Pedestrian injuries are the most common injury to children on Halloween night. Parents can help their children be safe by ensuring they wear light and bright costumes with reflective material or tape and have flashlights with fresh batteries in hand.  Parents should always accompany younger children during trick-or-treating, and always travel in groups on well-lit streets and preferentially on sidewalks. Trick-or-treaters should only visit well-lit homes and avoid any candy or treats from people on the street or cars.

- Michael Flaherty, DO, critical care physician and injury prevention researcher at MassGeneral Hospital for Children 

Halloween is centered around scares and sweets, but parents should be mindful when it comes to candy. The haunted holiday is a special occasion, so a few extra bites are understandable. Aim to eat a healthy meal before heading out to trick-or-treat and pick an appropriate size bag to collect candy in. Opt for popcorn snack bags, wrapped fig bars, trail mix bags and non-food items such as stickers and glow sticks, but be thoughtful of food allergies and ask a child’s parent before handing out nut-based products. Consider donating the acquired candy to charitable military programs that ship care packages to deployed troops. Dental offices and police stations often host exchanges where candy is swapped with toothbrushes, coupons and monetary incentives.

- Simona Lourekas, MS, RD, LDN, CHES, Meaghan Alexander, MS, RD, LDN, CNSC and Kelly Millan, MS, RD, LDN, of the Pediatric Gastroenterology and Nutrition Program

Culturally Conscious Costuming
The spirit of Halloween is to have fun and take on a different character, like an astronaut or Elmo. However, parents should be mindful when costuming their child to avoid choices that could hurt or harm others. Some costumes have a distinctive style that borrows from a particular culture. It’s important to respect that culture’s origin, story and garb while refraining from devaluating their history. Everyone has a unique background and we respect them.

- Deb Washington, PhD, RN, manager of Diversity, Equity and Inclusion Health and Community Partnerships

Food Allergy
The pillars of food allergy management are prevention and emergency preparedness. These must always be in place, especially on Halloween. Don’t be tricked by treats. "Mini candies" may have different ingredients than larger versions so parents should read each specific label. 

Be prepared for a possible reaction. Epinephrine auto-injectors should be kept in the hands of a trained person who can administer it and have a cell phone readily available. Discuss your child’s food allergies with your ghoulish group. They can help monitor the sometimes-hectic night.

- Michael Pistiner, MD, director of Food Allergy Awareness, Education and Prevention, MassGeneral Hospital for Children Food Allergy Center

Understanding Emotion
Through Halloween and it’s horrors, there’s an opportunity for healthy bonding between children and their parents. Children love playing hide-and-seek or yelling “boo!” to an unsuspecting mom or dad. But, how much horror can your child handle? Keep developmental rules in mind and avoid overwhelming or truly frightening your child. Children should never be forced to face their fears when they don't have to. Halloween should never be forced on anyone. We must get to know our children, their traumas, and vulnerabilities.

- Fernando Espi Forcen, MD, PhD, of the Department of Psychiatry at Massachusetts General Hospital

Sensory Sensitivities
Halloween can be a fun holiday but also challenging for many children with
autism spectrum disorder. Preparation can help make Halloween as successful as possible. Preview what to expect and practice interactions such as saying, “trick or treat” and “thank you.” Have your child try on their costume ahead of time to ensure they feel comfortable and have time to get used to it and consider a costume that fits over their regular clothing. On Halloween, know your child’s limits and start slow. Bring coping items to support their needs, such as noise canceling headphones, a flashlight, and a change of clothing. Get your child involved by creating with them a “toolbox” of coping items they can use if they feel overwhelmed. Lastly, if you child is afraid to go out at night, consider a daytime activity or a neighborhood or school party where they are already comfortable and know people.

Rachel Goldin, PhD, psychologist in the Lurie Center for Autism