Preventing head injuries in children

Your child should wear a seatbelt at all times when they are in a car or other motor vehicle.

• Use a child safety seat or booster seat that is best for their age, weight, and height. A seat that fits poorly can be dangerous. You can have your car seat checked at an inspection station. You can find a station near you by checking the National Highway Traffic Safety Administration (NHTSA) website -- www.nhtsa.gov/equipment/car-seats-and-booster-seats#35091.
• Children can switch from car seats to booster seats when they weigh 40 pounds (lb), or 18 kilograms (kg). There are car seats that are made for children who weigh more than 40 lbs or 18 kg.
• Car and booster seat laws vary by state. It is a good idea to keep your child in a booster seat until they are at least 4'9" (145 cm) tall and between 8 and 12 years old.

Do not drive with a child in your car when you have been drinking alcohol, used illegal drugs, taking medicines that make you sleepy, or are feeling very tired.

Helmets help to prevent head injuries. Your child should wear a helmet that fits properly for the following sports or activities:

• Playing contact sports, such as lacrosse, ice hockey, football
• Riding a skateboard, scooter, or inline skates
• Batting or running on the bases during baseball or softball games
• Riding a horse
• Riding a bike
• Sledding, skiing, or snowboarding

Your local sporting goods store, sports facility, or bike shop will be able to help make certain the helmet fits properly. The National Highway Traffic Safety Administration also has information on how to fit a bike helmet.

Almost all major medical organizations recommend against boxing of any sort, even with a helmet.

Older children should always wear a helmet when riding a snowmobile, motorcycle, scooter, or all-terrain vehicle (ATV). If possible, children should not ride on these vehicles.

After having a concussion or mild head injury, your child may need a helmet. Be sure to talk with your provider about when your child can return to activities.

Install window guards on all windows that can be opened.

Use a safety gate at the top and the bottom of stairs until your child can safely go up and down. Keep stairs free of any clutter. Do not let your children play on stairs or jump on or from furniture.

Do not leave a young infant alone on a high place such as a bed or sofa. When using a high chair, make sure your child is strapped in with the safety harness.

Store all firearms and bullets in a locked cabinet.

Make sure playground surfaces are safe. They should be made of shock-absorbing material, such as rubber mulch.

Keep your children away from trampolines, if possible.

Some simple steps can keep your child safe in bed:

• Keep the side rails on a crib up.
• Do not let your child jump on beds.
• If possible, do not buy bunk beds. If you must have a bunk bed, check online reviews before buying. Make sure the frame is strong. Also make sure there is a side rail on the upper bunk. The ladder should be strong and attach firmly to the frame.

Concussion - preventing in children; Traumatic brain injury - preventing in children; TBI - children; Safety - preventing head injury

Centers for Disease Control and Prevention website. Brain injury basics. www.cdc.gov/headsup/basics/index.html. Updated March 5, 2019. Accessed September 26, 2022.

Johnston BD, Rivara FP. Injury control. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 13.

National Highway Traffic Safety Administration website. Car seats and booster seats. www.nhtsa.gov/equipment/car-seats-and-booster-seats#35091. Accessed September 26, 2022.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.