Keeping Newborns Safe by Preventing Falls

Expecting parents and healthcare providers focus so much attention on pregnancy and delivery of their babies that it is easy to overlook how important it is to make sure that measures are in place to keep newborns safe during their first hours of life.

One peril is newborn falls, when a caretaker – parent or health care professional – unintentionally drops a newborn. A recent study by Elizabeth Kuklielka and Susan C. Wallace, published in the December 2019 issue of Patient Safety, analyzed instances of newborn falls in Pennsylvania and reviewed prevention strategies.

Newborn Falls: Scenario

A mother delivers her child in the hospital. A bassinet is set up in her hospital room right near her bed, so she can nurse her baby as needed. Thrilled, she is determined to be a great mother, but she is also physically uncomfortable and tired from the labor and delivery.

The baby is hungry, and the mother carefully gets up from her bed to retrieve the baby and breastfeed. As she takes the baby back to her bed so she can sit down, she loses her balance and the baby slips out of her arms.

The nurse arrives and takes the baby to the NICU. The mother is left behind, feeling guilty and blaming herself for harming her baby.

The nurse returns with the baby, who has not suffered any permanent injury. There is no conversation about what happened, and no one from the hospital staff attempts to comfort the mother. In fact, there is no discussion at all. She cannot sleep all night worrying about what she has done.

Newborn Falls: Causes

Kukielka and Wallace gathered data from 318 newborn falls that occurred in the first 72 hours after being born. They found that most falls occurred between 4 am and 5 am. They were also able to determine the circumstances that most often lead to this event:

Newborn Falls: Aftermath

Thankfully, a fall does not always result in lasting harm to the baby. Sometimes, it results in little more than some additional testing and a slightly longer hospital stay. In other cases, however, fractures (of the skull or other bones) can occur. In fact, in the data from Kukielka and Wallace, 25 of the 33 events that were deemed serious involved newborn fractures.

Unfortunately, sometimes even more serious injuries occur, significant brain bleeds that can cause permanent brain injury.

Caregivers can also suffer from significant distress after a newborn fall. If the caregiver who drops a newborn is the mother, the guilt and worry can cause significant emotional distress. Even if the mother is not involved in the fall, she may witness such a fall, which can itself be traumatic.

In a recent Ohio case handled by The Eisen Law Firm, a premature baby slipped from the arms of nurse after delivery and fell to the floor. The baby remained in the Neonatal Intensive Care Unit for almost four months with several complications. While it was not entirely certain whether the baby’s problems were the result of being premature or being dropped, one thing was perfectly clear: the parents suffered extreme emotional distress as a result of what happened. (The Eisen Law Firm was able to successfully handle this birth injury case and reach a settlement for the baby and for the parents. These settlements will ensure the baby receives all the care he needs for the rest of his life.)

Newborn Falls: Prevention

Understanding what causes newborn falls provides an opportunity to develop strategies to prevent them. Kukielka and Wallace consulted with Susan Dixon, RN who was part of a team that implemented several changes at Pen Highlands Elk (a multiple-hospital healthcare system in Pennsylvania) in order to reduce the likelihood of a newborn fall.

What is most impressive about the strategies that have been employed is that the healthcare system recognizes its responsibility and its power to ensure newborn safety. The action plan adopted by the system focuses on educating parents and providing support to them and includes the following elements: