Toddler safety: To Bounce or not to Bounce?
This Monday I opened my email to find a permission form from the daycare asking whether I would allow little L to go on a moonbounce. “The moonbounce?” I thought. My little itty bitty one going on a moonbounce?
Well, maybe. Today, at his daycare’s end-of-summer party, age-appropriate moonbounces were being brought into each playground. The children had the opportunity to try it, given that they received parental permission.
So on Monday, I was faced with a tough conversation with my husband T. Do we let little L go on the moonbounce or not?
For L, I couldn’t imagine any setting where I think he would even want to go on a moonbounce. He likes bouncing on our knees, but gets upset when he feels unstable or unprotected. At times he doesn’t even want to sit on our backs to play horsey if he feels like he may fall down. So would he even want to enter the dreaded moonbounce arena? I couldn’t be sure about that. At the same time, I did not want to limit his abilities. What if he saw other children crawling on the moonbounce and wanted to participate? In the desire to protect my child, the last thing I would want to do was to baby him so much that he was not independent in his thinking. I want him to explore the world and to try those things.
Balancing Safety with Adventure
It’s a challenging task to balance the safety needs in a toddler with their needs for exploration. After seeing other friend’s children be so bold and adventurous, I would love it if L was the same way. Although his personality shows more timidity, hopefully T and my parenting are not contributing to any limits in his confidence in himself.
Yet as a pediatrician, I have experienced firsthand knowledge of far too many injuries – unhelmeted A-TV accidents, bikes, scooters, motorcycles – we’ve seen it all. And the moonbounce falls in the category of injuries. Case in point: in my first year of residence patient was admitted on our service with a fractured humerus (upper arm) sustained when another child had landed on her while playing in the moonbounce. That patient had to have surgery done to her arm.
What was the full story with this patient with the fractured humerus? Unfortunately there are rarely absolutes when it comes to these stories. That child in the moonbounce had been small, and the child who had landed on her was very large. I have no idea whether these children were being supervised or if safety had been attended to in that case. Are their specifics in the case that could have led to the child being more safe in this risky situation?
Input from the Medical Community
The bottom line from the American Academy of Pediatrics (AAP) is that avoiding risky behaviors helps prevent injuries. Unfortunately there is no specific recommendations on the inflatable bounce houses themselves, but there is strong evidence that injuries can occur commonly in this equipment, especially when children of different ages and sizes are playing together. According to the Consumer Products Safety Commission in a memorandum published in 2007, approximately 30,000 children were treated for injuries sustained while in inflatable structures and slides between 2003 and 2007, with 90% of these injuries being associated with a “moon bounce.” 85% of the injuries sustained were in children between 5 and 14 years of age. 60% of the injuries affected the limbs. There were four deaths overall associated with inflatable amusements, though none were sustained as a result of moonbounces – instead, victims of injury had been on or near inflatable slides (2), inflatable rock climbing wall (1) and inflatable hill (1) and all had victims sustained injuries in which their heads had hit a hard surface.
Using a moonbounce poses an undeniable risk to children, but this risk seems the worst in situations where older children play with younger children in these devices. Lack of supervision also magnifies risk. The AAP has not made specific recommendations on inflatable devices, but have discussed clear recommendations on other athletic equipment. For instance, because of the high risk of injuries while jumping on a trampoline, especially during home use without direct supervision, the AAP strongly recommends against children using trampolines. For cases where trampolines are used, it is recommended that children under 6 do not go on at all, that they be directly supervised by an athletic instructor, and that the surface be intact with a safety pad covering all portions of the mat and strings to prevent child entrapment, which is a far too common complication of injuries on the trampoline.
How does Supervision Mitigate Risk?
So this evidence and data was definitely concerning to me. After looking at these recommendations, my next task was exploring common sense and the daycare providers’ perspective. According to the providers, at the toddler-level moonbounce most children simply crawl around on the moonbounce and then are finished. Some children have no interest in playing on the moonbounce. They are never pressured to participate and if they do not like it they are taken off, and they are always supervised. In all cases, a worker from the daycare is in the moonbounce with the toddlers or directly outside, ready to intervene when the young children get too close to one another. They did mention that children can sometimes hit one another’s limbs, which was consistent with what I had read with risks involving inflatable structures.
The Big Decision
So with all of the evidence together, I mustered up my courage and signed the form. My parents agreed to attend the party to play with little L, and were also able to keep their eye on him while he tried out the moonbounce. I was fine with this arrangement, knowing that L would be well taken care of and that every effort was being made to minimize risk.
So the moment of truth came: party time arrived, and shoeless and in socks my parents approached the playground with L in tow, ready to thrust him into moonbounce heaven. My dad, especially keen on seeing L bounce around, was pretty excited and rushed to get him there.
But L gave a firm, “No!” even before he approached the bounce house. I’m pretty sure that the enormity of the bounce house – which was probably about 16 feet tall or more, gave him quite a scare. Suffice to say that once his feet even touched the entrance to the bounce house, even when being held securely by my dad or me, he was not going near that thing. Case closed. He made my job pretty easy by deciding for me what he felt was safe or unsafe.
One day I know little L will grow bigger and hopefully begin to play organized sports. When this happens, I picture myself in the shoes of the mother from Little Giants who wrapped her child in foam prior to sending him to practice. Or maybe he will be the one to wrap himself up in foam. Who knows?
Here’s a nice safety article I came across: http://pediatrics.about.com/od/hiddendangers/a/0508_hdn_dangrs.htm