How Do You Select The Right Bike Trailer For Your Child?

Written by Denise Somsak MD

My autistic son’s latest request is both timely and ironic, “Mommy, I want to hear Bicycle Race.”

David has zero interest in riding a bike, hates the heat, and only wears a helmet with lots of cajoling, but he’ll listen to that Queen anthem for an hour straight if we let him.

“I don’t believe in Peter Pan, Frankenstein or Superman…Don’t wanna be a candidate for Vietnam or Watergate.  Cos all I want to do is bicycle bicycle.”

The fact that he knows EVERY word without understanding the song only adds to the irony.  He used to ride a bike with training wheels indoors with his occupational therapist, but it was never an activity he approached with any sort of enthusiasm.

In fact, he looked quite joyless and a little frustrated.  Compare that to music and dancing, and it makes me wonder if I should force him to learn.

I’d love it if our family could bike together.  If we could talk, laugh, share the sites and maybe a slurpee at the end of the ride.  But that’s fantasy, not my family, not my reality.

Instead my husband takes the girls biking while I hang out with David.  Honestly, it’s safer that way.  Pee Wee Herman looks like a triathlete compared to me.

Seriously, please consider your own skill and comfort level in riding before you make your child a passenger.  And I don’t care if you cycle like Lance Armstrong, the AAP recommends slower speeds, bike paths, and quiet streets when kids are on board.

Consumer Reports and the AAP recommend trailers instead of mounted seats for safety.  One study (about 10 years old) in the Archive of Pediatrics and Adolescent Medicine found that children in trailers were less likely to be injured than those on mounted seats.

Mounted seats are higher off the ground than the trailer, so children have farther to fall in an accident.  Mounted seats can make steering and balance more difficult and thus accidents more likely.  However trailers proximity to the ground make them less visible to drivers and more likely to stick out into the road.

Check out the tips from Cascade Bicycle Club Education Foundation to maximize your safety with either option:

What to look for in a trailer:

  • ASTM (American Safety Testing Materials) safety standards sticker
  • A full metal roll-cage
  • 16 or 20-inch wheels with inflatable tires: they roll on uneven surfaces more easily
  • A rotating hitch that allows the trailer to remain upright even if the bicycle falls or
  • is laid on its side
  • A safety flag to increase visibility

What to look for in a bike-mounted seat:

  • ASTM safety standards sticker
  • A back that comes up around the child’s head
  • Sides that wrap around the child
  • Straps that connect around shoulders, waist, and between legs
  • Straps for the feet in the foot wells (so that feet don’t get caught in the wheel or brakes)

Children less than one year of age should NEVER be passengers on a bike. They have big heads relative to neck strength and body mass.  Don’t do it. Even the best helmet won’t make up for the weak neck muscles.

Kids need good helmets that fit correctly (video link).

With all those safety tips, enjoy the ride.  I’m staying home.  If typical children or adults can choose their leisure activities,  why can’t David?

He’s not concerned with popular conventional play or the world’s bigger troubles (“Don’t wanna be a candidate for Vietnam or Watergate”), he just wants to listen to his favorite music and dance with me.  I’m a better dancer than biker anyway.  Maybe it’s genetic?

Dr. Somsak was born and raised in the heartland. She recently joined Pediatric Associates of Cincinnati. She’s a no frills, practical gal. Dr. Somsak blogs regularly at Pensive Pediatrician

