Healthy living Child accidents: a mitigable risk

When children start to explore and understand their environment, the most exciting and amazing moments can be experienced. Unfortunately, however, accidents can also happen – sometimes with serious consequences. In the case of babies and infants, accidents such as falls, burns or scalds in the home are particularly common. From primary school age, it becomes more common for accidents to occur outdoors. Parents, but also relatives, carers and teachers can better protect children against accidents if they are well informed about the risks.

It is important to know the most common hazards and to specifically think about improving safety in the home, for example.

At the same time, children should be helped to develop their own sense of risk awareness and to learn to behave in a safe manner. To do this, children require a lot of exercise and plenty of opportunities to test themselves in a protected environment. An understanding of child development can help people live up to these challenges.

We need various skills to identify and correctly deal with hazards. These include senses such as sight and hearing as well as the ability to control our movements, concentrate and have good judgment. These are skills that we only gradually develop during childhood and adolescence.

Developing the senses

Children can normally see and hear from birth. Despite this, their visual acuity and spatial vision still develop a great deal during the first few years of life. Spatial vision is important when it comes to estimating distances, for instance. Children’s spatial vision is only as good as that of adults once they are around 9 years old. The ability to distinguish between sounds and correctly determine where they are coming from is also not yet fully developed in young children.

Coordination and motor skills

New movement sequences often need a lot of practice before they no longer require our full attention. This also applies to adults. For example, when first learning to drive, people have to concentrate hard to simultaneously change gear, steer and keep their eye on traffic.

Avoiding hazards also requires complex processes in the body. First, sensory impressions are sent to the brain, where they are processed. The brain then plans the appropriate movements, which are ultimately performed by the body’s muscles.

In adults, many such movement patterns occur almost automatically. In small children, on the other hand, even seemingly simple movements still require full attention. For example, preschool children are unable to look around while cycling, reliably avoid pedestrians or brake quickly.

Concentration, attention and judgment

In their first two years of life in particular, children’s curiosity drives them to explore, look at, feel and taste everything. At the same time, they have not yet developed any sense of risk awareness. This makes it particularly easy for typical household accidents such as poisoning, scalding or falls to occur. 

The way two to six-year-olds think is largely self-centered. They are usually not yet able to understand other people’s perspective. For example, children of this age will assume that a car driver can automatically see them if they can see the car. Children below school age are also easily distracted. They only develop an awareness of acute risks between the ages of 4 and 6 and a foresighted awareness of danger from about age 8. Children and adolescents are only able to assess risks as well as adults once they are about 10 to 15 years of age. At this point, their abilities to concentrate and think logically are also similar to those of an adult.

Children are most likely to have accidents in the places they spend most time. Typical accidents involving babies and infants include falls, poisoning, scalding or suffocation in the home. As children get older and more mobile, it becomes more common for accidents to occur in places such as playgrounds or as a result of road traffic. Boys have more accidents than girls – regardless of age.

Typical hazards in the home in the first few months of life

Whether from a changing table, bed or sofa, falls from height are among the most common types of accidents in the first six months of a child’s life. Whether you need to answer the door or quickly grab a towel from the cupboard, never leave your child unattended at a height. Always keep at least one hand on the child.

To avoid accidents involving suffocation, care should be taken to give children a safe place to sleep. Children’s beds should not contain items such as cuddly toys or pillows. A sleeping bag is safer than a blanket. In the first few months of life, children should also always be placed on their back to sleep. There should not be any small items that could be swallowed in children’s beds or other places within their reach.

To avoid scalding, never drink hot tea or coffee while carrying your child. You should also always check the water temperature (36–37°C) before putting your child in the bath and tightly seal hot water bottles.

What do I need to consider in my home when my child becomes more mobile?

From their first attempt to stand to their first steps – the more mobile children are, the more important it is for your home to be child-safe. This can include:

• protecting sockets with a socket guard (please note that this recommendation may not apply outside Germany due to differences in socket and guard types)
• keeping power cables out of the reach of children
• attaching shelving units to the wall so that they cannot tip over if children pull on them
• putting padding on furniture corners
• installing stair gates
• putting locks on windows and balcony doors
• dispensing with baby walkers (risk of falling downstairs)

The use of tablecloths should also be avoided as children can be scalded by hot drinks if they pull on them. The following safety precautions should also be followed in order to avoid scalding and burns:

• Always turn the handles of pots and pans on the stove to face backward.
• Use the rear hobs on the stove where possible.
• Use guards to keep children away from hot surfaces such as stoves, ovens or hobs.
• Do not place hot liquids on the edge of a table. 
• Store kettles and irons in a safe place.
• Always store matches and lighters out of the reach of children.

