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Expert Q&A:
Should I make my clumsy 17-month-old wear a safety helmet?

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Suzanne Dixon
Answered by Suzanne Dixon M.D., M.P.H.
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"There is nothing so amazing as the development of a child," says Suzanne Dixon, M.D., a behavioral and developmental pediatrician who was one of the founding members of the Pampers Parenting Network. "Every day is a new adventure when you have a child around you. I never get tired of learning from the children who have been a part of my life, professionally and personally."Suzanne Dixon, M.D., M.P.H., was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her pediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr. Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former U.S.S.R. Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in pediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education and is in its fourth edition. She is Editor in Chief of the Journal of Developmental and Behavioral Pediatrics, an international journal of high standing in the professional world. She also has served as an associate editor for Infant Mental Health and currently reviews for several major pediatric journals. Dr. Dixon is a fellow of the American Academy of Pediatrics and served in national positions in that organization. She is a member of the Society for Pediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Executive Council of the Society for Developmental and Behavioral Pediatrics. She serves as consultant to several national and international organizations and has received an award from Healthy Mothers, Healthy Babies.Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental pediatrics in Montana and works with local advocacy groups on education and women''s health. Dr. Dixon has been married for over 30 years and has three sons. She and her husband travel frequently, are outdoor enthusiasts, and enjoy being amateur anthropologists.
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Question


My son is 17 months old, and though developmentally on track, is very clumsy on his feet. On many occasions he has fallen headfirst into solid wood furniture and face down onto pavement, sustaining large forehead bumps. On several occasions, we have had to keep him awake or arouse him every two hours for fear of concussion. I am concerned that he might accumulate brain damage from the repeated head injuries. Should I consider having him wear a helmet for safety?

Answer


I don't think you should get a helmet until you find out what's up. Most kids his age fall a lot but usually bottom first. If most of his falls are forward, his motor development needs to be evaluated more carefully. If his steps are toe first or if he walks on his toes, that would add to my concern. If he is unbalanced from side to side, or always falls to one side, or if things are getting worse rather than better, then a more careful look is needed. Goose-egg bumps are common in toddlers and don't cause any long-term problems. Make your 18-month checkup appointment now and let the staff know that you are concerned about his development and this falling behavior. They then can plan more time to check these things out completely.
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