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Falls in elderly patients are well-documented, but little is known about how often newborn infants fall to the floor in hospitals.1 Therefore, a recent study published in the journal Pediatrics sought to determine just how often, and under what circumstances, these accidents happen. Data were collected from 18 hospitals in a large hospital system, using risk management reports and International Classification of Diseases (ICD) codes in patient medical records.
During a 36-month period, 14 infants were identified as having sustained falls in the hospital.1 Nearly all were term or late-preterm infants who fell at or shortly after the time of birth. One was a former 32-week-gestation preterm infant, who fell from a swing at 78 days of age. Four newborns were dropped in the delivery room. One of the most common situations involved mothers holding infants while lying in bed in the early morning hours. These mothers fell asleep and their infants subsequently fell to the floor. Two of these mothers had recently received a sedative medication. In 3 instances, fathers holding their newborns in reclining chairs or beds fell asleep and the babies fell to the floor. One baby fell when the bassinette tipped over while being wheeled out of an elevator.
Most falls were of an estimated distance of 32 to 43 inches onto a linoleum floor. No patients died as a result of falling. One sustained a depressed skull fracture and another developed soft tissue swelling visible on computed tomography scan. Only 1 patient had an abnormal examination upon discharge.
Investigators determined that none of the study hospitals had protocols in place for preventing falls in newborn infants or for evaluating infants who fall. Because most infants fell from the arms of their sleeping parents, prevention efforts should be aimed at educating parents about the risks of falling asleep while holding or feeding their infants. Special efforts are need to avoid the situation of a sedated mother breastfeeding her infant in bed while alone in the room.1
1. Monson SA, Henry E, Lambert DK, Schmutz N, Christensen RD. In-hospital falls of newborn infants: data from a multihospital health care system. Pediatrics. 2008;122:e277-e280. [Context Link]
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