Dr. Gwenn S. O’Keeffe,  Editor-In-Chief of Pediatrics Now, blogger at Dr. Gwenn is In, and a spokesperson for the American Academy of Pediatrics, answered questions about shopping cart dangers. Here is the full text of the email interview. You can also follow her on Twitter.

Question: How serious of an issue would you say shopping cart hazards and the potential for injuries are?

Answer: With the current shopping cart designs, shopping carts are a serious hazard to small children as noted by the AAP in the 2006 Pediatrics statements.

Question: Have you treated any patients for shopping cart related injuries (if you can say in a general way)?

Answer: I have treated many kids over the years with shopping cart injuries in the office and in the emergency room. Typically we see head injuries but I’ve seen concussions, lacerations on the head and face, and a few broken bones. The older the child, the less serious the injury tends to be but head injuries in any child can be serious and I have seen some fractured skulls.

Question: Do you think parents are aware enough about the hazards that can be posed by improperly using shopping carts?

Answer: I do think parents are aware of the potential for danger with shopping carts in a general sense. The issue is with multitasking and not being able to keep kids, especially young and squirmy kids, as safe as we’d like them to be while shopping. The accidents I’ve seen all occurred in the blink of the eye by attentive parents who did what they could to keep their kids safe. All it takes is turning the back for a second to grab something off a shelf for a cunning child to wiggle out of the front seat and take a dive.

Question: Do you think retailers are doing enough to ensure their shopping carts are safe (working safety straps, etc.) and are being safely used by children when shopping?

Answer: No. There are too many old, rickety carts still in all the stores. Many carts have safety belts that do not work. The more modern plastic carts seem safer but not all stores have gone to those yet.

Question: I see that the AAP issued a policy statement that included recommendations that pediatricians educate the public, parents and so on about shopping cart hazards. I am hearing anecdotal statements from moms, however, that they never received any information during pediatrician visits. Do you think this is a factor?

Answer: The issue is time. There is a great deal of information to cover in a well child exam, especially for young children and infants. Most pediatric offices handle issues of shopping cart safety with fliers in the waiting room or handouts posted in the exam rooms. With all the issues a doc needs to cover in the visit, we may not get to other important issues such as shopping cart safety. But, if that is important to a family, a family should ask.

Question: Do you think enough is being done in the medical community to educate parents about the hazards? Do you personally recommend anything to your patients regarding shopping cart safety and, if so, what do you recommend?

Answer: We all post the AAP information such as this: http://www.aap.org/family/ShopCartPP.pdf I try to bring up issues of shopping carts whenever the topic arises, and it often does in basic conversation. I recommend parents use common sense and put the more wiggly toddlers in the main compartment of the shopping cart, or let the toddler help push the cart so they are not in the cart at all. I remind parents that their shopping will be slower but their child will be safer. Most toddlers would rather “help” so this allows for that. Many accidents actually occur by toddlers trying to grab something they feel the family needs!

Question: I saw in your About page that you are a mom yourself. When you go shopping (or when you did, if your children are too old for carts now), what precautions did you take when using carts?

Answer: My kids are tweens and teens now but we used to try to not take them shopping when they were really wiggly. I used to shop and leave the kids with my husband or vice versa. That isn’t always an option for people but if it can be arranged, that can help get through the most wiggly of phases. If I did have to take them, I would bring a toy or book to distract them if they had to sit in the front, or bring a snack. If a store had small shopping carts, we would get those to let the kids push their own cart.

Question: When you see other shoppers who are strangers who are using a shopping cart in a clearly unsafe manner, do you say something? If so, what do you say?

Answer: I say something like “excuse me, I know this is awkward but I’m a pediatrician and have seen a few accidents with kids your child’s age and shopping carts.” Then I make a friendly suggestion and hope for the best. To be honest, I find this only works 50% of the time. Some say “OMG, thank you. I had no idea.” While others say “I can handle my own child, thank you!”