Statement of purpose Falls are the leading cause of emergency department visits among children less than five years old. Parents are encouraged to supervise their children and provide a safe environment to prevent injuries, but there are few evidence-based interventions to prevent child falls. This analysis aimed to identify factors related to unintentional nonfatal fall injuries in children under five.

Methods/Approach Data about children under five years who experienced a fall in 2015 were extracted from the National Electronic Injury Surveillance System All Injury Program. The case narratives were reviewed and coded for what the child fell from, fell onto, the fall action (i.e. tripped, dropped, rolled), and the precipitating event leading up to the fall.

Results In 2015, an estimated 121,531 infants (<12 months), 443,867 toddlers (1–2 years) and 326,382 preschoolers (3–4 years) were treated in an emergency room for an unintentional non-fatal fall. Among infants the leading source of falls was from beds (36%) primarily due to rolling from a laying position onto the floor (90%). Toddlers most often fell from a standing position (23%), from the stairs (17%) or from the bed (17%). Falls from the stairs were primarily due to the child slipping or tripping (84%), but 5% were dropped, such as by an adult carrying them. Before falling from the bed, toddlers were jumping more than any other activity (52%). Among preschoolers, most falls occurred from a standing position (27%) or play equipment (16%). Falls from standing position usually occurred while the child was running (62%) or bathing (18%). Falls from the bed were usually preceded by jumping (62%).

Conclusion Infants primarily fall from beds; toddlers and preschoolers fall most often from standing by slipping or tripping.

Significance Understanding the circumstances of fall injuries can help identify new opportunities for prevention and intervention.