5 things I never let my kid do as a doctor who specializes in brains

The brain develops faster in childhood than any other part of life. That's why it's so important to take measures to protect your kid's noggin and promote healthy brain growth to ensure they reach their full potential.

Children's brains are especially vulnerable to injuries, infections and toxins, according to the U.S. Centers for Disease Control and Prevention. Certain activities or behaviors can increase the risk of harm or injury to the brain, or even death. But even habits that may seem more benign can impact brain development and cause long-term problems, experts say.

Neurologists and psychiatrist who are also parents share which activities they have their kids avoid in order to reduce the risk of harm or injury and keep their kids' brains healthy.

Contact sports — or anything — without a helmet

Kids participating in most contact sports or any activity involving wheels should wear a helmet, the doctors emphasize. This includes football, hockey, baseball, lacrosse; riding bicycles, scooters or horses; skateboarding, rollerskating, skiing and snowboarding.

Whether it's at practice, a competition or in the backyard, children's heads need to be protected — "especially when starting a new activity that they're not so sure about or where there is significant fall risk or potential for injury," says Dr. Brian Im, a physiatrist specializing in brain injury rehabilitation and co-director of the NYU Langone Concussion Center, tells TODAY.com.

Helmets can protect against concussions (a type of traumatic brain injury), fractures, lacerations and more.

Certain sports come with a higher risk, says Im. American football has the highest concussion rate compared to any other high school sport (followed by soccer and hockey), according to Dr. Puja Aggarwal, board-certified neurologist and epilepsy specialist based in Florida, tells TODAY.com. For Aggarwal, it's not a risk worth taking with her own kids.

Dr. Bennet Omalu — the forensic pathologist portrayed by Will Smith in the 2015 film “Concussion," who discovered the brain condition chronic traumatic encephalopathy (CTE) — previously told TODAY.com that he discourages playing high-impact, high-contact sports before age 18. These include American football, ice hockey, mixed martial arts, boxing, wrestling and rugby.

Im says that education can play a big role in reducing the risk of some contact sports. “You have to take risks in moderation to some extent, but ... if (parents and children) are fully educated, the risks you take are calculated risks,’’ he says. Ensuring your child always wears the proper protective gear for their sport, age and skill level, is a no-brainer.

Return to a sport after multiple concussions

Even one concussion is too many, the experts note. But repeated concussions, which are frequently seen among child and teen athletes who play contact sports, can cause brain damage and a lifetime of neurological consequences, the experts note.

“After repeated concussions, even just two, I would likely not let my child return to that sport or activity, period. ... To me it’s an indication that the activity is too risky,” says Im.

Even after the first concussion, Im says he would never let a child return to that sport — unless they are completely symptom-free and have proven they can tolerate their usual cognitive and academic tasks. “There is a very significant concern of triggering more concussions, as well as a risk of severe brain damage or injury when you return to activities before you’ve fully recovered,” Im adds.

Concussion symptoms can include a headache, head pressure, nausea, vomiting, dizziness, visual changes, balance problems, sensitivity to light or sound, mood changes and fatigue.

Anytime a child has a suspected concussion, they should see a doctor as soon as possible for an evaluation, the experts note. “Some people think if you get a head injury during a game and you’re up walking around and talking that you’re fine. ... Unfortunately that’s not the case,” says Aggarwal.

Repeated concussions can cause permanent damage, says Aggarwal. She also warns about post-concussion syndrome, where symptoms — such as "difficulty speaking, mental health changes so they may become more anxious or irritable, poor concentration, and memory issues" — persist for weeks or even months.

Knowing when it’s time to give up a sport or switch sports is ultimately a decision for parents, the child (if old enough) and their doctor. “I find that incorporating the child into the conversation early on is really important,” Dr. Aaron Abrams, pediatric neurologist specializing in neuroimmunology at the Cleveland Clinic, tells TODAY.com. He adds that children should understand the consequences if they continue to participate a sport that’s causing repeated concussions.

Routine or excessive caffeine consumption

Caffeine can be part of a healthy diet for adults, but consuming too much can come with health risks, TODAY.com previously reported. Side effects of caffeine can include headaches, insomnia, irritability nervousness, fast heartbeat and tremors, per the Mayo Clinic.

For this reason, and the fact that there isn’t enough research to determine what amount of caffeine, if any, is safe for children, the experts discourage a caffeine habit for kids.

According to the American Academy of Child and Adolescent Psychiatry, there's no proven safe dose of caffeine for kids, and kids under 12 should not consume caffeine. The group also discouraged children and teens of any age from consuming energy drinks. For adults, the U.S. Food and Drug Administration caps daily caffeine intake at 400 milligrams, or about four to five coffees per day.

Common sources of caffeine for kids include:

• Soda

• Coffee and some coffee-flavored ice creams, candies, etc.

• Tea, including iced teas and sweet tea

• Some waters and juices

• Energy drinks

• Some chocolates, mints, gummies, chewing gum, peanut butter and energy bars

• Some skin care products, like lip balms

• Some over-the-counter medications

• Some dietary supplements, especially for energy, weight loss, energy, exercise and combination CBD and caffeine products

“I see a lot of kids with various types of headaches and migraines, and I find that there seems to be an association with drinking a lot of caffeine,” Abrams says. The sugar in many sweet coffee or energy drinks can also increase overall inflammation in the body.

Like nicotine, caffeine can become habit-forming and lead to withdrawals and rebound headaches, says Abrams. Caffeine can also impact sleep duration and quality, the experts note. “We know that not getting enough sleep is problematic especially for kids, who need at least nine or 10 hours of sleep a night,” says Abrams.

Vape

E-cigarettes are the most commonly used tobacco product among youth in the United States, according to the CDC, and many health experts warn that teen vaping has become an epidemic with serious health risks, TODAY.com previously reported.

Although all 50 states prohibit the sale of e-cigarettes to minors, per the CDC, vaping is easily accessible to many kids and teens, the experts note. The concealable design of many e-cigarettes also make it easy for children to hide a vaping habit from parents.

"The general thought is that vaping is not as harmful, but the reality is vaping can be harmful and highly addictive because it has nicotine," says Abrams. In addition to the nicotine, “we don’t 100% know what exactly is in the vaping device (or e-liquid)," he adds.

Not only can e-liquids contain a variety of harmful substances, says Abrams, the levels of nicotine may be so high that they can become even more addictive, research shows. Per the CDC, nicotine use in adolescence can harm the parts of the brain that control attention, learning, mood and impulse control.

"If a child gets addicted to the nicotine in the vape, that can sometimes become a gateway to other substances, whether it's marijuana or other types of illicit drugs," says Abrams. The experts encourage parents to have conversations with their children about vaping and the health risks as early as possible.

Have uncontrolled screen time

"From a neurology standpoint, limiting screen time is very important," says Abrams. Citing recommendations from the American Academy of Pediatrics, Abrams says no more than two hours a day and suggests no screen time after 8 p.m. "The light stimulation can disrupt your circadian rhythms and mess up the sleep-wake cycle," he adds.

Research has shown that screen time can lead to bedtime delay and impact the quality of sleep, according to the National Institutes of Health. In a recent study, researchers found that, for elementary-school age children, routinely sleeping less than nine hours at night can have lasting effects on neurocognitive development, TODAY.com previously reported.

Excessive screen time has also been linked with other mental health issues, the experts note, and even poorer quality of life. “It’s not just a coincidence that we’re seeing a lot more kids having problems with sustaining attention and concentration with this huge increase in the amount of screen time,” says Abrams.

"I think that over time, it can actually rewire those connections in the nervous system," Abrams adds.

This article was originally published on TODAY.com