Many parents see them as a way to give babies independence.
But baby walkers actually account for such severe injuries, doctors say. Saying the devices do little good and may even harm development, the American Academy of Pediatrics has decided to reiterate and strengthen its opposition to them.
Its updated policy statement appears in Wednesday's Pediatrics. In its recommendations, the group asks for a complete ban "because there is no clear benefit from their use."
"Walkers are unsafe," said Gary Smith, a pediatrician and director of the Center for Injury Research and Policy at the Children's Hospital in Columbus, Ohio, and one of the authors of the restatement issued by the American Academy of Pediatrics. "Children are still being injured in them. There should be a ban on the sale and manufacture of walkers."
In just one second, a baby can move 4 feet in a walker with wheels that move, Smith says. And that's not enough time for a parent to catch a baby in a walker who is falling down the stairs or to prevent a baby's finger from being pinched in a door. Some babies have even drowned in walkers. Typically, the curious baby will walk into the side of a toilet, tip the walker over and go head first in the bowl, or tip into a swimming pool.
In 1995, however, a design standard was set that helped prevent many injuries. The voluntary standard, which allows companies to put a sticker on the product saying it was certified by the Juvenile Products Manufacturers Association, must meet one of two requirements. The first is it must be too wide to fit through a standard doorway (about 36 inches). And it must have features, such as a gripping mechanism or brake, to stop the walker at the edge of a step.
Injuries from walkers have since declined drastically. Since 1995, injuries due to baby walkers dropped almost 60 percent, according to the U.S. Consumer Product Safety Commission.
"We attribute that to the new voluntary standards and we have always recommended the stationary walker," said CPSC spokeswoman Nychelle Fleming.
May Slow Developmental Process
But the American Academy of Pediatrics decided to reiterate its opposition to walkers not only because of safety concerns and studies that showed that one out of every 10 children who used a walker had a severe head injury, but also other recent studies that said walkers may actually slow a baby's development.
Smith cites a study done by Andrea Siegel and researchers of Cleveland's Case Western Reserve University on the effects of baby walkers on infants that was published in 1999 in the Journal of Developmental and Behavioral Pediatrics. The study analyzed motor and mental development in 109 babies, with and without walker experience. Babies who used walkers sat, crawled and walked later than non-walker babies. They also scored lower on standard scales of mental and motor development.
"A much safer alternative is the stationary activity center," Smith said. "The study showed that babies who used a walker did eventually walk and crawl and do all those things, but it came a bit later than those who didn't use the walker."
The American Academy of Pediatrics initially petitioned to ban walkers in 1993. But the CPSC unanimously denied the petition.
"We feel that the standards have been effective, as the numbers show the decline of injuries," Fleming said.
If parents can't resist having a wheeled walker, the CPSC recommends they buy one that has incorporated the voluntary standard measures. Also, consider the stationary activity center, which does not have wheels. Follow these safety tips when using a baby walker or an activity center:
Close the door or gate at the top of the stairs.
Keep children within view. Keep children away from hot surfaces and containers. Beware of dangling appliance cords. Keep children away from toilets, swimming pools and other sources of water.