. Henary B et al. Inj Prev. 2007;13(6):398-402.
  3. Committee on Injury, Violence, and Poison Prevention, Durbin DR. Pediatrics. 2011. Apr;127(4):788-93.