When those first snowflakes start drifting out of the sky, do your children have their faces up against the window watching in amazement? Then it won't be long before the sleds are out and everyone's bundling up for a trek to the slopes.

Every year between 30,000 and 35,000 children across the United States are treated in hospital emergency rooms for injuries sustained while sledding. One in 25 of those injured will require hospitalization.

Both the severity of sledding injuries and the type of injury are directly related to a child's age and the type of downhill vehicle. The terrain of the hill and the slickness of the surface are additional factors related to the severity of an injury. The child's position on the sled is related to the type of injury.

Children under 5 suffer the most severe injuries to the head, neck, face and abdomen. These children typically ride a metal runner sled, laying on their stomachs and controlling the steering mechanism with their hands. Injuries most commonly occur when sled and rider collide with a tree or a telephone pole. Hands and fingers are often injured when caught under the runners, or between the sled and another object.

Older children tend to ride sleds, toboggans and inner tubes in a sitting position. A hard bump on rough terrain can send the rider up in the air and down again with force. Because of their position on the vehicle, these riders often suffer injuries to the spine and risk spinal cord injury. Limb injuries also are more common in older children who tend to use their arm and legs to break a fall or avoid an obstacle.

Make each downhill adventure for your children as safe as possible with these safety measures:

1. Select your child's downhill vehicle carefully. 

• Sleds without a steering mechanism are the most dangerous since the rider has no way of avoiding objects in his or her path.
• Consider a metal runner sled over a plastic sled. Runner sleds elevate the rider off the ground and away from small, stationary objects. A plastic sled, by nature of its design, will strike anything in its path.

2. Always inspect the terrain of the hill before allowing your child to use it. 

• The terrain should be smooth. A bumpy terrain may throw the rider into the air or off the sled, causing the child to land on the ground or in the path of another speeding sled.
• Avoid hills with trees, telephone poles, large rocks or fences on the slope or at the base of the slope. Hills should be wide and free of obstructions.
• Avoid hills whose slope ends at a road or area with motor vehicle traffic.
• Avoid sledding on icy surfaces. A slick surface increases the speed of the sled while further reducing the rider's control.

3. Encourage young children to sled feet first.

• This is the best way to protect your child from crashing or being thrown head first at 10-20 mph.

4. Dress your child appropriately. 

• Children should wear insulated, waterproof boots and gloves and well-padded clothing. Protective helmets are a must, especially for younger children.

5. Supervise your children and talk with them about sledding safety. 

• Children who understand the risks are more likely to exercise good judgment when sledding, and are less likely to be reckless.