Chicago ? With more than 24,000 U.S. children treated for shopping cart-related injuries last year, the American Academy of Pediatrics says better designs and stricter government regulation are needed.

Most injuries occur when children aren’t strapped in and fall while standing in carts. But many shopping carts are designed with a high center of gravity, making them prone to tipping over even when children are properly placed in the seating area, said Dr. Gary Smith, chairman of an academy committee that wrote the new policy.

Falls onto hard grocery store floors can result in head and neck injuries, and fractures also are common, according to the policy published today in the August edition of Pediatrics.

“Because of that, and because we don’t have a standard that adequately addresses the major mechanisms of injury, the best we can do is to caution parents that these injuries are very real, they’re very frequent, and if you have a possible alternative” to standard shopping carts, use it, Smith said.