With Halloween nearly upon us, careful planning for the big event is crucial for ensuring a safe and fun excursion around the neighborhood, especially for the youngest of trick-or-treaters, says pediatrician Dina DiMaggio, M.D.:

Allow for plenty of time to fright-prep.

As a parent, you know your child best. Keep a look out for fears and anxieties about Halloween. The best way to handle fear and get a toddler ready is to discuss what’s going to happen. Reading books and stories to your child about trick-or-treating—and Halloween in general—are great ways to help that discussion. You might even want to have your child practice in his or her costume before the big day. Toddlers need to know that Halloween is just for fun and the scary stuff is all pretend. If your little one doesn’t want to partake in Halloween, then let that be okay. There is always next year, and 12 months can make a big difference!


Let your infant or toddler get a little messy:

Play with pumpkins.

Allowing your baby or toddler to squish his or her hands around the insides of a pumpkin can be a great sensory activity. For little ones who “hate getting dirty,” there are plenty of no-carve pumpkin decorating options to try.


While we’re on the subject of pumpkins, the AAP advises:

  • Small children should never carve pumpkins. Children can draw a face with markers. Then parents can do the cutting.
  • Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If you do use a candle, a votive candle is safest.
  • Candlelit pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and not on a porch or any path where visitors may pass close by. They should never be left unattended.


Dr. Jaime Friedman emphasizes that last point:

If using lit candles in the pumpkin, do not leave it near anything that can catch fire and never leave it unattended. Try small tea lights instead.


Speaking of burns, you don’t want to show up at Dr. Christina Johns’ emergency department on Halloween night:

Sometimes you’d think it’s the 4th of July with all the sparklers that people apparently save from that holiday just to ignite on October 31. People light those up and kids get burned. Happens to someone every time. Recall that these can heat up to very high temperatures very quickly and can cause burns to hands and eyes.

Emergency-level lesson: Pass on these. Use the glow sticks instead. Or a flashlight.


Dr. Johns is a pediatric emergency medicine doctor who sees a lot of scary stuff on Halloween. This year she expects to see children struggling to breathe from peanut allergies (hypervigilant parents of food allergic kids should keep the Epipen close by!), asthma (don’t forget the inhaler and spacer), and inhaled foreign bodies in the form of small toys or pieces of hard candy. Dr. Friedman, a pediatrician, has seen it all before:

Don’t let children eat candy while out trick-or-treating to avoid choking. If your child has food allergies, check all labels first or look for non-candy items. Homes with a teal pumpkin have allergy-free treats.


Because infants and toddlers tend to put everything in their mouths, all treats should be viewed as choking hazards, says Dr. DiMaggio:

Keep an eye on what your child has in his or her mouth at all times while on the trick-or-treat trail—it’s so easy to get distracted! It’s best to avoid eating while walking or running. Once your child is ready to enjoy treats at home, keep in mind that babies and toddlers should not have any hard candies, caramel apples, popcorn, gum, small candies (jelly beans, etc.), gummy candy, pumpkin seeds, or anything with whole nuts. Candy wrappers, stickers, small toys, or temporary tattoos can be a choking hazard, as well. As all parents know, babies and toddlers will put just about anything into their mouths!


ER doctor Johns expects to see her share of injuries, too:

That time when the awesomely cool mummy costume unraveled, and then a major trip and fall occurred. There are ankle fractures and there are ANKLE FRACTURES, and one that I’m recalling required a trip to the operating room for pins and fixing.

Emergency-level lesson: I really think a “trial run” of the costume is a solid idea, because then you’re much less likely to have the fun holiday ruined with an injury that requires operative repair. Or any other procedural repair. (This includes any sharp edge of costume additions that can cause lacerations.) So have your kids practice running in their costumes like their hair is on fire.


Dr. DiMaggio has two other costume-related pieces of advice for infants and toddlers enjoying the excitement of the evening:

Watch for tripping-toddler hazards.

Even on their best days and in the best conditions, it is still a struggle for some toddlers to walk without falling. While you won’t be able to prevent all of the tumbles, choosing a costume that is not too long or too bulky will help a great deal. Be sure to check the forecast before you go out and try to include layers if needed. Also remember to help your little one climb up and down any steps and porches.

Always have a “Plan B” costume. 

From leaky diapers to spit up to toilet training accidents, this age is always reason to pack a backup costume and plan for the unexpected. If potty-training is still a new thing and there’s a narrow window between “I have to go” and an accident, you might want to rethink a complicated costume. There is also no harm in putting him or her in an easy-on, easy-off diaper.


Finally, kids are never too young to learn to pace themselves with all that sweet Halloween loot:

Take precautions with added sugar. 

Although Halloween and sugar often go hand in hand, the AAP recommends limiting the amounts of sugar kids get each day. This may not be an easy task when most Halloween treats are packed with added sugar and artificial colors your little one doesn’t need. Look out for snacks and treats that may seem “healthier” but still contain added sugars—flavored yogurts, flavored milks, sugary cereals, granola bars, juices, and fruit gummy snacks. Other options for trick-or-treating toddlers, or those who choose not to give out candy, include crayons and notepads, stickers, stamps, chalk, bubbles, tattoos, playdough, or stuffed animals.

  • If your baby is six months or older and is just starting solid foods: You can get him or her into the Halloween spirit with some pumpkin purees. Whether canned, frozen or fresh, pumpkin is packed with nutrients for your growing baby—beta-carotene, vitamin A, potassium, vitamin C, calcium, and more. Other fall-themed options include butternut squash, sweet potato, or roasted apple purees. You can even mix in a pinch of cinnamon or nutmeg to add in fall-inspired flavors.
  • Ideas for older toddlers: Seasonal treats may include soft bites of roasted apples or apple sauce, baked sweet potato fries dusted with cinnamon, apple zucchini muffins, pumpkin-inspired smoothies, or fruit ice pops made with fun Halloween molds.


Tomorrow on The PediaBlog, we will have more advice for keeping kids safe and having fun on Halloween.


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