Although the kitchen is recognized as a room that is hazardous for young children, parents seem not to recognize or anticipate the risk for burns and scalds. The ability of children, especially toddlers, to reach containers of hot liquids on elevated surfaces is reflected in the injury data and is explained by anthropometry data, yet there is an apparent failure on the part of parents to recognize children's ability to gain access to the hazard and a failure to recognize the potential severity of resulting injury. These failures might explain why behavioral interventions (eg, place pots on back burners of stove) have been nonmotivating and ineffective. A multifaceted spectrum of prevention that has individual, community, and organizational components may prove to be more useful.

ABSTRACT. Purpose. To document specific patterns and products associated with mechanical suffocation among infants younger than 13 months of age for the period 1980 to 1997.Methodology. A total 2178 case summaries from the US Consumer Product Safety Commission's Death Certificate File were reviewed. A computerized database was created for information about the infants, products, and patterns of suffocation. The relationships among products, patterns, and age groups were analyzed by 2 . Thirty-eight investigations conducted on a subset of cases involving cribs were reviewed for details on crib age, structural integrity, and compliance with the federal crib regulation. Mortality rates were calculated based on the US population younger than 1 year old.Results. The most frequent causes of suffocation were 1) wedging between a bed or mattress and a wall and 2) oronasal obstruction by plastic bag. Patterns of suffocation were significantly related to age group, but not to sex. Pattern-specific mortality rates comparing three time frames for the the 16-year period from 1980 to 1995 showed continued increases for overlain and oronasal obstruction; an increase followed by a plateau for wedging, a decrease for hanging, and no substantial change for entrapment with suspension.Conclusions. Suffocation hazards presented by beds, bedding, pillows, and plastic bags continue to be underrecognized by parents and caregivers. Bed-sharing and use of adult beds for infants should be discouraged. Only complying cribs should be used and maintained properly to ensure structural integrity. Suffocation deaths involving plastics should be investigated to determine the specific material characteristics and use patterns to design more effective interventions than selective labeling. Pediatrics 1999;103(5). URL: http://www.pediatrics.org/ cgi/content/full/103/5/e59;

Manufacturers of household products--including appliances, exercise equipment, and even some children's toys--expect consumers to supervise their children to prevent product-related injuries. This approach to hazard prevention places the burden of safety on parents and caretakers. This study examined actual supervision practices of parents of children between the ages of two and six years. 59 parents, aged 31 to 40 years, residing in Montgomery County, Maryland, completed a 24-item self-administered questionnaire, consisting of multiple choice and open-ended questions. Nearly all respondents reported that there are times when their children are in a different room from them. When the children are out of sight, parents reported checking on their children periodically, with increasingly longer periods between observations, as the child gets older. Nearly half of the children got out of bed in the morning always or often before a parent. Ninety-five percent of parents perceived that their child was at no risk or slight risk of injury when getting up in the morning before them. In conclusion, it can be said that many parents supervise their children by being close-by and on-hand as needed, rather than being directly involved in the child's activities. Manufacturers are encouraged to employ passive measures and sound designs, rather than rely on close parental supervision for injury prevention.

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