Nearly one in five children who died last year were from families with a child protection history, according to the NSW Ombudsman's annual child death review.
Child deaths were the lowest in 17 years, but Ombudsman Bruce Barbour said more lives could be saved if parents followed safety advice. He said parents were still not getting the message about the dangers of quad bikes, and risks of sudden unexpected death in infancy associated with not putting babies to bed on their backs.
''We've got parents not using correct and appropriate child safety restraints, we've got 50 [sudden unexpected death in infants] where there are modifiable risk behaviours and parents are not responding to them,'' he said.
''We've got two little babies drowning in a bath tub. These are the areas that we need to be focusing on, because this is where the largest number of deaths are.''
The review looked at the deaths of 493 children from all causes last year. There were also four deaths because of fatal assaults and two of those children were from families with child protection histories.
The report also says the families of 88 children - 18 per cent of those who died last year - had a child protection history. Mr Barbour said that history was not necessarily linked to the cause of death.
The Ombudsman's office will table a special report in Parliament next year which provides a more detailed investigation into the causes of death of children with a child protection history from 2002 to 2011.
Of the 88 children who died last year, 59 had been the subject of a report of risk of harm in the three years before their death. Five children were in state care when they died. One child had been reported to the Child Wellbeing Unit, but this did not result in a report to Community Services.
More than half of the adolescents who died of unintentional poisoning between 1998 and 2012 had complex needs and had experienced childhood trauma, abuse and contact with the criminal justice system. Almost all were known by agencies for their drug use.
The report found 13 boys of an average age of 14 died off-road while riding dirt bikes, mainly on state forests or fire trails. Six children, who were on average aged nine, died in accidents involving quad bikes. Mr Barbour said there had been 25 deaths in the past 10 years related to the use of off-road motorbikes.
''We've got young children riding off-road motorcycles, dirt bikes and quad bikes in circumstances where there is no protection, no supervision and there's no regulation,'' he said. ''Quad bikes are not designed for children to operate them. Manufacturers' instructions say children under 16 should not be using them, yet we see young children being permitted to use them and young children dying. Behind those deaths are very serious injuries and we are not dealing with those issues effectively. So that's an area that we need to improve on.''
The report also showed there were more than 30 children who died in motor vehicle accidents last year.
Mr Barbour said the overall reduction in deaths was probably a result of improvements in community education and strategies to deal with pre-pregnancy and perinatal conditions.
''We welcome the work of agencies over the past year to raise awareness and reduce deaths associated with swimming pools, low-speed vehicle run-over incidents, and accidental poisoning,'' he said.
Violence strategy comes under fire
The government's strategy to tackle domestic and family violence has failed to fix serious problems in the system, a NSW parliamentary committee has found.
The public accounts committee, headed by Liberal MP Jonathan O'Dea, found a joint response by police, Department of Family and Community services, Department of Health and the Attorney-General's office was unfocused and limited, and had failed to adequately address the problem.
In its report, the committee says it is concerned about the ''limited action'' taken by government agencies.
It says the government's responses to concerns raised by the NSW Auditor-General have been ''limited to partial implementation, often lack focus and do not thoroughly examine or fully address the specifics''.
The Auditor-General released a report into family and domestic violence in 2011 which was highly critical of the system. It found agencies did not have a clear and co-ordinated strategy for working together and sharing information about people at risk of domestic violence.
Correction: The original version of this story said the NSW Ombudsman mentioned that the risks of sudden unexpected death in infancy were associated with putting babies to bed on their backs. This should have said the risk was associated with not putting babies to bed on their backs.