Children under five are at significant risk of death, disability and serious injury from unintentional injury. Public Health England makes a strong argument to focus on tackling the leading, preventable causes of death and serious long-term harm. 

Falls are one of five principal causes of serious injuries for the under-fives in England. Here we look in more detail at the issue and the steps local authorities and their partners can take.

The scale and nature of the problem

Falls lead to the most accident-related admissions for the under-fives – nearly 20,000 each year in England. 

90 percent of the admissions are for less than two days. However, even a fall from a low height can have serious consequences including brain damage. About 700 under-fives stay in hospital for more than three days a year. 

Falls are also the third most common cause of death for this age group but these are still rare – about five a year. 

There are four broad groups of serious falls for the under-fives:

  • Falls from furniture including beds and chairs lead to most of the hospital admissions but few deaths. They result in average lengths of emergency admissions.
  • Falls on and from stairs and steps continue to be a leading cause of hospital admissions for the under-fives – especially for one and two year olds. Deaths are very rare.
  • Falls while being carried have resulted in five deaths in the past five years. These injuries primarily affect children under the age of one.
  • Falls from/out of buildings such as from windows or balconies led to five deaths during 2008-12.

The links with child development

Falls are an inevitable part of growing up for babies and young children – initially their heads are a large proportion of their body mass which makes them unstable. Their centre of gravity gradually changes as they develop and begin to roll, crawl and walk. However, much can be done to prevent serious falls with long-term consequences for children and their families.

The economic case for prevention

Injury prevention can be low cost and there is a tremendous return for young children in terms of disability adjusted life years. For example, the lifetime educational and social care costs for a three-year-old child who suffers a severe traumatic brain injury from a serious fall at home total £1.43m.

Action by local authorities and their partners

PHE shows that injury prevention does not require major new investment – much can be achieved by co-ordinating existing services and programmes, building on strengths and developing capacity. Support and training for the early years workforce is key. 

Injury prevention initiatives can include home safety equipment schemes that supply and fit safety gates and window restrictors, and educational campaigns and resources on falls prevention.

Support from CAPT

CAPT worked closely with PHE to develop the resources and is now offering local authorities evidence-based support for effective action. This includes an opportunity to talk through the PHE guidance and explore local prevention opportunities. To find out more, contact Kevin Lowe on 020 7608 7363.

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Updated September 2014