Babyproofing is one of those things you just do, perhaps while nesting during those last comparatively lazy months of a first pregnancy or during those first frantic weeks when kiddo starts walking. With babyproofing, it's not a question of whether, but when.
But should it be?
In this installment of our safetyshaming series, we'll look at just one type of babyproofing gear: outlet covers. But first, we have to figure out what exactly outlet covers are meant to prevent.
Electrocution deaths are incredibly rare: In the US, there are approximately 1000 deaths per year due to electricity. That's all people in the US and all types of electricity, including workplace and home accidents. Likely as a result of occupation (construction, for example), men are far more likely to die of electrocution than women. Roughly 80 percent of all electrocution deaths are adult men.
In short, electrocution death is extremely unlikely for anyone, and especially so for children. If you're installing outlet covers to avoid accidental electrocution death, there are much better uses of your time.
But what about non-fatal electrical injuries? Google "electric shock kids" and you'll find a terrifying array of articles with first aid procedures for kids who have managed to wedge a fork into an outlet or bite through a lamp cord or grab a high voltage wire.
How common is the risk of electric shock? And how often is an electric shock going to cause an injury (generally a burn, but perhaps a cardiac event) worthy of a trip to the emergency room? These answers are tricky, first because lots of children receive electric shocks and don't visit the ER (touching the car door handle is one example). Furthermore, when children do visit the ER for electric shock, the causes of electric shock can be widely varied.
The Healthcare Cost and Utilization Project (HCUP), a group of databases maintained by the Agency for Healthcare Research and Quality, tracks information about US hospitalizations and emergency room visits, searchable by billing diagnosis codes. One of the HCUP databases, the National Emergency Department Sample (NEDS), can be used to find out how many people in the US visited an ER due to an "accident caused by domestic wiring and appliance."
In 2013, 68 children under age 1 received this diagnosis. Of those infants, none were admitted to the hospital, meaning their injuries were sufficiently minor for them to be discharged from the ER. The NEDS shows that 1,718 children between the ages of 1 and 17 came to the ER in 2013 as a result of domestic electric injury; 1,687 of those children were discharged from the ER. It is unclear what exactly happened to the 31 children not discharged from the ER. They may have been admitted to the hospital for further treatment, transferred to a hospital better equipped to handle a serious burn injury, sent to a rehab center, or died in the ER.
In 2013, the estimated population of children under age 1 was 3,941,783. The estimated population of 1 to 17-year-olds in that year was 69,644,089. That means for children under age 1, there was a roughly 17 in one million chance of an electrical injury sufficient to warrant a trip to the ER. For children ages 1 to 17, that chance was slightly higher: roughly 25 in one million.
Based on the NEDS, we know that electrical injuries are uncommon in children ages 17 and under. We also know fatal domestic electrical injuries are extremely unlikely. But there is a lot we don't know.
We still don't know exactly how many of those injuries are related specifically to electrical outlets. The diagnosis code "accident caused by domestic wiring and appliance" is broader than just electrical outlets. It includes accidents caused by sticking a knife in the toaster or touching a frayed extension cord. So the 17-in-a-million and 25-in-a-million chances of electrical injury are likely to be even smaller if you could narrow the focus to just electrical outlets.
We also don't know if covering outlets could prevent some of these emergency room visits. There are not many large studies of outlet cover effectiveness. One frequently cited by those in the safety industry is Ridenhour's 1997 "Age appropriateness and safety of electric outlet protectors for children." 37 children ages 2 to 4 were presented with three different styles of outlet cover, and Ridenhour measured the time it took to remove each type.
Although one style of outlet cover was found to be much easier to remove than the other two, the children's longest average time to remove the most difficult outlet cover was just 38.9 seconds. Ridenhour concludes that "some outlet protectors may provide a false security to parents who elect to use these devices in the home."
One last thing we don't know is how changes to our building codes are affecting the electrical injury rate. Now that the National Electrical Code requires tamper resistant receptacles, which include spring-loaded gates that make it difficult for adults, let alone children, to insert anything into an outlet, the question of outlet covers may be altogether moot for homes built after 2014. (Some state codes required these outlets earlier, so your home may have them even if it was built before 2014.)
At under 10 cents a piece, outlet covers are possibly the cheapest item of baby gear you can purchase. Go go ahead and buy them if it makes you feel safer. Or go buy those sliding plates that let you plug your phone charger in without an epic battle, even though your child will spend a few weeks watching you and then slide them easily at an impossibly early age. But you might be investing more in safety theater than actual safety.
Babyproofing is partly a question of safety, but mostly a question of philosophy. How dangerous is the world to your eyes? What level of risk are you willing to tolerate? What do you gain by giving your child a relatively long leash (a metaphorical leash! not a real one!)?
I prefer to avoid questions of "safe" and "unsafe" and focus instead on "cheap" versus "expensive" lessons, because they allow me to think about babyproofing as education. A box of Cheerios spilled on the floor because kiddo can pull his stool to the cabinets? That's a cheap lesson about how careful pouring avoids lengthy cleanup. A slip on the floor because a wet towel gets left there after bathtime? That's a painful but helpful lesson in picking up after oneself. Even a fall down the stairs can be a cheap lesson depending on the child's age (and the relative cushiness of said stairs).
The NEDS data suggests that electrical outlets might be closer to the cheap category of lessons than we initially supposed.
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