The number of children treated in emergency rooms for injuries caused by baby gates has nearly quadrupled since 1990, leading researchers to warn parents and caregivers about the dangers of using these gates.

Many parents and caregivers use baby gates in an effort to prevent babies from falling down stairs and in other dangerous situations. Now, a new study, conducted by researchers in the Center for Injury Research and Policy at Nationwide Children’s Hospital, has found gates can lead to injury if used incorrectly.

According to the study, published in Academic Pediatrics, from 1990 through 2010, emergency departments in the United States treated an estimated 37,673 children younger than seven years of age for baby gate-related injuries. That is an average of 1,794 per year, or about five injured children per day.

Data for the study were obtained from the National Electronic Injury Surveillance System (NEISS), which is operated by the U.S. Consumer Product Safety Commission.

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The researchers found that more than 60 percent of the children injured were younger than two years old, and they were most often injured by falls down stairs after a gate collapsed or when it was left open. Injuries caused by these accidents lead to soft tissue injuries, such as sprains and strains, and traumatic brain injuries, said the researchers.

The cause of injury for children aged two to six years was most often contact with the gate after climbing on it. This action caused cuts.

Lara McKenzie, Ph.D., the study’s senior and corresponding author and associate professor of Pediatrics, Center for Injury Research and Policy at The Research Institute at Nationwide Children’s Hospital, told Healthline, “Baby gates are one of the most widely used home safety products. They are used to protect children from accessing stairways, doorways, and other home hazards. However, sometimes these safety products can cause injuries to children due to user error, or when a child pushes through or climbs over a gate.”

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McKenzie said the most common types of gate-related injuries were bumps and bruises (33 percent) and cuts and lacerations (30 percent). “Over 16 percent were traumatic brain injuries,” McKenzie told Healthline.

When queried as to what advice the researchers have for parents, McKenzie said, “Gates are a common, if not essential, safety device in homes to prevent young children from potentially hazardous stairways, and to limit access to restricted areas — for example, the kitchen when you are cooking. Current recommendations suggest that gates be installed in stairways and between rooms in homes with children between six months and two years of age, or until the child has learned how to open the gate or when the child is able to climb over the gate.”

McKenzie continued, “Only use a mounted/installed gate at the top of stairs. Even very young children can push through a pressure-mounted gate, so you do not want to use that type at the top of stairs. Pressure-mounted gates can be used at the bottom of stairs or between rooms.”

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McKenzie advised that it is important that grandparents and other caregivers heed these recommendations. “When your grandkids come to visit, it is essential to have the correct types of gates in place to keep your grandkids safe in your home. You can be strategic in limiting children’s access to dangerous areas by installing gates at the top and bottom of stairs and between rooms. Also, do not use the old accordion-style gates. The sale of these gates was banned because of the risk of strangulation. Make sure any gates you use meet current safety guidelines,” said McKenzie.

Emphasizing that the rate of injury associated with this safety product nearly quadrupled during the time period covered by the study, going from 3.9 per 100,000 children in 1990 to 12.5 per 100,000 children in 2010, the researchers stated that the study findings underscore the need to prevent these types of injuries. They also recommended a combination of efforts to educate families on correct ways to use gates and changes in gate design to reduce these types of injuries.

McKenzie went on to say that previous advancements in gate design have included component upgrades to hinges, slats, and mounting hardware.

Pointing out that voluntary standards of the American Society for Testing and Materials (ASTM) for minimum safety performance have been contributory in decreasing gate-related hazards to young children, McKenzie noted there are no federally mandated regulations for gate design in the United States.

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“Our study results highlight the need for further advances in gate design to limit children’s ability to climb gates, to prevent gates from collapsing, and to better cushion children when they fall on gates,” McKenzie told Healthline, adding, “It also wouldn’t hurt if gates were easier to install.”

Finally, the researchers issued the following advice to help reduce injury in children:

• Use hardware-mounted baby gates at the top of stairways. Gates that only press against walls, called pressure-mounted gates, are not secure enough to prevent falls.

• Install gates in homes with children between six months and two years of age.

• If possible, remove the gates when the child turns two, or when the child has learned to open the gate or climb over it.

• If you can’t remove a gate because of other children in the home, use a gate without notches or gaps that could be used for climbing.