Table 2 Representative quotes

Environmental strategies

Out of reach and restricting access

Yeah and any medicines… ‘cause at the moment we have all got colds and coughs again they are on top of the… kitchen bench pushed to the back but again they all have the child locks on. They are not in a cupboard because we are actually using them regularly but normally all the medicines are at a height that even I have trouble to reach so they wouldn’t be able to reach those at all. (Mother of girl age 4, Control, <median IMD).

What we try to do all the time is to ensure that we don’t put things that she is able to reach. She is a bit ‘touchy’ so we try to keep away all things that we perceive to be dangerous… We try to keep these chairs away from her. We try not to put things on top of the desk for her to be able to reach. We keep bottles, medicines, cooking utensils, irons and almost everything she is likely to touch so we just try to leave her toys on the floor for her play mostly….she is very, very active (Mother of girl age 2, Scald injury, >median IMD).

There’s two doors that we always keep closed, which is the bathroom door and the erm, kitchen door,– because those are the two rooms that we can’t really make safe… Erm, and the same with the kitchen, we only let–allow them to go in the kitchen when there’s an adult with them. (Mother of boy age 3, Poisoning injury, < median IMD).

Yeah I have just discovered that I need to erm to keep my door locked because [Child Aged 2] can reach that handle now. About two weeks ago he couldn’t so you know they just surprise you all the time don’t they with new things (Mother of boy age 2, Control, < median IMD).

We try and keep all kind of small parts of toys out of reach which is harder now she is getting taller and taller. Erm things like keeping knives and that out of her reach again now because she is moving chairs up to things that is getting quite a tricky. (Mother of girl, age 1, Control, >median IMD).

Tidy home

But there are ways like I said you can try and prevent them I always like to keep this floor tidy. Nothing on the stairs, you know, so they can’t fall over going up the stairs and… I do generally keep the floor tidy. I think that would help because they can’t fall over anything then can they? (Mother of boy age 3, Control, <median IMD).

Adapting the home

Water temperature

My water is set at a certain degrees so it doesn’t come through hot enough for him to burn himself. (Mother of boy age 2, Fall injury, < median IMD).

Rooms perceived as having greater risks of injury

Sharp knives and anything like that they are all kept up but I have got a bungee rope did you notice it in the kitchen? From the top cupboard on to the cooker because he would pull the cooker down and stand on it and climb on the work surfaces. Right the cooker rocks I have had duct tape I have had this industrial tape to keep the bottom oven door shut none of it worked until we put the bungee rope on and he didn’t touch it. (Mother of boy age 2, <median IMD).

Accommodation factors

It varies from landlord to landlord …The only thing about living here is the fact that there is no carpet downstairs. Erm we have always had carpet and when we moved here I was just a bit worried about him falling on this floor obviously coz it’s although wood is soft it’s not as soft as when you have got carpet on… I mean he fell down like hence why he ended up in hospital. (Mother of boy age 2, Fall injury, <median IMD).

Safety equipment

Erm, I’ve got all the plug sockets in, I have got the stair gates, erm, we’ve gone to the extent of radiator covers now because they were touching the radiators while they were on and obviously burning their fingers a little bit.. I’ve tried fridge locks, I’ve tried freezer locks–I will literally try anything and everything that’s about (Mother of boy age 1, Poisoning injury, >median IMD).

…I still keep the sockets covered now just in case. That’s the only thing really because nothing worse than a baby crawling towards a socket. (Mother of boy age 3 Control, >median IMD).

I don’t have any cupboard locks because I found that the children [are] actually more inquisitive if they can’t get in to it. So I actually let them lose in things like the saucepan bits and… they went through a stage of banging doors and I just know that the more you try to stop them, the more they did it. We let them do it and then in a day it was done. (Mother of girl, age 3, Poisoning injury, > = median IMD).

Safety equipment and the ages and stages of child development

I did have stair gates but I took them off because they can climb over them… So yeah, I thought it was safer to remove them rather than leave them there. (Mother of girl age 2, Poisoning injury, > median IMD).

Safety equipment reactive and proactive approaches

we haven’t really put locks and barriers up, trying to, we may put a lock on the kitchen cupboard with the cleaning things in it if [F] is showing an interest in cupboards and he’s not showing an interest in following rules, but it worked well with the first so and then as they get older, you know, it’s just about teaching them… but if you can’t just assume that they’re going to learn. So we may have to resort to barriers for certain areas and that’s fine, you know, we’ll do that if necessary. (Mother of boy age 3, Scald injury, <median IMD).

Parental strategies

Parental supervision

I think the most predominant thing is I rarely… I just don’t leave them on their own whilst she is so small. She is only what 20 months now, so I tend to just have to watch her all the time…(Mother of girl age 1, Fall injury, <median IMD,)

I think you just have to do the best like keep an eye on them when you can but obviously you can’t always… If he goes quiet I just have to make sure he is not doing anything bad [laughing]. (Mother of boy age 2, Control < median IMD).

