Gary A. Smith, M.D., Dr.P.H., FAAP, recognized the danger of shopping carts when a child came into the emergency department (ED) after a fall and had blood collecting inside his skull. If the child hadn't been rushed into surgery, he would have died in 20 minutes. Dr. Smith then realized he was seeing about one shopping cart-related injury per week in the ED.

An estimated 24,000 children, 87% of whom were younger than 5 years old,were treated in EDs in 2005 for shopping cart-related injuries, according to the U.S. Consumer Product Safety Commission (CPSC). Children in shopping carts are at risk for tip-overs and falls that can result in head and neck injuries,said Dr. Smith, lead author of the American Academy of Pediatrics' (AAP's)policy statement on shopping cart-related injuries.

Parents are encouraged to avoid shopping carts, if possible. Some alternatives include having another adult watch your child at the store or at home while you shop; putting your child in a stroller, wagon or front pack;asking an older child to walk; looking for stores with a supervised in-store play area or shopping online.

If you decide to put your child in a shopping cart, the AAP recommends the following:

  • Use a safety belt or harness at all times.

  • Never allow your child to stand in a shopping cart.

  • Never leave your child alone in a shopping cart.

  • Use carts that allow children to ride closer to the ground, like a small model car in the front of the cart.

  • Do not place an infant carrier on top of a shopping cart or put a child in the basket.

  • Do not allow a child to climb on the cart, ride on the outside of the cart or push the cart with another child in it.

  • Shop at stores that offer a pick-up area or help bring groceries to the car.