As an ER doc and a mom. Here are five things I don’t let my kids do because the risks are too high | Canada Voices

Ask a Doctor is a series of physician-authored columns offering insights and advice on common health topics. It is not a substitute for seeking medical care.

As an emergency doctor and a mom of young kids, I often see how quickly a regular day can turn into a nightmare. I’ve spent my career treating children who were just having fun – at birthday parties, the cottage or after-school adventures – when something went sideways and they ended up in the emergency room.

We can’t (and shouldn’t) protect our kids from every bump or bruise, but seeing what I do for work has shaped how I think about acceptable risk. There are some things I simply don’t let my kids do, not because I’m overprotective, but because I’ve seen what can happen when things go wrong.

I don’t let them jump at trampoline parks

Trampoline use, especially in commercial parks, is a leading cause of fractures, head and neck injuries and spinal trauma, according to the Canadian Paediatric Society and Parachute, a national charity focused on injury prevention. In many cases, it’s not reckless play that causes these injuries, but simple physics: A heavier child jumping beside a lighter one can lead to the so-called ’double jump,’ resulting in leg injuries, a collision with another child’s head or an awkward fall putting the spinal cord at risk.

I’ve treated kids with broken bones, severe concussions or neck fractures after what was supposed to be a fun birthday party at a trampoline park. The risk just isn’t worth it to me.

There’s a role for risky play in childhood, with solid evidence that it benefits a child’s physical, mental and social development. Thankfully, there are plenty of ways for a child to engage in risky play where they are the ones in control.

In my family, we focus on playgrounds, biking and climbing – situations where the ground is stable and the hazards are visible. And while my kids aren’t allowed to jump at busy trampoline parks, I do let them jump solo on completely enclosed backyard trampolines, because I think the risk is significantly lower.

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I don’t allow them on ATVs or dirt bikes

Every summer, the ER fills with all-terrain vehicle and off-road dirt bike injuries. As I’ve written before, helmets save lives, but they can’t prevent every outcome when a 300-pound machine flips over or hits a tree. The Canadian Paediatric Society advises that children under 16 shouldn’t operate ATVs at all because they lack the size, strength and good judgment to handle them safely.

I’ve seen everything from broken bones and devastating head trauma to ruptured spleens and liver lacerations sustained in ATV or dirt bike accidents. Even with full protective gear, these crashes can be catastrophic.

When my kids want that outdoor thrill, I have them stick to biking, frontcountry skiing or camping and hiking with family. They still get to feel capable and adventurous, just not at the controls of something that can lead to serious injury or death.

I don’t let them walk or run around while eating (and no popcorn until they know better)

Choking is one of my biggest fears as a mom and a doctor. A grape, a hot dog bite, a piece of popcorn – all of these foods are the perfect size to block a child’s small airway. According to SickKids, choking is one of the most preventable injuries and leading causes of death in infants and children – often from small, round foods.

The risk isn’t only what kids eat, but how. Toddlers and young children frequently move around while snacking, and it takes only a minor trip or fall for food to obstruct the airway.

The rule in our house is simple: If you’re eating, you’re sitting or standing still. We skip certain foods entirely (popcorn, hard candy or whole grapes) until our kids are old enough to manage them safely, which experts say is around age four.

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I don’t let them go to sleepovers, with some exceptions

Not every risk is related to physical injuries. Some involve emotional readiness and personal boundaries. Parents may think sleepovers are low risk but I’ve seen how easily situations can become unsafe, whether from bullying, exposure to inappropriate content or just being in a setting where a child doesn’t yet have the confidence to say no or call for help. That’s why I believe sleepover invitations should be considered carefully.

For my young kids, I’ve opted for ‘sleepunders’ instead of sleepovers. When my kids are invited for sleepovers, I let them stay until bedtime and then pick them up to sleep at home. And their friends can come for dinner, movies and even pyjamas at our house, but at bedtime, everyone goes home.

As my first child has gotten older, and we’ve had ongoing conversations about potential risks, listening to discomfort and knowing how to advocate for themselves, we’ve revisited this rule and they can now attend some sleepovers that we both feel comfortable with.

While some parents may find it awkward to approach these conversations, there are resources that can help guide you.

I don’t let them have smartphones or social media

In my work, I see how smartphones and social media use contribute to youth mental health crises.

The U.S. Surgeon General has warned that frequent social media use is associated with higher rates of anxiety and depression in adolescents. The Canadian Paediatric Society has raised concerns about the effects of screen use on sleep and emotional well-being, particularly when children have unrestricted or unsupervised access.

In our home, we use shared devices in public areas to look up information together or connect with friends and relatives. We recently reintroduced a land line so our kids can talk on the phone. The goal isn’t to avoid technology, it’s to delay the most high-risk aspects of it until our kids can navigate those spaces with more maturity and support.

These decisions aren’t about eliminating all risk or shielding my children from the world. They’re about using the vantage point I have, shaped by years in emergency medicine, to identify the situations where a small adjustment can meaningfully reduce the chance of preventable harm.

Dr. Shazma Mithani is an emergency physician working with adult and pediatric patients in Edmonton. Dr. Mithani is actively involved with the Canadian Medical Association, Alberta Medical Association and Sexual Assault Centre of Edmonton. She is also co-host of The Doc Talk Podcast.