Parental supervision interrupted by distractions/household tasks

Just that it’s really hard you know it’s really hard especially when you are on your own you know if you have got a mother and father, fair enough, it’s a bit more easier but like I say I mean I said it before it’s a bit of a hassle to keep taking [Child’s Name] everywhere it’s not because I know she is safe then but it would be a lot easier if I had like a dad here just to say well I will keep an eye on her I will just go upstairs or I’ll go do the ironing. (Mother of girl age 1, Fall injury, female, <median IMD).

I mean if I’ve got household task to do I kind of run between the kitchen and here in the lounge just to check on him and make sure he’s not doing anything crazy, but most of the time I don’t like to do that because I find it really stressful. I only do that if I really have to. You know if I really need to make some lunch so that we can eat. (Mother of boy age 1, Poisoning injury, <median IMD).

It’s basically just keeping your eye on them. We don’t leave her for too long and I know it only takes seconds we do try and make sure that if we are not watching her that our 7 year old is aware that she is on her own as we do tell him. The idea is that he we are not leaving him in charge of her we are asking him to just we are often saying to him what is she doing what’s she doing and he gets really cross and says she’s fine. (Mother of girl age 1, Control, > median IMD).

Erm now she is moving when she was younger and she was just sitting somewhere she was there and you could keep an eye on her but now she is like in here out here she wants to be kept busy all the time… (Mother of girl age 4, Fall injury, female, <median IMD).

Parents modify their own behaviour

sometimes what I do is erm just not doing things in front of her to avoid her thinking about it. Like I never plug and unplug things in front of her. I just wait for her to turn around and I use the socket without her [seeing] so she wouldn’t… obviously they are going to do what you are doing so I tend to avoid her to see me. (Mother of girl age 1, Fall injury, >median IMD).

Teaching strategies

Learning about hazards

So for instance she is much better since she tried to get into the oven and I have been telling her you can’t open the over door…we actually had to go over and show and put her hand very close and say this is heat this is hot, this is last night’s conversation, if you do this it is going to hurt, which is far better if she has actually experienced it then trying to explain it to her. (Mother of girl age 3, Fall injury,>median IMD).

Erm we tell them not to run in the house they have a star chart with behaviour and running is one of the key erm points. They run they get a black cross erm he has been [Child’s Name] in particular who is very energetic he has been told and taught how to come down the stairs nicely the top of the stairs are very narrow and the stairs are steep and so ever since he started to crawl he has been watching and learning how we come down the stairs and now he can actually walk down the stairs holding on to the banister and he knows erm that it is steep and he has to be careful erm mainly through watching watching [Older Child’s Name] and my husband and I how we act. (Mother of boy age 3 > median IMD).

They have got to learn …I think age is important too because obviously you can’t show a child who is obviously not going to understand what you are showing it, or isn’t aware of what is actually going on. As they get older you have to obviously you have to explain in depth as to why things are dangerous and why you can’t do that so they know…(Mother of boy age 1, Fall injury, <median IMD).

Controlled risk taking

As I say teaching as early as you can and sometimes they can have these little accidents so they learn that if you do that it will hurt cos these two use to jump off the end of the sofa and once I let them do it and think he hurt his knee and he hasn’t done it since. (Mother of boy age 1, Scald injury > median IMD).

I think it’s educating them as to why we do it because you can just say no no so many times unless the child knows why you are saying no I don’t think it goes in. It is not that all the time they have to experience it themselves but there has to become that understanding for them to want to do it. (Mother of girl age 1 Control, > median IMD).

I mean I said I don’t use everything, because I think you know your children and I think equally it’s, I think you can have overkill on locks and things like that. I think that couldn’t, in the long run, I’m not sure it particularly helps, I don’t know, that’s from my experience. I think it just makes children, you know, what have you got locked in that cupboard… I didn’t, to be fair I just didn’t want loads of locks over the cupboards, because I just felt that it would cause more problems long term (Mother of girl age 3, Poisoning injury, >median IMD).

Near miss as a deterrent

We haven’t done any plugs or any corner things we haven’t done any safety measures erm and again it’s about teaching him and to be fair at the moment he hasn’t really shown any interest in plugs and sockets that’s been an advantage but you know if he is doing anything that we think is dangerous then we kind of teach him say no and give him something else to do erm he has probably learnt a bit the hard way you know if he has banged himself then actually he is careful the next time. (Mother of boy age 1, Control, <median IMD).

Most important strategies

Using a combination of strategies

Supervising them, being aware of what they are doing. Being aware that they can change within a week. I think that as well as teaching them and reinforcing it (Mother of boy age 2, > median IMD).

To me and that’s it’s educating her constantly supervising to make sure she is actually sticking to what you tried to teach her. (Mother of boy age 1, Control, <median IMD).

Uncertainty over which strategy to use in line with ages and stages of child development

You look forward to the next stage and you’re all ‘what are they going to do next, what are they going to learn next?’ and you kind of assume that it’s going to be a long time… Yeah, so I think you’re just thinking it’s going to be a long time. Like with walking he started walking a little bit and I was like–I was writing my diary ‘oh, he’s walking a little bit, it will be a month or so before he starts walking I think’ and it was a few days… you see the beginnings of it and think ‘oh, I’ve got a bit of time to make arrangements’ you know if you need to do something like with a cupboard and–no actually it surprises you how quickly they change (Mother of boy age 1, Poisoning injury, < median IMD).