Just because the box says a toy is appropriate for children of a certain age doesn’t necessarily mean it’s safe for the kid on your Christmas list. Pam Hoogerwerf, injury prevention coordinator at the University of Iowa Children’s Hospital, says careful thought is needed before you buy almost any gift for a child, especially if the recipient has a younger sibling.

“Sometimes we get so excited about the toy itself that we don’t stop and think about the possible injuries that could happen to a younger child playing with the toy,” Hoogerwerf says. That toy may have to be plugged in and have electrical needs or it may have small parts that could break off and pose a serious choking hazard.

She says the Iowa City facility’s emergency room is always busy during the winter months, especially with kids who are choking or suffering from electrical burns. The next most common injury is kids that get a new bike, skateboard or sled. Hoogerwerf says, “We’re seeing a lot of head injuries over the holiday because kids are excited to get out there and ride those new pieces of equipment and they’re not stopping to think about what (safety gear) they need as far as a helmet to protect that head in those cases.”

Even if a toy is labeled as being right for a toddler or a teen, it doesn’t mean they can just be turned loose with it. She says parents always need to keep an eye out for the child’s safety. “Supervision is so important with any type of toy, especially something brand new you’re introducing to a kid, whether they’re a one-year-old or a 12-year-old,” Hoogerwerf says. “I think age appropriateness and supervision is very important.”

She says during the holiday weeks last year, more than 181-thousand children were rushed to emergency rooms nationwide for toy-related injuries. More than half the injuries involved children younger than five.