Every year, thousands of babies suffer preventable injuries from falling off changing tables, beds, or other elevated surfaces. Between 2000 and 2018, approximately 2.3 million infants were rushed to emergency departments (EDs) due to unintentional falls in the United States.
Many parents underestimate how quickly a baby can move, but education and awareness play a huge role in preventing falls. Miller Children’s & Women’s Hospital sees countless cases of completely preventable injuries from falls every year.
Why Infant Falls Are a Serious Concern
Infants are more vulnerable to falls than older children due to their developing bodies. Their heads are disproportionately larger compared to the rest of their bodies, making them top-heavy and less balanced during movement, which increases the chance of landing headfirst. Additionally, their neck muscles are still weak, providing less support to absorb impact. As a result, head injuries are more likely during a fall. Even a seemingly minor fall can lead to serious injuries, including skull fractures, concussions, or internal bleeding.
Because infants are unable to communicate their pain or symptoms effectively, it’s crucial for parents and caregivers to recognize the risks and take proactive measures to prevent falls.
Why Changing Table Falls Happen
Although infants may appear immobile, their ability to kick, wiggle and roll develops quickly.
Common ways babies fall from changing tables:
- Sudden Movements: Babies can push off with their legs, shift their weight, or roll over unexpectedly.
- Reaching for Objects: A baby’s natural curiosity may lead them to reach for toys, wipes, or other nearby items, increasing the risk of rolling off the table.
- Multi-tasking Parents: It’s common for parents to get distracted, whether it be from a phone call or reaching to grab supplies. Turning away even for a second can be enough time for a baby to roll off.
- Unstable Changing Tables: Narrow or poorly designed tables without adequate safety features increase the risk of falls.
- Using Beds or Sofas as Changing Areas: While convenient, these soft surfaces lack protective barriers, making it easier for babies to roll off.
Preventing Changing Table Falls
The good news is that most falls are preventable by following these essential safety precautions:
- Always Keep One Hand on Your Baby: Never leave your baby unattended, even for a moment. If you need to grab something, keep one hand on them at all times or take them with you.
- Use a Sturdy Changing Table: Choose a table with a wide, stable base and raised sides at least two inches high to prevent rolling. A safety strap adds extra protection but should never replace direct supervision.
- Have Supplies Within Reach: Before placing your baby on the table, ensure everything you need – diapers, wipes, creams, and clothing – is easily accessible so you don’t have to step away.
- Choose a Safe Location: If you do not have a proper changing table, it is best to opt for a safe, low to the ground option like a changing pad on the floor.
- Be Mindful of Your Baby’s Mobility: Once your baby starts rolling over, stay even more vigilant, as their movements become quicker and less predictable.
What To Do if Your Baby Falls From a Changing Table:
Despite precautions, accidents can still happen. If your baby falls, stay calm and assess the situation carefully.
Evaluate the Fall:
- How far did the baby fall?
- What surface did they land on?
- Did the baby hit anything on the way down?
The first instinct after a baby falls is often to pick them up. However, if they are hurt, picking them up may make the injury worse. Before making any movements, it is important to judge the situation.
Check Your Baby for Serious Injuries
Call 911, if any of these symptoms are present:
- Blood or fluid coming from the nose or ears
- Unresponsive or difficulty waking up
- Breathing difficulties
- Vomiting
- Seizures
- A swollen or bulging soft spot
- An obvious head injury (deep cut)
If a baby is exhibiting any of these symptoms, it is important not to pick them up but instead wait for the ambulance. The only exceptions are turning them on their side in case of a seizure or administering CPR if necessary. It is also important to pay particular attention to the head, as infants are prone to head injuries due to their proportionally larger heads and weaker neck muscles.
Parents and caregivers should know that unintentional falls rarely cause death among infants under one year of age, but they are the leading cause of non-fatal injuries.
Check for Any Broken Bones or Fractures
- Swelling or a visibly misshapen limb
- Difficulty moving or bearing weight on a limb
- Pain when touched or moved
- Skin appearing pale or cool to the touch
Broken bones and fractures require prompt medical treatment from pediatric orthopedic specialists to ensure proper healing and prevent long-term complications. The Orthopedic Center at Miller Children’s & Women’s Hospital provides specialized orthopedic care for children, offering expert surgical and non-surgical treatments. Their multidisciplinary team approach supports recovery and long-term mobility. Seeking timely, specialized care allows children to continue growing and developing without setbacks.
Check for Head Injuries
If your baby hit their head during the fall, there is a chance of a concussion. A concussion is a temporary and mild head injury. Some signs of a concussion include:
- Brief loss of consciousness
- Dazed or confused appearance
- Increased fussiness or unusual crying
- Vomiting (more than once)
- Mood or behavior changes
If you think your baby has a concussion, it’s important to notify your baby’s pediatrician and have them evaluated. Mild concussions usually resolve within a few weeks, but all head injuries should be evaluated by a doctor. Our pediatric Emergency Department is specially equipped to treat infants, children, and teens with head injuries — from mild concussions to more serious trauma. As a designated trauma center, we provide specialized, around-the-clock care tailored specifically to children’s unique needs.
Seek Immediate Medical Care If Your Baby:
- Throws up more than once or after the fall
- Has balance problems (if they walk)
- Has new weakness in any limbs
- Has a seizure
If your baby does not have any of the above symptoms
- Comfort Them: Hold and soothe your baby to provide reassurance
- Apply a Cold Compress: For minor bumps or bruises, gently apply a cold compress to reduce swelling. Ensure the compress is not too cold and is wrapped in a cloth to protect your baby’s skin
- Observe Closely: Continue to monitor your baby for the next 24 hours
Key Takeaways for Parents and Caregivers
- Never leave your baby unattended on a changing table, bed, or other elevated surface
- Always keep one hand on your baby during diaper changes
- Have all changing supplies within arm’s reach before starting
- Be aware of the surface you are changing your baby on including the surrounding areas and height of the changing table
- Seek medical attention if your baby shows any signs of serious injury after a fall
By making small but impactful changes in daily routines, parents and caregivers can significantly reduce the risk of falls and keep their baby safe. In cases where a fall results in a serious injury, the Cherese Mari Laulhere Pediatric Intensive Care Unit at Miller Children’s & Women’s Hospital provides round-the-clock care with specialized care teams equipped to handle complex trauma, ensuring the highest level of support for infants and young children.
