Mothers in our study did have knowledge of common safety devices. However those who were recent arrivals in the UK were less likely to be aware of the dangers of household equipment not used in their country (e.g. kettles). Social networks were a source of information and helped encourage positive behaviours as mothers considered these behaviours as acceptable social norms. In addition, safety behaviours learned by mothers during childhood from their parents were practiced as adults, such as wearing car seat belts.
One important point of concern from the study was a lack of accessible advice regarding the use of pre-owned safety equipment. Mothers frequently mentioned re-using old safety gates and child car seats. The British Standards Institution (BSI) Kitemark  on safety products was one valuable source of information mothers from deprived neighbourhoods in particular found useful when purchasing toys and safety equipment with limited funds. They were reassured that pricing did not reflect the quality and safety of differentially priced devices.
Another area of concern was that mothers believed children were never too young to learn about injury risks, perpetuating the belief that children have the ability to remember safety rules and manage risky situations, and highlighting their lack of knowledge about child development . This was regardless of the fact that mothers themselves had commented several times of their own difficulty in trying to remember safety messages which they had read, or which had been communicated to them by health professionals. Our study indicate that mothers were lacking in knowledge when it came to infant cognitive and physical development and as a consequence they delayed the purchase or installation of safety equipment before they perceived the need , thereby exposing their child to risks.
Mothers of first-born children were more likely to purchase multiple safety devices, whilst mothers with a number of children appeared to adopt a more relaxed approach to child safety. The increased confidence and belief in their own parenting skills could possibly reduce mothers’ adherence to safety practices. We also found mothers frequently invoking the notion of common sense as a means to injury prevention, but at the same time some mothers acknowledged that common sense was not always adequate in keeping children safe from injury. A Canadian study uncovered in a self reported interview study of 121 mothers that mothers’ belief in “common sense” was one of the determinants of childhood injury .
Our findings demonstrate that recently migrant families may lack awareness of commonly used household appliances, such as kettles, which might pose child safety risk. This finding is in accord with previous research which found that childhood injury rates in Hispanic immigrant families in the US were higher in those families where the caregiver had been resident in the host country for less than five years . Other research has shown that close social networks can protect immigrant children from injury, due to the nature of sharing child care within families [41–44]. Coupled with the importance of the role of family members in raising awareness of child injury risks, (that was particularly common among mothers from deprived neighbourhoods ), our findings suggest that strengthening social networks could be a valuable strategy in injury prevention.
Injury messages can play a significant role in reducing injury. A survey of 900 parents with children ≤6 years of age indicated that adherence to safety messages by parents reduced home injury incidents by 36 percent . Mothers in our study recommended that injury messages should be appropriate to the developmental age of the child, concise and logical to aid memory recall. Suggestions were made to place child safety information within advertising breaks in football matches to capture the attention of fathers, or within storylines of popular television dramas. It was recommended that injury messages should be communicated by influential and appropriately trained individuals and reinforced in a variety of settings, such as hospitals and clinic waiting rooms, child care and community venues, supermarkets, and nappy-changing areas. Case studies, written leaflets, books, social media and help-lines were also suggested. Our findings are supported by Aldoory et al.  who undertook a literature review to find that multi-component, multichannel campaigns (mass media, printed sources, and interpersonal) are most effective in injury prevention campaigns. They suggest employing a mix of voices including both peer and authority figures to ensure the trustworthiness and acceptability of messages. They also argue that simple messages are far more effective than complex behaviour change advice.
Limitations: This study only examined the views of mothers. Fathers and other care providers’ views were not included and they may give very different responses. In addition, self reported responses to interview questions may have affected the accuracy of our data and therefore there may be information bias. Despite these limitations the strength of our study arises from the inclusion of views from mothers of differing neighbourhood deprivation status, social background and migration status (which later emerged from the data). There have been very few studies in the UK which have documented home injury according to such diverse range of social background [47, 48], and those that have done so have not categorised families in terms of migration status. Finally during the course of the interviews we identified that fathers have a role in preventing injury-related risks in the home. Possible future studies could interview mothers and fathers together, and move away from a polarised view of mothers as the only caregiver who is responsible for reducing childhood injury. This would truly allow for a socio-ecological multi-level  understanding of the issues around injury prevention and strengthen injury prevention strategies.