Child safety advocates are hailing the reduction in child deaths and hospital admissions from unintentional injuries, but say much more must be done to protect children.
A just-released report says that on average, about 80 children a year up to age 14 die from unintentional injuries. In the latest reported year, 2013, there were 38 deaths, down from 126 in 1989.
Hospital admissions for non-fatal unintentional injuries peaked in 1995 for this age group, with 11,006 patients, and by 2014 this had declined to 7290.
Deaths and non-fatal unintentional injuries have declined for most causes including motor-vehicle crashes and this is in line with the long-term decline in the road toll from its peak in the early 1970s.
An analysis by Safekids Aotearoa, the Starship hospital's child safety unit, shows that the annual per-capita rate of unintentional-injury deaths declined between 2001 and 2010, from 10.5, to 8.5, for every 100,000 children.
Of those deaths, suffocation has been the leading cause since 2007, climbing ahead of motor vehicle crashes, which declined across the decade.
"This may be related to an increasing tendency for coroners and pathologists to recognise suffocation as a contributing factor in many cases of sudden [unexpected] death in infancy, SUDI, among children under 12 months old," the Safekids report says.
The report shows an approximate halving of the per-capita rates of child deaths and non-fatal injuries from motor-vehicle crashes since 2001.
Drowning was the third most common cause of death from unintentional injury in children, accounting for 10 per cent of such deaths from 2006 to 2010. Around 37 children die or are admitted to hospital from drowning incidents each year and there has been a slight decline in the per-capita rates since 2001.
Starship emergency department specialist Dr Mike Shepherd, a Paediatric Society council member, said the Safekids report showed New Zealand had become a safer place for children, but performed worse than many other developed countries and a lot more work was needed.
"A tremendous amount of time and energy and dollars go into injury prevention. What this demonstrates is that it works. What it also demonstrates is there are still far too many children and young people being injured and killed through unintentional injury, so we have still got quite a long way to go," Dr Shepherd said.
"The current concern in this area is around swimming-pool fencing and swimming-pool drownings. This is a good example of where we have made great progress with swimming-pool drownings. But the new legislation [currently before a select committee] is going to water down this protection for children based on some pretty poorly thought-out legislation that isn't based on the appropriate science."
Dr Shepherd advocated wider use of lower traffic speed limits in residential and school zones and said the society supported Safekids' call to make booster seats compulsory in vehicles until a child is 148cm tall.
At present the law requires children travel in restraints - capsules for babies, then car-seats and booster seats as they get older - until age 7.
Safekids director Ann Weaver said a 148cm law would require most children to be in booster seats until aged 10 or 11. It was an obvious law to adopt because it was well established as the best practice and had been introduced by many other countries.
Crash boys saved by safety seats
Blair Pitts-Brown has seen first-hand the saving power of booster seats for children in a car crash.
His family were involved in a horror crash near Te Anga in the Waikato in 2010 when the trailer of a rubbish truck crossed the road, hitting their people-mover head on.
Mr Pitts-Brown suffered broken bones, internal injuries and a head injury, and was in a coma for 39 days. His partner, Lou Pitts-Brown, spent two weeks in hospital.
Their children Archie, then 7, and Finley, 6, were in booster seats. They received only minor bruising.
Health workers told the family if the boys hadn't been in booster seats they could have suffered severe injuries from their seatbelts or been flung out of the vehicle.
Mr Pitts-Brown, a pig farmer, said that although car-crash deaths and injuries for children were declining, the Government should make booster seats compulsory for children until they are 148cm tall, regardless of their age. At present the seats are no longer compulsory after the seventh birthday.
"I absolutely swear by booster seats. My boys didn't have any physical injuries apart from bruised shoulders where the safety belt tightened on them.
"If they hadn't been in booster seats the safety belts would have been across their necks and it would have been a completely different story."