To maximize fun and minimize injuries, please make sure that your children always walk on the sidewalks and cross at corners, traffic signals or crosswalks. Trick-or-treat on well-lit streets. Supervise your children and make sure they don’t run into streets and stay aware of their surroundings. It is important for them to be seen by others so using reflective clothing and carrying flashlights are strongly recommended. Costumes that fit properly and masks that do not obstruct their vision help avoid trips, falls and other injuries. Be careful so you don’t have to spend Halloween in the emergency room!

- Ari Cohen, MD, chief of Pediatric Emergency Medicine at Mass General for Children (MGfC)

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 at MGfC

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 at Massachusetts General Hospital

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 at the MGfC 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 Mass General

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 at MGfC and Mass General