CHILD-SEAT - HIDDEN PERIL: A child-seat is indisputably the only way to carry a baby in a car - but now a report has warned of the hidden danger. Image: Shutterstock
HERSHEY, Pensylvania - A study of young-child deaths in devices such as car seats, swings and baby-bouncers has exposed how most were caused by asphyxiation by improper positioning or strangulation in straps.
Particularly dangerous, it claimed, were incorrectly used car child safety-seats - though it emphasised that a child in a correctly adjusted car seat "was in very little danger".
Using these devices as directed and not as a substitute for a crib would reduce the risk of death.
USE THIS 'ABC'
The report's lead author, Erich Batra of Penn State College of Medicine in Hershey, Pennsylvania, said: "The overarching advice goes back to a more basic message of safe sleep."
He told Reuters Health. "For an infant, a safe sleep environment includes the ABCs: they sleep
Alone, not in Bed between parents, on their Back, or in a Crib or bassinet without any loose bedding."
Infants who fell asleep in one of the other devices, such as a car seat, he warned, should not be left unattended. "Infants should not be placed in these devices for sleep."
The researchers reviewed reports of 47 children younger than two years that happened in a car seat, bouncer, swing, stroller or sling and were recorded by the US Consumer Product Safety Commission between 2004 and 2008.
Most deaths, 31 of 47, occurred in a car seat. Five happened in a sling, four each in a swing or bouncer, three in strollers.
Batra explained that this was not a complete database of all such events, only those reported by buyers or manufacturers. So, while they appeared to be rare, the study could not assess how often they really happened.
About half of deaths in a car seat were due to strangulation by a strap; the other half by suffocation due to positioning, the authors reported in The Journal of Paediatrics.
Batra said car-seat strangulation usually happened when restraints were not fastened as directed; whenever a child was in a car seat the harness should be secured.
"If people leave an older infant or young toddler, in a car seat and undo the straps thinking that it makes them more comfortable, that's a significant hazard," he said. "A child properly secured in a car seat is in very little risk of danger."
MOST COMMON SETTING
Dr Shital Parikh, an orthopaedic surgeon at Cincinnati Children's Hospital Medical Cenre in Ohio, has studied the risk factors for injury in such devices in infants aged up to 12 months.
He also found a car child-seat to be the most common setting.
"The most common mechanism of injury was caused by infants falling from a car seat while it was NOT used in a car, but in the home," Parikh told Reuters Health. Often parents would bring the car seat in the house while the infant still slept, undo the straps, and place it on an elevated surface.
Even four-month-old babies, Parikh warned, were mobile enough to wriggle out of the top straps and fall, or topple the whole seat, from an elevated surface.
DEATH IN AS LITTLE AS FIVE MINUTES
"These are very simple things, very basic things," Parikh said. "The basic idea is that you use (the devices) for their intended purpose only. For infants, you should not use it to make them sleep or carry them around if it's not intended for that."
Batra added that most devices, used as directed, were relatively safe, but a baby in a sling needed to be "visible and kissable" or the child's head could end up in "a hazardous position".
Some deaths occurred after as little as four or five minutes of being left alone.SOURCE: The Journal of Paediatrics, online April 27, 2015.