What better way to keep kids active in cold weather than by racing down snow-covered hills with a toboggan? But before you send youngsters sailing down a snowy bank, be sure to take precautions to keep all participants safe.

Sledding injuries, which can range from bumps and bruises to fractures and severe head injuries, are common among children under age 19. In fact, emergency departments treat an average of 20,000 patients annually, according to a recent study in the journal Pediatrics. Boys ages 10-14 years are injured most often, and fractures are the biggest culprit.

The American Academy of Pediatrics offers the following advice:

  • Avoid collisions with cars, other people, trees, rocks, fences and other obstacles by choosing an open sledding site that ends in a flat clearing. Never sled down a road or on a slope that ends near a road or stream.

  • Ride sitting upright with feet first, facing forward to reduce the likelihood of a head injury.

  • Never ride on a sled behind a car, all-terrain vehicle or snowmobile.

  • Consider having your child wear a helmet while sledding.

Choose sled equipment wisely. According to the Pediatrics study, snow tubes and disks can reduce visibility. These sleds, which can spin out of control and do not enable passengers to steer or brake, are more likely to cause injury, including traumatic brain injuries. Similarly, toboggans are more likely to collide with other sleds and result in injuries.

Finally, dress children for warmth while sledding. Hypothermia, which can occur when clothing gets wet in cold temperatures, occurs faster in children than adults.