Holidays

Doctors share top reasons children end up in the ER over the holidays

Viruses, accidents in new homes, unsafe toys. Pediatricians and ER doctors share common reasons children end up in the hospital over the holidays

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Photo of young girl and her dog cuddling Christmas Eve.

The holidays should be about spending time with loved ones, not spending time in the emergency room. But plenty of children do end up in the hospital over the holidays with various injuries and illness. Which ones are most common?

We spoke to emergency room physicians and pediatricians about the top reasons kids end up in the hospital over the holidays and how parents can help keep kids safe.

Flu, colds and respiratory viruses

"Right now we are smack dab in the middle of cold and flu season. We're seeing a lot of RSV and influenza and still a bit of COVID-19 (among children),"  Dr. Meghan Martin, a pediatric emergency medicine physician at Johns Hopkins All Children’s Hospital, tells TODAY.com. 

Up to 5.4 million people in the United States have already gotten the flu this season so far, according to the U.S. Centers for Disease Control and Prevention. Respiratory syncytial virus (RSV) is also on the rise in most of the country, and COVID-19 cases are increasing as new variants continue to circulate.

What are preventative measures you can take to avoid RSV? The CDC recommends washing hands and avoiding close contact with others.

During the holidays, people often travel and gather indoors, which creates more opportunities for children to share germs, Dr. Kara Kowalczyk, an emergency medicine doctor at Riley Children’s Health in Indianapolis, tells TODAY.com.

While most kids will recover from these common respiratory viruses, some may end up with serious illness, difficulties breathing, or hospitalized, Martin notes. Young children under 2 or those with underlying conditions are at higher risk, says Martin.

The experts recommend parents make sure all family members are up to date on their vaccinations, including the seasonal flu shot and updated COVID-19 vaccine. RSV vaccines are also available for pregnant people to help protect infants, says Martin.

"For newborns (under 3 months old), the risk of RSV and hospitalization are a lot higher so I would consider skipping the large gathering or opting for a smaller gathering," says Martin.

If a child is not feeling well, parents should try to isolate them from other family members during holiday gatherings, Dr. Danielle Grant, a pediatrician with Texas Children’s Pediatrics, tells TODAY.com.

Gastrointestinal illness

Stomach bugs and food poisoning will send plenty of kids to the emergency room with vomiting and diarrhea this holiday season, the experts warn. "We see these fairly consistently, but we will see an increase again, especially with group gatherings,” says Martin.

Norovirus, aka stomach flu, peaks between November and April and often causes outbreaks around the holidays. It's highly contagious and transmitted through direct contact or contaminated foods, drinks and surfaces, TODAY.com previously reported. Norovirus can spread rapidly in homes, schools and day cares.

There also tends to be an uptick in food poisoning around the holidays, says Kowalczyk. People are often preparing large meals that are left out at room temperature for longer periods of time, Martin notes, which can allow bacteria to grow to unsafe levels.

Feasting on home-cooked meals is one of the best parts of the holidays, but it's crucial to follow food safety practices to keep kids and families safe. Hand-washing is also crucial to prevent the spread of gastrointestinal illness, Kowalczyk says.

Most cases of gastroenteritis only last a few days and can be treated at home, but it can put a real dent in holiday plans. Children who are sick with vomiting and diarrhea should stay home and isolated until they feel better, and get plenty of rest and fluids.

Injuries in unfamiliar homes

Over the holidays, many children will be spending time in new environments or homes — whether it's a grandma and grandpa's house, a neighbor's party or a hotel. "We tend to see a lot of kids coming in for (injuries) from new places not being child-proofed," says Martin. The experts have seen everything from bumps and cuts to broken bones and head injuries.

“Around the holidays, we do sometimes see more burns,” says Kowalczyk, adding that these are often from candles, hot water or open flames on stoves. Children can get injured from playing with fireplaces or fire pits, especially when unsupervised, says Dr. Lois Lee, pediatric emergency medicine physician at Boston Children’s Hospital.

“Decorations can become a (choking) problem. Things like holly berries, poinsettias and mistletoe are all toxic for kids, and they tend to try to put that in their mouth,” says Martin.

Even if a home is child-proofed, a child’s excitement and curiosity can get them into trouble. Martin warns about poisonings caused by what she dubs "grandma's purse syndrome."

"A lot of grandparents keep medications in their purse and if it's on the ground or a low level (surface), kids can get into it," says Martin.

Children with food allergies may get into unsafe foods or snacks in a new home, Lee adds. Pediatric edible cannabis exposures are also rising, says Lee. These products can be easily mistaken for regular candy and a child may end up overdosing cannabis, Lee notes.

Children, especially young children, should always be supervised in new homes or environments, says Martin. Always ensure any medications, toxic or poisonous substances, and other hazards are kept out of reach, the experts emphasize. When in doubt, call poison control.

Toy-related injuries

New toys are one of the best parts of the holidays for children. They also cause a number of injuries that send children to the emergency room on the holidays, TODAY.com previously reported. The most common culprit are rideable toys with wheels, says Lee, including scooters, bicycles, skateboards and hoverboards.

“Kids will open a gift and just jump on it and boom, there’s an accident,” says Grant. Children may end up with sprains, broken bones or head injuries, so it’s crucial to make sure kids wear a helmet and other safety gear before taking their new toy for a ride, the experts note.

“Make sure any items given to kids are appropriate for their age. The reason those recommendations exist is to prevent choking,” says Kowalczyk. Toddlers love to put things in their mouths, and it can only take seconds for a toy or a small piece of a toy to cause a “life-altering event,” Kowalczyk adds.

Toys like water beads and magnets can also cause severe injuries if they are ingested, which is why many experts do not recommend giving them to young children.

If a toy contains button batteries, parents should take extra steps to ensure children can’t get their hands on them, the experts warn. “They can get stuck in the esophagus and within just a few hours it can erode the esophagus and can cause lifelong damage or even death,” says Kowalczyk.

Parents should check the toy’s label for age guidelines and safety warnings before gifting it to the child, the experts emphasize, and supervise young children around new toys whenever possible.

Bites from unfamiliar pets

Similarly, children may be around new pets or and vice versa during the holidays, leading to accidents. "There's absolutely an increase in animal bites and scratches," says Martin, adding that many of these are from dogs.

The holidays are stressful for pets, too. Even well-behaved dogs can become overstimulated or upset by new people, new environments and new routines over the holidays, Kowalczyk notes.

Children, especially young children, may not be able to resist approaching or petting a pet that looks cute, says Grant. Curious toddlers can grab tails or ears.

Even if a child isn't touching the dog, simply being nearby or unsupervised can be dangerous, says Lee. "Many dogs, their mouths are right at the same level of a child’s face," she adds. "Sometimes ... something happens and the child is right there."

Additionally, “with bites, there’s a high risk that those can get infected and some of these dog bites on the face can be fairly disfiguring,” says Martin.

Children should always be supervised around pets, especially ones they don't know, says Lee, and parents should teach children how to behave appropriately around animals. During big holiday gatherings and parties, Martin recommends keeping children and pets safely separated if possible.

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