Although strollers and carriers are typically used to safely transport children, injuries do occur while using these products. A study conducted by the Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital found that, over a 21-year period from 1990 through 2010, almost 361,000 children aged 5 years and younger were treated in U.S. hospital emergency departments for stroller- or carrier-related injuries -- that's about two children every hour.

The study, published online today in Academic Pediatrics, found that most children were injured when they fell from the stroller (67%) or carrier (63%) or when the stroller (16%) or carrier (29%) tipped over. The head (43% stroller, 62% carrier) and face (31% stroller, 25% carrier) were the most commonly injured parts of the body.

While many of the injuries were soft tissue injuries like bumps and bruises (39% for strollers, 48% for carriers), traumatic brain injuries (TBIs)/concussions accounted for one-quarter (25%) of stroller-related injuries and one-third (35%) of carrier-related injuries. In fact, the proportion of stroller-related TBIs/concussions doubled during the study period going from 19% of injuries in 1990 to 42% of injuries in 2010 and the proportion of carrier-related TBI/concussions tripled going from 18% of injuries in 1990 to 53% of injuries in 2010.

"While these products are used safely by families every day, when injuries do occur they can be quite serious," said Kristi Roberts, MS, MPH, study author and research associate in the Center for Injury Research and Policy at Nationwide Children's. "The majority of injuries we saw were head injuries which is scary considering the fact that traumatic brain injuries and concussions in young children may have long term consequences on cognitive development."

While most of the children were sent home after receiving treatment in the emergency department, 7% of children with a carrier-related injury and 2% with a stroller-related injury were hospitalized. This means that every day in the U.S. a child is hospitalized for a stroller or carrier-related injury. TBIs/concussions accounted for 65% of stroller-related hospitalizations and 79% of carrier-related hospitalizations.

"As parents, we place our most precious cargo in strollers and carriers every day," said Roberts. "By taking a few simple steps like making sure your child is buckled up every time he is in his stroller or carrier and being aware of things that can cause these products to tip over can help prevent many of these injuries."

Safety experts recommend the following to help prevent injuries from strollers and carriers:

Always buckle up. Follow all manufacturer's instructions for properly securing children in strollers or carriers. Make sure your child is seated and buckled in at all times.

Keep handles clear. Hanging heavy items like purses and bags on the handle of strollers can cause them to tip over. Store these items under the stroller or on your shoulder. If getting a new stroller, look for one with a wide wheel base that will be harder to tip over.

Get a model that fits your child. Strollers and carriers are not one-size fits all. Both strollers and carriers have age and weight limits. Make sure to get one that is the right size for your child and follow all manufacturer's guidelines for use.

Lock it. Lock stroller wheels when you "park" to prevent it from rolling away unexpectedly. Be careful using a stroller near a curb and in high traffic areas where sidewalks are not available.

Keep it low. Keep carriers low to the ground so the child has a shorter fall if the carrier tips over.

Check for recalls. Both strollers and carriers have had recalls in recent years. Check http://www.recalls.gov to see if the model you plan to use has been recalled.

"While the number of overall injuries from strollers and carriers did go down during the 21 years we looked at in our study, it is still unacceptably high," said Roberts. "The updates to voluntary manufacturer standards and frequent product recalls in recent years have been a good first step but the large number of injuries we are still seeing shows we need to do more."

Data for this study were obtained from the National Electronic Injury Surveillance System (NEISS), which is operated by the U.S. Consumer Product Safety Commission. The NEISS database provides information on consumer product-related and sports- and recreation-related injuries treated in hospital emergency departments across the country.