TIPP—Child as a Passenger on an Adult's Bicycle

A young passenger on an adult’s bike makes the bike unstable and increases the braking time. A mishap at any speed easily attained during casual riding could cause significant injury to the child. Following these guidelines decreases, but does not eliminate, the risk of injury.

  • Preferably, children should ride in a bicycle-towed child trailer.

  • Only adult cyclists should carry young passengers.

  • Preferably ride with passengers in parks, on bike paths, or on quiet streets. Avoid busy thoroughfares and bad weather, and ride with caution and at a reduced speed.

  • Infants younger than 12 months are too young to sit in a rear bike seat and too young to wear a helmet. They should not be carried on a bicycle. Do not carry infants in backpacks or front packs on a bike.

  • Children who are old enough (12 months-4 years) to sit well unsupported and whose necks are strong enough to support a lightweight helmet may be carried in a child-trailer or rear-mounted seat.

  • A rear-mounted seat must

    • Be securely attached over the rear wheel.

    • Have spoke guards to prevent feet and hands from being caught in the wheels.

    • Have a high back and a sturdy shoulder harness and lap belt that will support a sleeping child.

  • A lightweight infant bike helmet should always be worn by a young passenger to prevent or minimize head injury. Small Styrofoam helmets that meet US Consumer Product Safety Commission standards are available.

  • The child must be strapped into the bike seat with a sturdy harness.

  • Remember, the risk of serious injury still exists when you carry a young child on your bicycle.

Patient education handouts from TIPP—The Injury Prevention Program help pediatricians implement injury prevention counseling for parents of children newborn through 12 years of age.

The information in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Copyright © American Academy of Pediatrics Date Updated: Nov 01 2025 00:00 Version 0.30000000000000004

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Is Your Child Sick?®

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starfish
February 12, 2026
There have been cases of measles in NC, with exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. Two doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!