Michelle Garrett had been meaning to move the empty laundry basket at the top of the stairs. But before she could, her 3-year-old daughter decided to use it as a bobsled.
"She thought it would be fun at the time," said Garrett, who lives in Columbus, Ohio. "Not so fun after all."
Garrett's heart sank when she heard the thud at the bottom of the 15-step staircase.
"We knew it was something worse than a little bump," she said, recalling how tiny Kate "ran to her room and covered her arm with a pillow."
Garrett and her husband rushed Kate to nearby Nationwide Children's Hospital, where an X-ray revealed two broken bones in her forearm.
Although stair-related injuries among young children are on the decline, they still prompt more than 93,000 emergency room visits per year, according to a new study published today in the journal Pediatrics.
"The good news is that in 10 years these injuries have dropped by 11 percent," said study author Dr. Gary Smith, director of Nationwide Children's Hospital's Center for Injury Research and Policy. "But the wake-up call is that we're still seeing a child less than 5 years old injured every six minutes. To me that means we have a lot more work to do."
Smith and colleagues used the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System to track stair-related ER visits between 1999 and 2008.
"We need to know how these injuries are happening to know how to prevent them," said Smith, whose research on baby walkers helped fuel policy changes linked to a 76 percent decrease in related injuries. "These are kids who have good parents. We just need to design the environment so parents aren't expected to do the impossible."
While some children were injured in strollers, walkers or other vehicles such as a laundry basket, 87 percent tumbled on their own.
"Stair gates should be standard in homes where young children live or visit," said Smith. "These kids have the mobility and curiosity, but they don't have the sense of danger."
Dr. Estevan Garcia, director of pediatric emergency medicine at Maimonides Medical Center in New York City, said it's important to have gates at the top and bottom of every staircase.
"A lot of people forget that if a kid can get up, they can come down," he said.
In another sobering statistic, one-quarter of children younger than 12 months old were injured while being carried by a parent or caretaker. And they were three times more likely to be hospitalized with serious injuries.
"As a parent, I can relate," said Garcia, whose 1-year-old broke his leg on the stairs while he was being carried. "Here I was thinking it was the safest way, and that's when he got hurt."
Broken arms and legs, while common, were vastly outnumbered by head and neck injuries, which accounted for 76 percent of ER visits.
"The biggest concern is bleeding or bruising in the brain," said Garcia, describing damage that can't be fixed with a plaster cast. "We worry about long-term consequences of head injuries."
While gates and easy-to-grip railings can help prevent accidents, Garcia said it's just as important to teach kids how to tackle stairs safely from an early age.
"Show them how to scoot down on their bottoms," he said. "You don't want them to be afraid, but you want them to understand the risks."
Despite two broken bones, Kate Garrett -- armed with a blue cast -- sang at her preschool's Christmas recital later that day.
"She never complained," said Michelle Garrett. "She soldiered through."
Garrett said her family learned a lasting lesson that December day.
"I know it could have been much, much worse," she said.