Windows, balconies and climbing kids: preventing falls at home

Falls: the biggest culprit in the home

When parents think about danger at home, outlets and the stove usually come to mind first. The numbers tell a different story: falls are by far the most common cause of injury in young children. Dutch injury-prevention institute VeiligheidNL registers tens of thousands of emergency-room visits every year for children under four after a fall in or around the home. It ranges from falling off the changing table, out of bed or down the stairs to falling from a window, or simply tripping over a toy car on the floor. Most of these accidents happen at moments when an adult was actually nearby. That is not an accusation but an important insight: fall prevention is not about paying closer attention, it is about arranging your home so that a moment of distraction cannot have serious consequences.

How the fall risk grows along with your child

The type of fall changes with every developmental phase, which makes fall prevention a moving target. A newborn rolls off the changing table or the sofa unexpectedly, often at the exact moment a parent reaches for something. A crawler bumps into table edges and tumbles off the first stair step. Once your child pulls up and starts climbing, entirely new risks appear: the cot he tries to climb out of, the chair that becomes a step towards the windowsill, the chest of drawers used as a climbing frame. Children between two and four are the biggest risk group for the most serious falls, precisely because they can climb but have no sense of height or consequence yet. So walk through your home again at every new phase and ask: what can my child reach now, and what is standing underneath a window or next to a railing?

Windows: the most underestimated risk

Every year children in the Netherlands fall out of windows, and the outcome is regularly serious. The classic scenario is always the same: a window is open on a warm day, there is a bed, sofa or cabinet underneath it, and a toddler climbs up. A few things are structurally underestimated. An insect screen offers no protection whatsoever: it is made to keep mosquitoes out and pushes out with hardly any force. A tilted window looks safe, but a small child fits through a surprisingly narrow opening; anything wider than ten centimetres is too much. And children who cannot climb yet learn faster than you expect, usually in exactly the week you were not counting on it. So treat every window above the ground floor as a potential fall site, including that one transom window you assume your child could never reach.

Choosing and fitting window restrictors

Good window security means a window cannot open further than a gap of about ten centimetres, or only opens fully with a key or a deliberate adult action. For side-hung windows there are lockable window handles and add-on locks, for tilt windows there are restrictors that limit the opening. Choose a system you can unlock in one movement as an adult, because a window may also need to be an escape route in case of fire; that is exactly why you should never screw windows permanently shut. Fit the restrictors on every window on an upper floor, not just in the nursery: children get everywhere. If you rent, read our article on childproofing a rental home too; window restrictors can almost always be fitted without permission because most systems work with small screws or clamps. And the simplest advice is also the most important: never put a bed, sofa, cabinet or chair underneath an upstairs window.

Furniture as a climbing frame: anchoring is not optional

A chest of drawers looks stable, until a thirteen-kilo toddler pulls out all the drawers and uses them as a staircase. Tipping furniture causes serious accidents worldwide, and there is a reason manufacturers include an anti-tip strap with nearly every cabinet, which then stays in the bag. Anchor every cabinet, bookcase and dresser taller than your child to the wall with the supplied bracket or a separate anti-tip kit; it is a ten-minute job per piece of furniture. Do not forget the television: a falling flatscreen lands with tens of kilos of force at exactly child height. Put the TV on a low, wide unit, push it as far back as possible and secure it with a TV strap or wall mount. Check again after every move and with every new piece of furniture, because this is exactly the measure that gets forgotten when redecorating.

Six fixed rules for fall prevention

• •Never place furniture under an upstairs window: no bed, sofa, chair or cabinet as a stepping stone
• •Window restrictors on every window above the ground floor, with a maximum gap of ten centimetres
• •Every cabinet and the TV anchored to the wall with anti-tip straps, including in the nursery
• •Always one hand on your baby at the changing table, and change a wriggly baby on the floor
• •Stair gates at the top and bottom of the stairs as soon as your child becomes mobile
• •Lower the cot mattress to its lowest position as soon as your child can pull up

Balconies, galleries and roof terraces

If you live in an apartment, the balcony deserves the same attention as the windows. The railing itself is regulated in the Netherlands, but those rules do not protect against what is standing in front of the railing. A planter, side table or stack of cushions together make a perfectly good staircase for a determined toddler. So keep the edges of the balcony empty, or place furniture with its back against the facade instead of against the railing. Also check the spacing of the balusters: there should be no more than ten centimetres between vertical bars, and horizontal bars are by definition a climbing ladder. On older balcony railings you can mount a transparent safety net or acrylic panel on the inside. Never leave a child on a balcony unsupervised, not even for a moment: this is a place where the combination of height and climbability gives no second chance.

The changing table: the most common fall of all

The fall from the changing table is the classic among baby accidents, and it almost always happens in a fraction of a second: you turn around for a clean onesie and your baby rolls over for the first time. That is exactly why the rule is so strict: always keep one hand on your baby while he is on the changing table, and get everything you need ready before you start. Keep changing supplies within arm's reach so you never have to take a step. A changing pad with raised edges slows a rolling baby down at best, it does not stop him; never rely on it. Once your baby gets bigger and more mobile, simply change him on a mat on the floor or on the bed. It is less ergonomic, but a fall from zero centimetres is the only fall that is guaranteed to end well.

Make it a monthly round

Fall prevention is not a one-off job but a routine, because your child can do something new every month. So walk a fixed round through your home every month, literally on your knees, at your child's eye level. Look at what is standing under every window, pull on every cabinet to feel whether it is anchored, and consider for every piece of furniture whether it could by now serve as a step towards something higher. Use the room checklists in this app to tick off what is done per room, and update your child's age stage as soon as it changes, so the right attention points appear. There will always be falls; that is part of learning to walk and climb. The goal is not to prevent every bump, but to make sure the height your child falls from is never greater than his own body length.