To avoid accidents involving suffocation, items such as plastic bags or tissue packaging should also be kept away from young children. Small items that are left lying around can also get into a child’s mouth or nose and be inhaled.

In addition to inhalation, it can also be particularly dangerous for certain items to be swallowed. For example, if several magnets or a magnet and small metal parts are swallowed, these can attract each other in the intestines. In doing so, they can clamp around the intestinal wall, leading to life-threatening injuries. On the other hand, button batteries that have been swallowed can cause severe burns to the esophagus. If your child has swallowed a magnet or a battery, immediately call the emergency services on 112 or go straight to an emergency department. Cleaning products and other household chemicals can also cause severe burns or poisoning and should always be stored safely.

Typical outdoor hazards

One of the key hazards for children is road traffic. This also applies to young children as passengers in a car, in a child seat on a bike or simply as pedestrians. Children see their environment differently to adults and are unable to appropriately assess distances and speeds until the age of 10. Even in the case of older children, you should therefore be particularly careful and regularly practice road safety with your child. Think about setting a good example and always follow the rules of the road yourself.

The safety regulations for children as passengers in a car can be found, for example, on the portal kindergesundheit-info.

There are also a few things to consider when children first learn to ride a bike. The bike should be of a size that enables the child to put both feet on the ground when sitting on the saddle. Children should also be able to sit as upright as possible.

You should also get your child used to wearing a helmet from day one. Think about the fact that preschool-aged children are unable to look around while cycling, avoid pedestrians or brake quickly. Children under the age of 8 must ride on the pavement, with parents allowed to accompany them on their own bike. From age 11, even children have to use bike paths.

Drowning is the third most common type of accident that leads to death in small children (after traffic accidents and accidents involving suffocation). The center of gravity of children’s bodies differs from that of adults due to their head being comparatively large compared to their body. This makes it harder for children to surface in water and makes it easier for them to drown, often silently. Never leave your child unattended in or by paddling pools or garden ponds! This applies even if you use swimming aids such as armbands. Secure areas of water in the garden. Once children turn 4, they should learn to swim as soon as possible.

Child safety does not only depend on adults keeping an eye on potential hazards. It is just as important for children to gather their own experiences and test themselves. This is the only way they will learn to develop their own sense of risk awareness and be able to protect themselves against hazards over the long term. As such, it is not useful to “wrap children in cotton wool” in case they have an accident.

Make children aware of hazards right from the start, even if they do not yet understand everything. Young children in particular are “getting to grips” with their environment in the truest sense of the phrase. Fun ways to practice safety could include enabling your child, under your supervision, to find out for him/herself that a needle is sharp. Allow your child to feel the difference between hot and cold, for example by using ice cubes and a bottle of water with a temperature of around 40°C.

Children who are not active enough sometimes massively overestimate their abilities. This leads to riskier behavior and a higher risk of accidents.

You should therefore offer your child plenty of opportunities to move around, climb, balance and play. Don’t help your child too much – only be at their side if it gets dangerous. This enables your child to develop their coordination and motor skills and teaches them to correctly assess their abilities. 

People who are aware of the most common hazards and the ways in which accidents can be prevented can reduce the risk of child accidents. However, there is no guarantee that they can be ruled out entirely. It is therefore important to know what to do if a child is injured or has an accident. Important tips and advice on what to do in the event of typical child emergencies can be found, for example, in our article First aid for children.

Parents and legal guardians, but also people who regularly work with children, can also complete first aid courses that are specially geared toward treating children. These teach people everything they should know in an emergency: from how to treat wounds and burns to chest compressions for children.

The following organizations all offer child first aid courses:
German Red Cross (DRK)
Workers’ Samaritan Federation (ASB)
St. John Accident Assistance (Johanniter-Unfall-Hilfe e.V.)
Malteser Aid Agency (Malteser Hilfsdienst e.V.)

Detailed information about child safety can be found on many websites, including the following: kindergesundheit-info-de from the Federal Institute of Public Health (Bundesinstitut für Öffentliche Gesundheit, BIÖG), kindersicherheit.de from the German Association for Child Safety (Bundesarbeitsgemeinschaft Mehr Sicherheit für Kinder e.V.) or the German Association for the Prevention of Road Accidents (Verkehrswacht).

BIÖG also provides the free guide for parents “Protect Children – Prevent Accidents” (Kinder schützen – Unfälle verhüten) – in German only.