Each year, thousands of children are treated in hospital emergency rooms for injuries associated with high chairs. Deaths also occur. The majority of the injuries result from falls when restraining straps are not used and when children are not closely supervised. The majority of deaths occurred when children slipped down under the tray and strangled. Most often, these children were either unrestrained or were restrained only by a waist belt. To help prevent injuries and deaths, high chairs should have a waist strap and a strap that runs between the legs. While in the high chair, children should ALWAYS be restrained by both straps. The tray should not be used as a restraining device in place of the straps. Without these two straps, children can stand in the chair seat and topple from the chair, or slide under the tray and strangle on the waist strap or when their heads become trapped between the tray and the chair seat. Other accidents occur when the chair tips over. High chairs may tip if an active child pushes off from a table or wall, stands up in the high chair, or rocks it back and forth.