Baby Walkers Cause Thousands of ER Visits Every Year, Experts Warn

By Carolyn L. Todd

Seemingly innocent baby walkers are being called out as a serious safety hazard for American children. A new study shows that the devices have caused hundreds of thousands of ER visits in the U.S. over the past 25 years. Significantly, their findings support the American Academy of Pediatrics' (AAP) call for a total ban on the baby walker.

The study, published in the journal Pediatrics this month, analyzed data from the National Electronic Injury Surveillance System from 1990 to 2014, which collects information about patients treated in emergency departments from approximately 100 hospitals across the country. The researchers found that 230,676 children under the age of 15 months were treated in emergency rooms for infant-walker-related injuries in that time span, averaging 9,227 cases every year. But most kids were treated and released from the hospital, with only 4.5 percent being admitted for further treatment.

The type of injuries that occurred varied, but the vast majority of them (90.6 percent) were to the head and neck. Just over half (50.5 percent) of all injuries were to soft tissue, while 26.5 percent were concussions or blows to the head that did not break the skull. Lacerations accounted for 10.1 percent of the injuries, and fractures for 5.1 percent.

"Parents sometimes mistakenly think it's going to speed up their child's development and help them learn to walk, and it doesn't," Bonnie Lovette, R.N., a pediatric nurse practitioner and injury prevention coordinator of trauma services at UCSF Benioff Children's Hospital Oakland, tells SELF. "Really there is no reason why any child, baby, infant, [or] toddler should be using walkers."

In fact, there is some research to suggest baby walkers can actually cause a small delay in motor development because they cause babies to use their leg muscles in a different way, Kimberly Giuliano, M.D., a pediatrician at Cleveland Clinic, tells SELF.

There is indeed some evidence supporting this. For example, a study conducted in Ireland and published in the BMJ in 2002 compared the age at which 102 infants who used baby walkers and 88 infants who did not use baby walkers achieved certain locomotor milestones. They found that babies who used walkers started crawling on average 3.9 weeks later, standing alone 3.32 weeks later, and walking alone 2.98 weeks later than babies whose parents did not put them in walkers. They also found that the effect was cumulative, with every 24 aggregated hours of baby walker use being associated with a 3.3 day delay in walking alone. (One weakness of this study is that it relied on parents recording and reporting these dates, as opposed to clinical observation.)

"The explanation is that the muscle pattern that is used to scoot across the floor when you’re being suspended in the baby walker is different than the set of muscles used when you're pulling yourself up and learning to walk," pediatrician and study coauthor Gary Smith, M.D., director of the Center for Injury Research and Policy at Nationwide Children's Hospital, tells SELF.

And because infants can't see their legs and feet in a baby walker, they’re not getting the visual feedback associated with the movement of their limbs that they ordinarily would, Cynthia Katz, M.D., associate residency program director in the Department of Pediatrics of the Icahn School of Medicine at Mount Sinai, tells SELF.

"Every parent thinks, ‘Oh I would never let such and such happen, I would always watch them," Dr. Katz says. "But we know that injuries happen because even the best intended parents have moments where they take their eyes off the child—and it only takes a split second."

According to this study, staircases are the most common hazard, and falling down stairs in the walker accounted for 74.1 percent of injuries that sent infants to the ER. The second most common was falling out of the walker, which accounted for 14.7 percent of injuries. But there is no end to the number of other ways kids can endanger themselves with the help of a walker. "Even if a parent is watching 100 percent of the time, it's still possible for [the baby] to get to something much faster than a parent can—sharp objects, hot stoves, objects they can pull down."

Lovette says she has heard of children pulling on the edge of a table cloth, for instance, and inadvertently causing a hot mug of coffee sitting on the edge of a table to fall on them. Dr. Katz has seen children be burned by radiators.

Something to keep in mind is that this data only includes children whose injuries were severe enough for their parents to bring them to the ER, not children who had injuries that were treated at the pediatrician's or at home. "We don't even have the data for the minor injuries—the bumps, cuts, scrapes, bruises," Dr. Giuliano says.

This potential for harm, in combination with the lack of benefits and clearly demonstrated dangers, make it pretty easy to understand why pediatricians rail against baby walkers so strongly. "There's no good that can come out of them," as Lovette puts it. "There's no need to have them on the market."

"We’ve seen a dramatic decrease in the number of baby-walker-related injuries over the past two-and-a-half decades and we should be very happy about that," Dr. Smith says. The sharpest decline in walker–related injuries took place between 1990 and 2003, when ER visits went down by by 84.5 percent, which was mostly fueled by a 91 percent decrease in falls down stairs during that time period.

The study authors speculate that part of this plummet is thanks to an increase in public awareness about the risks associated with the products (following a failed petition by several groups, including the AAP and the Consumer Federation of America, to ban the product in 1992), as well as an uptick in the use of safer alternatives (like stationary activity centers, which hit the market in 1994), and there simply being fewer older walkers in homes.

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Another potential explanation for this progress are the increasingly stringent safety standards on the devices (established as voluntary in 1986, strengthened in 1997, and made mandatory in 2010. The most effective safety improvements, instituted in 1997, were a requirement that the walkers be wider than a standard doorway, preventing kids from moving through them, as well as a brake to stop the walker from going down stairs. After all of these manufacturing specifications were made compulsory by a federal mandatory safety standard in 2010, the average number of injuries fell 22.7 percent (when comparing the four years before the standard was enacted to the four years following), the study authors write.

Yet the danger remains. From 2011 to 2014, there were on average 2,165 injuries a year (compared to an average of 2,801 injuries annually from 2006–2009). That's why experts, including those at the AAP, are still pushing for a ban. "Despite that decrease, we should not decrease our vigilance on this issue," Dr. Smith says. "We should not relax and say we’ve solved the problem."

Pediatricians know that realistically, parents need to be able to have their hands free at different points during the day. Fortunately, there are better options out there that come with fewer risks and more benefits. Putting your child in a contained space where they can move around freely—"good old fashioned belly time," as Dr. Smith calls it—without getting into trouble is ideal. "This is how children develop their muscle coordination and strength, and learn to crawl [and] then walk."

Additionally, Dr. Giuliano is a fan of play yards and playpens for this reason. "The child is able to sit, crawl, walk, and learn to transition themselves between different positions and different types of activities," she says. "But it also keeps them safe, which the walkers are lacking."

And Levette recommends stationary activity centers, which are similar to walkers but don't have the wheels. However, Dr. Giuliano suggests only using them for short periods of time so that the child still has plenty of opportunity to move themselves around and develop their motor skills. "It really is best for motor development to have them crawling."

Dr. Katz is also a fan of a couple products that fall under this umbrella: the Exersaucer and the Jumparoo, both of which "allow for play and exploration of toys" while keeping your kid in one place. "The take home message here," Dr. Smith says, "is that parents do have safer alternatives."

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