As a society, we could do a lot more for the safety of our children if we focused on accident prevention instead of being consumed by irrational fears.

I am a child neurologist and neuroscientist, as well as the parent of a 4-year-old and a 19-month-old. My research and patient care revolve around childhood brain injury and how to prevent it.

Since having kids, I have noticed that my parenting concerns are strikingly different from those of many other parents. My kids get to eat loads of candy. They get to stay up late if they want to. They’re allowed to watch cartoons till they’ve had their fill. I don’t care if they use swear words. When they fall down, I don’t pick them up. If they’re eating dirt, I don’t stop them. I don’t really care if they get bitten by other kids at daycare – but if they do, I’d like them to bite back.

So you might think I’m just super laid back and laissez faire, but you couldn’t be more wrong. There is a long list of pretty standard childhood activities that my children will never experience if I can help it. Riding the public school bus? No, too often there are no seat belts. Staying at a hotel with an unfenced pool? Not until they’re expert swimmers. Bike riding on busy streets? No way. Staying at a friend’s house? Not until I’ve verified that there are no guns there. Playing American football? Don’t even think about it.

The real dangers are not where we think they are

Why would I, as a child neurologist and parent, have such a divergent notion of what’s dangerous for my kids? It’s simple. Precisely because I am a neurologist, I know that what hurts the brains of otherwise healthy children in developed countries is not too much television, or junk food. It’s trauma and asphyxiation.

The most common preventable cause of severe brain damage in babies is so-called non-accidental trauma (NAT), which means that the baby was shaken or beaten by an adult caregiver. These types of cases are astonishingly common, peak around three months of age and often leave surviving children neurologically devastated. As a neurologist, I have seen this horrific scenario play out too many times.

Cars and swimming pools represent the greatest threats to toddlers. The top causes of death in that age range are motor vehicle-on-motor vehicle collisions, motor vehicle-on-toddler collisions, and drownings. Many of the most severely brain-injured children I’ve taken care of were ejected from the car during a crash. While most serious car-on-car crashes happen at highway speeds, most car-on-toddler accidents happen at slow speeds in the most seemingly innocuous settings.

“Even though it will feel unnatural, let your worrying be guided by statistics and not your instinctive fears, or the news.”

As for swimming pools, I would never live in a house with a pool. Although pools have surprisingly good PR, they should really be renamed “toddler-drowning devices.” They’re the number-one cause of death for male toddlers and the source of my worst nightmares.

The following is not an exhaustive list, but to keep your kids safe from the gravest dangers, here are some simple guidelines you should follow:

  • Never speed, and never drive when sleep-deprived or intoxicated.
  • If you can afford it and square it with your conscience, you should also buy a big, heavy car.
  • Never let small children ride in a car without the appropriate child or booster seat and never let older children ride without a seat belt, even for just a few yards.
  • Never let your children play near roads, and hold their hand or carry them when walking through parking lots and garages.
  • Never let your children ride an all-terrain vehicle or motorcycle, even as a passenger.
  • Never let your children ride a bike, skateboard or rollerblade without a helmet.
  • Never stay at a home or hotel with a pool unless it is protected by a security fence.
  • Teach your children to swim at the youngest possible age.
  • Carefully vet all babysitters.

The human brain is terrible at intuitively judging the dangers of the modern world. I’m afraid of sharks and bears even though the chances of me being hurt or killed by a wild animal are essentially zero. On the flip side, I have no natural fear response to cars, although they’re incredibly dangerous and I’m surrounded by them every day.

“I wouldn’t be surprised if televisions, iPads and computer games are saving children’s lives every day, by keeping them away from cars and swimming pools.”

For many children, the commute to school or daycare is the most dangerous thing they do every day, yet their parents might be more worried about kidnappings, which are infinitely less likely than car accidents.

Even though it will feel unnatural, let your worrying be guided by statistics and not your instinctive fears, or the news. As a society, we could do a lot more for the safety of our children if we focused on accident prevention instead of being consumed by irrational fears.

On a final note: I wouldn’t be surprised if televisions, iPads and computer games are saving children’s lives every day, especially in the summer, by keeping them indoors, away from cars and swimming pools.

To our blog readers – parents and child development professionals: Are swimming pools really “toddler-drowning” devices, as our author puts it? Would you let your kids eat dirt? What are the greatest dangers for children, from your viewpoint? Tell us what you think!

