Tykes on Bikes and Trikes Need Helmets.

From the WebMD Archives

Nov. 14, 2000 -- Bicycling is becoming a sport for all ages, as more children younger than age 5 are pedaling around. But with the fun comes a risk for injury, and a new report shows that these young children are at high risk for head injuries caused by falls from bicycles or tricycles, with most of these accidents occurring at home.

The American Academy of Pediatrics says that "all cyclists should wear a properly fitted ANSI [American National Standards Institute]- or Snell-approved helmet specifically designed for cycling. Children riding as passengers must wear appropriate-size helmets in specially designed protective seats." Experts advise parents to start the helmet habit early by having children wear helmets as soon as they start to ride and to set a good example by always wearing a helmet, too. The experts also recommend talking to kids about why they should protect their heads and rewarding them when they put on their helmets without being told.

Dr. Robert R. Tanz, the senior author of the Archives of Pediatric and Adolescent Medicine report, tells WebMD that most bicycle safety programs have ignored preschool children and that new programs aimed at preschoolers and kindergartners are needed. "We found that young children age 1-4 are at higher risk from cycling injuries than had been appreciated," says Tanz, who is director of medical education at Children's Memorial Hospital and associate professor of pediatrics at Northwestern University Medical School, both in Chicago. He also is chair of the American Academy of Pediatrics section on injury and poison prevention.

Tanz examined nationwide data on children treated in emergency rooms for cycling-related injuries. He estimates that each year more than 45,000 young children visit the emergency department for bicycle-related injuries, numbers that tend to rise for older kids and boys. A significant number of these injuries are head injuries. Children aged 5-9 also had the highest rate of facial injuries. Tanz says this probably means that few of these children were wearing helmets.

For children under age 1 and for those who cannot sit up unassisted, Dr. Danielle LaRaque, tells WebMD that they should not be on bicycles at all. LaRaque is chief of general pediatrics at New York's Mount Sinai School of Medicine.

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The American Academy of Pediatrics also says that children riding as passengers on bicycles should sit in separate restraining seats that are fastened securely to the bicycle frame, strap the child in securely, and protect the child from moving parts of the bicycle.

"Our impression is that we are seeing more injuries from children even 3 and 4 who are already riding bicycles. Helmets are extremely important for these young cyclists and also for those on tricycles," Tanz says. "Toys like Big Wheel-style tricycles look extremely safe, but children use them in ways parents have never thought about. They try to do wheelies on tricycles and then fall right off the back onto their heads. With bikes, trikes, or scooters, the point to remember is that if you can fall off it, you can land on your head. Children on any of these should wear a helmet."

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