10 Tips To Help Your Child Make The Medicine Go Down

Written by Denise Somsak MD
Explain that medicine needs to be taken to make your child feel better.  Around the age of three years old, this explanation will have much more meaning and may increase ease of compliance. In the words of Yoda, “Truly wonderful, the mind of a child is.”  They sense your compassion and conviction.  You don’t need luck.
  1. Ask your doctor before you start.  Better to avoid screaming than to manage it.  Some kids do better with liquid others chewable.  Many medications can be crushed and put in food.  Pharmacist can add flavoring to liquid medications.  This is usually better than adding the medication to juice or milk because not all meds can be mixed in other beverages and more importantly, the child might taste it and refuse the rest leaving you with an even larger amount of liquid to get down.  Rectal medication is sometimes an option, but few medications other than tylenol, anti-emetics and seizure medications are made for this route.
  2. Know you can.  There is no try.  Only Do or Do Not.
  3. You need a syringe.  No, not to give the child a shot.  An empty syringe that you can fill with the correct amount of medicine.  The pharmacy should have given you one.  Always ask especially for children less than 3 years old.
  4. Make sure the child is not afraid of the syringe.  Let him hold it.  Fill it with water and let him sip it and drip it into his hand.
  5. If the child will try a little medication willingly, give a little more.  If the Force is with you, that’s all it takes.
  6. If the child does not like it, promise a chocolate milk chaser or some other highly desired treat that the child can only earn after the medication and at absolutely no other time.  This technique only works for children who can understand cause and effect and delayed gratification, about 2.5 to 3 years old and up.
  7. If the child spits the medicine back at you immediately or vomits within 10 minutes, you need to repeat the dose.  Call your doctor with variations on this theme.
  8. To avoid the spitting, lie the child on her back.  You might need a holder to steady her head.  Slowly drop the medicine in a little at a time by putting the syringe at the back of the throat, but DO NOT GAG the poor girl.  A few drops at a time even during crying should get the job done.  It will feel like forever, but I promise you it is less than a minute.  She might cough a little.  Go slow.
  9. If she will not open her mouth, gently hold her nose until she does.
  10. Do not reward the child for protesting.  In other words, refusing and protesting the first dose should not mean that he never has to take it again.  In the words of Mary Poppins, “Be firm but kind.”

Always keep medicine safely out of the reach of children and never confuse them by calling medication candy.  Apparently this is confusing enough according to recent research presented at the National AAP conference which showed that both kindergartners and teachers had difficulty telling the two apart.


Dr. Somsak was born and raised in the heartland. She describes herself as a no frills, practical gal.  She writes regularly at

Embracing Your Child’s Silliness

Written by Denise A. Somsak MD

Photo Credit - peasap

Every household and every child has a silly meter, funny bone, goofy factor. At five years old, our daughter’s understanding of language has taken off. She knows what sarcasm is. She is conversational about a variety of topics.

She knows how to make rhymes. She has a preference for stories about magic and happy endings. She likes simple poetry. She knows the words to songs from Mary Poppins and Sound of Music. She can even sing in Spanish: La Bamba.

The downside of this mastery of language is her attempt at humor. She tells knock knock jokes without quite understanding the punch lines and riddles without getting the solutions. She loves to say things like poopy face, booty, and booger sandwich.

If we do not laugh at her verbal antics, she moves on to physical comedy. She imitates the odd noises her autistic brother sometimes makes and does a dance with them which cracks up our toddler.

She will crawl under our legs and yes sometimes chew our socks. The other day I told her, “Keep your teeth off my feet. No mother should have to say that to her five year old.”

She giggled so hard she lost her grip on my socks. She laughed at her own ridiculous behavior repeating, “Keep your teeth off my feet.”

We probably allow more silliness than most families. On good days we meet challenges with humor not anger. Our son is sweet, but he is odd. When our daughter tries to give him a drawing or share a piece of candy, he usually drops it on the ground and walks away sometimes departing with a thank you.

While of course we are working on his communication skills, we also feel the need to rescue her self esteem after this type of interchange. Most of the time we do this with humor. Over time, her story telling skills have embellished her brother’s actions.

“Mommy David looked at my picture and then dropped it to see if it would blow in the wind.”

We embrace our daughter’s silliness. We see it as a sign of normal development. We rejoice that she understands humor and language in a way her autistic brother never will.

Check out the National Institute on Deafness and Communication Disorders or the American Speech-Language-Hearing Association for language milestones at various ages to see how your child is developing and things you can do to foster communication skills.

Dr. Somsak was born and raised in the heartland. She recently joined Pediatric Associates of Cincinnati. She’s a no frills, practical gal. Dr. Somsak blogs regularly at Pensive Pediatrician