Shopping trolley–related injuries to children are common and can result in severe injury or even death. Most injuries result from falls from carts or cart tip-overs, and injuries to the head and neck account for about three-quarters of all cases. In the US, each year approximately 23,000 children are treated in hospital emergency departments for shopping trolley injuries. In New Zealand, child shopping trolley injuries averaged around 500 ACC claims per year (2012-2017). Children under the age of 5 years accounted for the majority of these injuries, with 0-4 year olds involved in 70% of all shopping trolley injuries. Falls from shopping trolleys are most common, followed by trolley tip-overs. Accidents also occur when children are riding on the outside of a trolley or are struck or run over by a moving cart. Injuries often occur when there is no restraint available or children aren’t properly strapped in or unbuckle or wriggle out of the restraint. Children also fall when they are restrained in an infant seat, carrier or car seat and put in the trolley. The most common injuries affect the head and neck region, accounting for around three-quarters of injuries. Fractures are the most common injury requiring hospitalisation, followed by concussions, and straddling and laceration type injuries. Children younger than 5 years account for most hospital admissions. • Between 2012/13 and 2016/17, child shopping trolley injuries declined by 17 percent. • Fall related injuries account for nearly two-thirds (64%) of all injuries. • More than half (55%) of all injuries were to the face and head area. Shopping trolleys come in different designs, and some may not be as stable or safe as they look. Caregivers may wish to consider some safer alternatives to putting their child in a shopping trolley: • Put your child in a stroller, wagon, or front pack instead of in a shopping cart. • Have your older child walk, rewarding them for behaving and staying close. • Leave your child at home with another adult while you shop. • Shop online if available. If you do decide to have your child ride in a shopping trolley we recommend you: • Place your child in a safety belt or harness at all times when in a shopping trolley. • Never leave your child alone in a shopping trolley. • Do not let your child stand up in a shopping trolley. • Do not place an infant carrier on top of the shopping trolley. • Do not put your child in the basket. • Never allow your child to ride on the outside of a cart. • Do not allow an older child to climb on the cart or push the cart with another child in it, because it is very easy for a child to tip the cart over. REFERENCES 1. Smith GA, Dietrich AM, Garcia CT, Shields BJ. Epidemiology of shopping cart-related injuries to children: an analysis of national data for 1990 to 1992. Arch Pediatr Adolesc Med. 1995; 149:1207–1210 2. Smith GA, Dietrich AM, Garcia CT, Shields BJ. Injuries tochildren related to shopping carts. Pediatrics. 1996;97:161–165 826 AMERICAN ACADEMY OF PEDIATRICS Downloaded from by guest on February 1, 2018 3. US Consumer Product Safety Commission. National Electronic Injury Surveillance System data for 2005 [from database]. Washington, DC: US Consumer Product Safety Commission; 2003 4. US Consumer Product Safety Commission. National Injury Information Clearing House Reported Incident File for Grocery/Shopping Carts (Code 1679) January 1991–June 1993. Washington,DC: US Consumer Product Safety Commission; 1993 5. Centers for Disease Control and Prevention. Deaths associated with infant carriers: United States, 1986–1991. MMWR Morb Mortal Wkly Rep. 1992;41:271–272 6. American Society for Testing and Materials International. Standard Consumer Safety Performance Specification for Shopping Carts F2372-04. West Conshohocken, PA: ASTM International; 2004 10 safekids news | April 2018 ISSUE No 79 SHOPPING TROLLEY SAFETY OF ALL SHOPPING TROLLEY INJURIES; Children aged 0-4 account for 70%