Hazards Associated with Sitting and Carrying Devices for Children Two Years and Younger.
OBJECTIVE
To analyze reported mechanisms of injury and characterize risk factors for infants and young children ≤ 2 years of age who died in sitting and carrying devices.


METHODS
A retrospective review of deaths involving sitting and carrying devices (car seats, bouncers, swings, strollers, and slings) reported to the US Consumer Product Safety Commission between 2004 and 2008.


RESULTS
Of the 47 deaths analyzed, 31 occurred in car seats, 5 in slings, 4 each in swings and bouncers, and 3 in strollers. The reported elapsed time between the last time a child was seen by a caregiver and found deceased varied greatly, with a mean of 26 minutes in slings; 32 minutes in strollers; 140 minutes in car seats; 150 minutes in bouncers; and 300 minutes in swings. The cause of death was asphyxiation in all cases except one. Fifty-two percent of deaths in car seats were attributed to strangulation from straps; the others were attributed to positional asphyxia.


CONCLUSIONS
Infants and children 2 years of age and younger should be properly restrained and not be left unsupervised in sitting and carrying devices. Car seats should not be used as sleeping areas outside of the vehicle, and children should never be in a car seat with unbuckled or partially buckled straps. Infants in slings should have their faces visible and above the edge of the sling, should not have their faces covered by fabric, and their chins should not be compressed into their chests.
Departments of Pediatrics and Family and Community Medicine, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA. Electronic address: ebatra@hmc.psu.edu.
Erich K
EK
Batra
Office of Hazard Identification and Reduction, US Consumer Product Safety Commission, Bethesda, MD.
Jonathan D
JD
Midgett
Division of General Pediatrics and Community Health, Goldberg Center for Community Pediatric Health, Children's National Medical Center, Washington, DC; Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC.
Rachel Y
RY
Moon
D001237:Asphyxia / Q000401:mortality*; D002423:Cause of Death; D002675:Child, Preschool; D003257:Consumer Product Safety; D005260:Female; D006801:Humans; D007223:Infant; D015370:Infant Equipment / Q000009:adverse effects*; D007231:Infant, Newborn; D008297:Male; D011187:Posture; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology