Why Kids Should Stay Out of the Boxing Ring

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An estimated 18,000 children and teens are involved in amateur boxing, but a new policy statement from the American Association of Pediatrics says that the risk of both chronic and acute brain injury is simply too high and that children should be encouraged to pursue other sports, like swimming, soccer and basketball.

Boxing often involves blows to the head, and somewhere between 6.5% to 51.6% of injuries among amateur boxers are concussions. Over time, that can lead to traumatic brain injury and a host of other symptoms. Head trauma, such as bleeding in the brain (acute subdural hematoma) is also a concern. In the only data available on boxing-related death, the authors report that between 1918 and 1997, there were an estimated 650 deaths, most of them from acute head trauma. And while these numbers reflect injury to adults, pediatricians say that children and adolescents are even more vulnerable the the effects of concussions.

“Concussions are particularly concerning in children and adolescents, because there is evidence that a child’s brain is more vulnerable to injury and that recovery from concussion is prolonged when compared with adults,” the authors wrote.

MORE: Health Special: Kids and Concussions

One study of high school and college athletes who had suffered concussions found that the older athletes were able to recover normal cognitive function in three days, while high school students had problems like memory dysfunction for as long as ten days after the injury.

Younger brains have less of an insulating protein called myelin, which surrounds nerve cells and protects them from injury, Dr. Robert Cantu, co-director of Boston University’s Center for the Study of Traumatic Encephalopathy, told the Boston Globe, while describing the dangers of fighting during teenage hockey games.

Repetitive minor concussions can also lead to long-term problems with memory and other brain functions, and other aspects of boxing culture can be harmful to health as well: broken bones, facial lacerations and dental problems. In addition, the pressure to “make weight” — to stay within the confines of a designated weight class — leads to dangerous eating behaviors like starvation, over-exercising or extreme liquid loss. That can lead to electrolyte imbalance and heat stroke.

MORE: Boys, Girls Suffer Different Concussion Symptoms

Reported MedPage Today:

Some have argued that the risk of chronic brain injury has decreased in recent decades, with shorter careers among boxers, and particularly for amateurs, whose bouts are shorter.

However, longitudinal studies will be needed to clarify this.

The AAP and Canadian Pediatric Society offered the following recommendations:

– Parents, educators, and coaches should know about the risks and hazards of boxing.

– Adults should encourage teen athletes to pursue other sports with less physical impact.

– Boxing associations should provide dedicated medical personnel who can consult with teens before, during and after a match. Teen boxers should also receive regular screening for neurocognitive deficits.

Meredith Melnick is a reporter at TIME. Find her on Twitter @MeredithCM. You can also continue the discussion on TIME’s Facebook page and on Twitter @TIME.