9 comments

  1. Article is good, however we have to change the precautions as per the situations. Being alert always pays off. when there are sounds coming from play area or total silence, checking is important. Even while giving bath, feeding etc. Parents need to be attentive and patient. At times it is difficult to predict what the child’s next action will be, so being alert with babies can help prevent accidents.

  2. Thanks for reminding us of the greatest childhood dangers in our society – but what about the next 70 years? As an adult Neurologist, I am afraid I find your article a little short-sighted. Sure, I can keep my children safe by putting them in an indoor bubble with a bag of junk food and some computer games…but when they’re an obese 45 year old struggling with their first stroke I’m not they’re going to thank me! YES, lets make sure we look at the statistics and avoid the real dangers in life – but those dangers include diabetes and physical inactivity (and some would include the air pollution that your big heavy car is contributing to). So please, don’t let your profession as a child-centered neurologist make you forget about the other decades of life…

    1. Ania – I’m obviously not advocating letting kids become obese. Despite my relaxed attitude towards sweets and television my kids are very active and in top shape. They participate in safe, organized sports and play in a large yard protected by a security fence. Unfortunately, those types of activities are expensive and therefore unavailable to many children. My point is that children aren’t just little adults and that their health risks are fundamentally different from those of adults. That’s why it’s important to strongly modulate our primary health concerns based on age. So for my kids I am most worried that they will get hit by a car and I try very hard to minimize that risk. For myself I have had to become more concerned with my weight and relatively sedentary lifestyle.
      The choice of car is an interesting conundrum. The weight of a car is clearly the #1 safety factor. So if you’re most concerned about the passengers in your vehicle surviving a crash with another vehicle, you should purchase the heaviest vehicle you can afford. If you’re also concerned with fuel-efficiency and pollution and you can afford it, you should consider a heavy electric or hybrid SUV. However, those are too expensive for most. The safest and most environmentally friendly strategy is to reduce the distances traveled and to drive extremely slowly.

  3. Excellent article and validated a lot of my concerns. It’s nice to have that validation because people think I’m nuts for worrying about driving with my (now 3 year old) son. Luckily, he HATES the car, so most of the time we walk in a pedestrian neighborhood to where we are going or bike (taking bike paths.) We taught him from a very early age to stop at streets and alleys and look both ways and I’m happy to say he does this automatically now. Whether he actually would notice a car, is another test I haven’t done. At six months old, he learned how to float. I had income concerns, so we stopped swimming lessons. At a little over one year, he jumped in the deep end of the pool unexpectedly! I was a few steps behind him and jumped in, too. (Fully clothed, I might add.) I called the expensive swim lessons place the next day and didn’t care how much! Just last week, we were in a river and he got in over his mouth and then instinctively floated!
    Two questions, I’m no expert, but the research I’ve seen shows that smaller, nimble cars are more safe than big heavy cars for two reasons: 1) They can AVOID the accident, which is much more important and 2) Big Heavy Cars flip and crush the people inside. Also, I have heard (but haven’t researched myself) that sugar (or stress in general from junk food or other sources) is harming the development of child’s brains in the womb and as toddlers. Moderation is fine. No need to be crazy. Thank you, again

  4. I agree with most of this article. Except with the binging on junk food and TV. In my opinion that’s not necessary at all and actually also kind of a serious health hazard. And if your kids are that fit and active (at these young ages) then you should have added that to the article as a caveat!

  5. Great write, I’ll definitely let my kid (in 4 months it’ll be a reality) eat dirt or play in the forest, let him jump and climb. But as you say, cars are different. I’ll tend to be even more cautious. I pay attention to all possibilities on the road and it saved a crash many times. I anticipate a possible collision all the time, anywhere and it gets me a lot of time to react and avoid it.

  6. Dear Nico, I just discovered your work via NOVA’s “Memory Hackers.” Regarding your article above, I see all your good points and warnings to be common sense ideas. But then, common sense isn’t so common! I would add to your list to strive to avoid choking hazards in children and NEVER letting young children chew gum! I’m not sure a what age gum chewing is relatively safe, but I know a man who makes a living from transporting donor organs. The child deaths he sees from chewing gum blocking the airway is so staggering he warns EVERY parent to never let children chew gum. Period. Keep up the good work, Nico!

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