They're sounds no parent ever wants to hear.
"I heard lots of thumps, little baby thumps, and I knew immediately. I just knew what was going on," said Jessica Fannon.
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Her 9-month-old daughter, Ella, had tumbled down 14 stairs in their home.
The baby gate Fannon thought would protect Ella had come loose, because it wasn't made for the top of a staircase.
"I didn't know there was specific upstairs or downstairs gates," Fannon said. "She was totally fine, but I was very lucky."
A study by Nationwide Children's Hospital found that, between 1990 and 2010, the number of baby gate related injuries nearly quadrupled -- to an average of 1,800 a year.
"We can do a better job to make this product easier to use, easier for parents to install, and where kids won't be injured when they come in contact with this product." said Nationwide Children's Hospital Dr. Lara McKenzie.
Even though standards for baby gates are only voluntary, not federally mandated, the study's researchers still strongly recommend using them. But having the right type in the right place is key.
"Pressure mounted gates are great at the bottom of the stairs or between rooms, but you don't want to use a pressure mounted gate at the top of the stairs because they're too easily pushed through," McKenzie said.
Researchers say gates should be used in homes with children ages 6 months to 2 years. And that hardware mounted gates should always be used at the top of the stairs.
Parents and caregivers can also follow these tips to help reduce injury:
• Use hardware-mounted baby gates at the top of stairways. Gates that only press against walls, called pressure-mounted gates, are not secure enough to prevent falls.
• Install gates in homes with children between 6 months and 2 years of age.
• If possible, remove the gates when the child turns 2, or when the child has learned to open the gate or climb over it.
• If removing a gate is not possible because of other children in the home, use a gate without notches or gaps that could be used for climbing.