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Heads-Up on Helmets

How to Choose One and Why to Wear It

Let’s talk helmets. The latest U.S. Consumer Products Safety Commission survey shows only about half of all bicycle riders regularly wear helmets. Each year about 350,000 children are injured in bicycle crashes. This makes bicycle-related injuries higher than any other sport. Head injuries are one of the most common. Helmets are the single most effective piece of safety equipment; they can reduce the risk of severe brain injury by 88 percent.

Take the time to make sure your child’s helmet fits properly so it can do the job it is designed to do. Have your child with you to buy the helmet, not only to assure a proper fit, but also to allow some buy-in. Letting them choose the color or style makes it more likely to be used. Don’t be tempted to buy one that he will grow into. A properlypositioned helmet should sit level on the head and low on the forehead, no more than one to two finger-widths above his eyebrow. A child looking up with his eyes should see the rim of the helmet. Adjust the straps on both sides to form a “V” under each ear. Once the side straps are adjusted, buckle the chinstrap and tighten until no more than two fingers fit under the strap.

Once the straps have been adjusted, a few simple maneuvers are in order to assure the right fit. When your child opens his mouth wide, the helmet should pull down on the forehead. Ask him to move his head in all directions. If the helmet rocks more than one inch, re-adjust the straps. Helmets are designed to reduce the peak energy of an impact. A helmet that slips around leaves areas of the head unprotected.

Equally important to remember is that the helmet needs to be replaced if it is struck in a crash where the head is involved. The foam cushioning inside the helmet is made for a one-time use. This is true even if the cushioning and helmet still looks intact. Also, treat the helmet with respect. Throwing the helmet down on a hard surface can cause damage and diminish protection. Most helmets are made with UV inhibitors, but over time, sunlight exposure can degrade the shell material. So check the helmet inside and out, before using. Because damage is not always visible to the naked eye, don’t buy helmets second-hand. Most helmets should fit a child for several years. The majority of helmets have removable pads that can be replaced with thinner ones as the child’s head grows.

Bicycle helmets are designed to be light, but a child’s neck muscles need to be strong enough to hold a helmet. Babies younger than one year have relatively weak necks. For this reason the American Academy of Pediatrics does not recommend bike riding or helmets for this age group.

Wear the helmet during every ride! Riding and falling on grass can cause just as severe an injury as when riding on asphalt. If you are having a hard time getting this point across, the National Highway Traffic Safety Administration has an excellent how-to for families interested in bicycle helmet effectiveness. Two demonstrations explored are the egg drop and the watermelon drop. These may be messy, but they provide a great visual for what happens to the head and brain when a crash occurs.

Children should always wear a helmet for all wheeled sport activities. So a bike helmet is just as effective and important when riding a scooter, roller-skating, or inline skating. There are specifically designed helmets for skateboarding and long-boarding. Kids learn just as much, if not more, from watching your behavior. So adults, wear your helmets too! For more information, visit or

Jan Dalby, CPNP, is a nurse practitioner with Pediatric Associates of Richmond where she has counseled parents for over twenty years.
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