Kids will be kids, and accidents happen, but certain activities carry more risk than others. Injury is still the leading cause of death for children and teens in the United States, according to the U.S. Centers for Disease Control and Prevention, and unfortunately, many of these are preventable.
We spoke to pediatricians who are also parents about things they’d never let their children do because of the heightened risk of injury or death, and how to make sure your child is as safe as possible.
Ride in the front before they turn 13
Motor vehicle crashes are a leading cause of unintentional injury and death in the U.S., per the CDC. Children should always be in the backseat with the proper restraints, the experts note.
“This means using the appropriate size and type of restraints — whether that’s a car seat, booster seat, seatbelt — for their age, height and weight,” Dr. Brent Kaziny, medical director of emergency management at Texas Children’s Hospital, tells TODAY.com.
While it may be obvious to buckle up younger children, parents also need to be vigilant about school-aged children and preteens, the experts say.
Even if a child seems large enough to ride in the passenger seat, stick to this hard and fast rule. “My kids will not ride in the front seat before the age of 13, which is the recommended age that kids can move to the front,” Dr. Katie Lockwood, a primary care pediatrician at Children’s Hospital of Philadelphia, tells TODAY.com.
“The (front) airbags are potentially dangerous to children, whose skeletons are still developing and aren’t the right size to be in the front,” says Lockwood, adding airbags can cause rib fractures, punctured lungs and injuries to the head, neck and spine.
No matter how much pressure kids put on their parents because their friends ride in the front, Lockwood stresses that 12-year-olds and younger go in the back, no matter how short the drive.
Jump on most trampolines
Unfortunately, the highs of this beloved backyard accessory may not be worth the lows. Some trampolines are riskier than others, the experts say.
Dr. Ee Tay, a pediatric emergency medicine specialist at Hassenfeld Children’s Hospital at NYU Langone, tells TODAY.com that public trampolines or trampoline parks are out of the question for her kids. “There’s just so many broken bones and orthopedic injuries,” says Tay, adding that the uncontrolled environment and greater number of kids increases the risk of collisions and falls.
“It depends on the weight of the child, how hard they can bounce, how high they can jump, if there’s another child next to them. ... It’s just very unpredictable,” says Tay. Other trampoline-associated injuries include lacerations, concussions and spinal injuries.
While he does see many trampoline injuries, Kaziny says he thinks there are ways to do it safely. Trampolines that are in-ground or have enclosure nets are safer, and parents should always supervise trampoline sessions, minimize the number of kids jumping at once, and make sure there aren't significant differences in age or weight among kids, says Kaziny. (The same applies to bounce houses.)
The American Academy of Orthopaedic Surgeons recommends children under 6 do not use trampolines at all, and the American Academy of Pediatrics recommends children only use them in supervised training programs for gymnastics or other sports.
Ride an ATV
“My kids will never, ever go on an ATV. ... They are so dangerous,” says Tay, adding that the all-terrain vehicles cause many preventable accidents among children. This applies to both riding and driving ATVs, though most are built for just one person.
Motor sports have become increasingly popular in the U.S., and ATV-related injuries are on the rise, TODAY.com previously reported.
ATVs do not require any training or a license, Tay points out, and children often don’t have the ability to properly judge speed or distance. “They just kind of go at it,” says Tay. The heavy machines can also flip easily.
Although ATVs do come in youth sizes, Kaziny says he commonly sees parents get an ATV that the child won't outgrow too quickly. “The child ends up being on something that’s really not age appropriate ... from a size and power perspective,” says Kaziny.
The AAP recommends that no one under the age of 16 ride or operate an ATV, and that this is the most effective way to reduce ATV-associated injury or death.
If parents choose to let their child ride an ATV, Kaziny recommends making sure it is age-appropriate, the child is wearing a helmet and other protective equipment, and that they follow safety measures.
Drowning is another leading cause of unintentional injury among children. “More children ages 1 to 4 die from drowning than any other cause of death (per the CDC),” says Lockwood, adding that these often occur in swimming pools but also bathtubs (especially among infants) and natural water sources.
The experts encourage parents to teach their children how to swim as early as possible — but even after kids learn, parents should remain vigilant and set rules.
“As kids get older and they know how to swim, they have increased confidence," which can lead kids to take more risks, such as swimming alone, Lockwood says. So it's important to remember your child can still drown, even if they know how to swim.
“I teach my kids from a young age not to swim alone and that they should always have an adult who’s watching them,” Lockwood continues. She stresses parents should ensure there is always one designated and sober "water watcher."
Even if the child is swimming in their own pool at home, the experts warn that tragedies can happen. “It’s shocking how quickly a kid can end up getting themselves in trouble if you’re not really paying attention,” says Kaziny. He recommends that all home pools should have child-resistant barriers, like locking gates.
Ride anything without a helmet
“I don’t let my kids ride anything with wheels without wearing a helmet,” says Lockwood. This includes bikes, scooters, skateboards, rollerblades and hoverboards.
"Kids have a disproportionately large head compared to their body, so they’re more likely than adults to fall and hit their head," explains Lockwood. Resulting injuries range from bumps and lacerations to concussions and severe brain bleeds that cause permanent damage.
Tay agrees: “There are too many injuries that we see in the ER for something that can be very easily prevented with (head) protection.”
Children should also wear helmets while skiing, snowboarding, ice skating, horseback riding and during water sports. "If they make a helmet for it, you should wear one," says Kaziny.
Lockwood encourages parents to remind children that no matter how good they are at something, accidents happen and other people can cause crashes.
"I also try to model that good behavior by always wearing a helmet myself," adds Kaziny.
Pet unfamiliar animals
Parents can prevent a lot of ER visits by teaching kids how to behave appropriately around animals, especially ones they do not know.
“We have a rule at my house. ... If we see an animal we want to interact with, that we do it in a safe and controlled way and make sure the owner is OK with it,” says Kaziny.
Children may feel more confident approaching animals if they have pets at home, but Kaziny recommends teaching kids about boundaries with animals. For example, a child can’t kiss or hug any dog because they do this to their own dog.
“One of the common types of injuries that we see is when the child gets right up in the animal's face then the child gets bitten on their face,” says Tay, adding that she also sees bites occur when children approach an animal while it is eating.
Go to a house without asking about firearms
"I would not let my kids go to someone’s house without verifying if they own guns, and if they do that they’re safely stored," says Lockwood. Safely stored means they are locked in a safe and out of reach of children — which is especially important as kids get older and hang out without parental supervision, she explains.
“Firearm injury has now exceeded motor vehicle collision injury as a cause of child mortality,” Dr. Marc Auerbach, professor of pediatrics and emergency medicine at Yale School of Medicine, tells TODAY.com. “Unfortunately we have seen a large number of both unintentional firearm injuries and in the older child or teenage population, related to suicide or homicide."
Fortunately, firearm-related injuries and deaths in children are preventable, says Kaziny. Families that own firearms should always practice firearm safety and store them appropriately, and parents should feel empowered to ask about firearms in any home their child will be.
Auerbach also encourages parents to have early conversations with children “so they can really understand how dangerous and life-threatening firearms can be.”