Fall has arrived, which means the weather is getting colder, the days are getting shorter, and pumpkin spice is back on the menu. As children settle back into school and the leaves start to fall, there are plenty of fun fall activities and holidays to look forward to.
But autumn also presents some unique health and safety risks to children, whether they're at home, school or a friend's house, experts tell TODAY.com. Here, ER pediatricians share fall activities that can lead kids to injure themselves and how to keep kids safe.
Trick-or-treating without considering car safety
Forget the age-old myths about tainted Halloween candy — the biggest danger while trick-or-treating is motorists who can’t see children and vice versa, Dr. Daniel Corwin, emergency department lead at the Children's Hospital of Philadelphia, tells TODAY.com.
In an analysis of 42 years of data from the National Highway Traffic Safety Administration, researchers found that the risk of pedestrian death was 43% higher on Halloween compared to regular nights — and the highest relative risk was among children, according to a 2019 research letter in JAMA Pediatrics.
Trick-or-treating occurs in the evening when it can be hard to see but there are still plenty of cars on the road. Add in a bunch of sugar-fueled, excited children running around the streets, and accidents can happen. But there are ways to make the evening safer.
Children should always stay on sidewalks and use crosswalks when possible, the experts note. “Remind kids not run out in the street from between cars or cut across driveways because these are areas where drivers may not expect to see child,” says Dr. Lisa Gaw, a pediatrician with Texas Children’s Urgent Care, tells TODAY.com.
Put your child in a bright or reflective costume; or add reflective tape to their costume, shoes and trick-or-treating bag; or have them wear a glow stick as a bracelet or necklace, Gaw advises.
Ensure masks or headpieces don't obscure your child’s vision so they can see cars as well, the experts note. “You can always make the eye holes a bit bigger or find an alternative they can actually see out of,” Gaw adds.
Children should be able to move in their costume without tripping or falling. “If it’s difficult for them to walk in the daylight, just imagine them trying to go trick-or-treating in the dark with it on,” says Gaw.
Playing sports at school (or home) without protective equipment
The fall marks the start of many school sports, including football and soccer. Sports have many benefits for kids, but it’s important to take precautions, on and off the field, to prevent injuries.
“When (kids) start training for fall sports ... we see a huge uptick in musculoskeletal injuries,” says Corwin. The number of sports-related concussions also tends to go up.
It's crucial for both kids and parents to be educated about these risks and how to avoid them, the experts note.
Children should always wear the appropriate protective equipment — whether it's helmets, pads, guards, etc. — and make sure it fits properly beforehand, Dr. Sage Myers, an emergency medicine physician at the Children’s Hospital of Philadelphia, tells TODAY.com. This goes for any sport, but especially contact sports, Corwin adds.
It’s also important to make sure that children use the proper sports technique (when tackling, for example), Corwin says.
Protective equipment and proper technique are just as important during games as they are during practices, scrimmages, and backyard plays. “I think I see more children who come in injured from a practice or from a pre- or post-game, when they’re kind of messing around,” says Myers.
If a child is playing unsupervised, “make sure they understand what you expect of them as far as equipment they should be wearing and what they should be doing,” Myers explains.
“It’s also important (for parents) to have awareness of traumatic brain injuries and concussions ... (so they can) recognize the signs and symptoms and remove the child from play,” says Corwin. Children who have a suspected concussion or head injury should always be evaluated and cleared rather than going back to playing, he adds.
Kids should also stretch adequately before exercising, cross-train to prevent overuse injuries, and have days off to rest as well, says Corwin.
Going to school sick
The fall is respiratory virus season, and there’s no shortage of bacteria, viruses and other nasty bugs spreading through schools and making kids sick.
"We're starting to see a surge (in respiratory viruses), and this happens invariably about two weeks after school starts," says Corwin. While it's too early to tell whether respiratory syncytial virus (RSV) will be as severe this October and November as it was last year, Corwin notes, parents can expect cases to keep rising.
Flu, COVID-19 and colds will also ramp up as the fall progresses, experts note. Even though it can be hard on parents and caregivers, it's important to keep kids home until they feel better.
“If your kid is sick, you shouldn’t send them to school, especially they have a fever or they’re actively vomiting and have diarrhea,” says Gaw. Children should not go back to school until their symptoms have resolved, and those with a fever should be kept home for at least 24 hours or until the fever is gone, Gaw adds.
“We’re also seeing a lot of strep ... and not just strep throat but other infections that the same strep bacteria are causing," says Meyers.
Sending a sick child to school can delay their own recovery and allow infections to spread to other children who can then spread it to their families, the experts note.
At school, children should wash their hands (especially after the bathroom and before eating) and avoid sharing food or drinks, says Myers. Children should also be up-to-date on their annual vaccines for flu and COVID-19, the experts emphasize.
Unsupervised pumpkin carving
Carving jack-o-lanterns is a classic Halloween activity for families, but it can easily lead to hand injuries if it isn't done safely. Sharp knives and pumpkins don't always mix and can end in cuts, stab wounds and stitches — for kids and adults alike.
There were an estimated 20,579 pumpkin-related knife injuries in the U.S. from 2012 to 2021 — with peak incidence on Oct. 30 — and the most common demographic injured were children ages 10 to 19 followed by children under 10, according to a 2022 study in the American Journal of Emergency Medicine.
In general, young children shouldn't be doing the cutting or carving, experts note. Leave those steps to adults and have children scoop out the pumpkin or draw designs instead. If older children want to get involved, they should always be supervised and using a pumpkin carving kit with special tools instead of a sharp kitchen knife.
"If kids are touching something sharp in any setting, (an adult) should be right there and have spoken ahead of time about how to use it safely," says Myers.
Playing with or near fire
Fall often ushers the return of bonfires, campfires and fireplaces to warm up colder nights. But these settings can also result in burns or smoke inhalation injuries for kids.
Burns are the fifth most common cause of non-fatal childhood injuries, per the World Health Organization, and improper adult supervision is a major factor. An adult should always be present anytime a child is near an open flame, even if it's a bonfire in their own backyard, the experts note. Following fire safety practices and teaching these to kids is also crucial.
"Ensure that there's a known perimeter around where the fire is going to be and that it's not near anything else that could catch fire," says Myers. Children should always stay at least 3 feet away from the fire, per the U.S. Fire Administration.
"Kids (should) recognize that not just fire is hot, but also anything near the fire is hot," says Myers. This includes coals, embers and structures covering fire pits, for example. Outside, it's important to pay attention to the wind, says Myers, and keep kids out of the direction of flying sparks and plumes of smoke.
Inside the home, children should never be unsupervised around lit fireplaces and candles, the experts note. Parents should also keep candles, lighters and matches out of reach from children, and use barriers around fireplaces, the experts note.
Always make sure all smoke alarms and carbon monoxide detectors are working as well, says Corwin.