An excerpt from Parenting in a Pandemic: How to help your family through COVID-19.

When my husband and I made the decision to purchase a house outside of New York City, the prior owners left behind a trampoline. The trampoline is big, above ground, and in fair condition at best. We had a decision to make — should we have it removed or let the kids play?

As a pediatrician, I know the risks of trampolines. If you ask me, “Should I get a trampoline?” the answer is a resounding no! The professional societies of both pediatricians and orthopedists have strong statements against their use. 300,000 children had injuries requiring a medical visit due to a trampoline in 2018. Some of these injuries are minor, but 53 fractures occur per 100,000 children over a year. A handful of these injuries (0.5%) are devastating, life-changing injuries to the spine.

So, I got rid of it, right? Well, here’s the time to be honest — I did not. As much as I reviewed the statistics available about the risks, I also considered how the risks applied to my family specifically. I have young rule-abiding children who are always supervised and tend to avoid risks. Since 75% of trampoline injuries occur when multiple people bounce at the same time. Injuries on home trampolines also tend to be less severe than those at jump parks. For my kids, I felt the risks were manageable.

Then, I thought about the benefits. For my children, particularly during the pandemic lockdown, the benefits were substantial. Without their friends, my kids were more sedentary. I could play tag with them or race with them for a while when I had the energy, but they would lose interest. They are too young to really engage in sports, biking or jogging, and hardly get their heart rate up from video sports classes. The trampoline is a way to get them moving. This exercise helps them sleep, improves tantrums and behavioral problems, increases appetite, and helps with their core strength. The deciding factor: They love it.

We kept the trampoline. I bring up this story because it’s an example of how we approach decisions in real life. We think about the risks and benefits specific to our family, and we consider ways to mitigate or decrease the risks. Emily Oster, the bestselling author of Cribsheet and Expecting Better, describe this framework in her Parent Data newsletter to encourage parents to thoughtfully approach decisions. Pose the question first as specific as possible. Evaluate the risks and benefits. Consider how you can mitigate the risks. Then decide.

For our children specifically, we felt the risk was in a range we could accept, and we could further mitigate this risk to promote safety. We bounce one at a time, under supervision, no flips or “moves,” we don’t go on the trampoline if it’s raining, and if anyone isn’t listening or is acting out on the trampoline, it is closed for the day. The benefits for us were worth it. This works for us … but I still won’t recommend you get one.

Decision-making sounds so easy in this framework, but unfortunately, it’s not. There is high social pressure to do the safest thing possible to protect your child from harm, at all times. Even sharing my controversial trampoline decision, I wonder if you will judge me or think less of me as a parent and a pediatrician. But truly, I believe that the best person to make these sorts of decisions is the parent.

Individuals who challenge your decisions as being too conservative or too liberal often do so out of fear. Sometimes these fears aren’t about you. Your decision as a parent can make others second guess their own choices.

Or your decision may cause others who care about your well-being to be concerned. In fact, that’s why I don’t want you to get a trampoline. Your child could get hurt — a broken arm or worse. I worry that you’ll underestimate the risk and make a decision you regret.

Regarding coronavirus, some of these fears may be misplaced. If someone questions your decision to send your young, healthy child to school because of your child’s risk of coronavirus and getting sick, while we don’t have certainty that is not a fear well supported by evidence. If others question your decision out of concern for your health as a parent, particularly if you have cancer or a heart condition, that concern may be well-justified. Our brains are wired to overly consider rare threats and under- imagine potential benefits.

You, as a parent, know your children and your family in a way that no one else does. Many times people love you and have their own strong opinions about the choices you make. When someone questions your decision, remind yourself that they don’t have all the facts. When others make different decisions for their family, remind yourself that they are answering a different question.

We second-guess our own decisions, and this is natural. Sometimes the worry, uncertainty, and guilt that follow a decision are clues that we should reconsider. Writing this has me rethinking that trampoline — it’s on thin ice. But many times these emotions are also manifestations of our love and concern for our children. The decisions feel so important to us because we care so greatly for our children.

You have made difficult choices about your family’s health and safety already. Pediatricians help parents make these kinds of decisions all the time. The shared- decision model for practicing medicine encourages doctors like me to help provide information and counseling to empower you to make decisions.

You’ve already made decisions essential to your family’s health, whether about vaccination, safe sleep, or car seats. Other more everyday decisions parents make also carry real risk — driving while tired or distracted or selecting other activities like skiing or soccer. You can make difficult decisions and, in the process of coping with the pandemic, maybe you’ll learn more about what’s important to your family.

Kelly Fradin is a pediatrician and author of Parenting in a Pandemic: How to help your family through COVID-19.

Image credit: Kelly Fradin