Halloween is a special time for kids and parents alike. But it can be important for parents to exercise some caution, as some activities can create potential hazards, especially for younger children.

To help keep the holiday healthy and fun, Tessa Scripps, MD, Assistant Professor, General Pediatrics, at the Mount Sinai Kravis Children’s Hospital, offers parents some simple tips around picking a costume and trick-or-treating safety. She also shares advice on handling treats and how to navigate trick-or-treating with food allergies, including the significance of the teal pumpkin.

Costumes:

• When choosing a costume, make sure it fits well and is comfortable to prevent falls and ensure that your child can enjoy the evening.
• Be mindful that temperatures on Halloween can vary significantly and that costumes can sometimes be too hot or too cold depending on the weather. Pack layers just to be safe.
• Make sure the costume’s fabric is “flame resistant.”
• Consider non-toxic make up and wigs instead of masks. If you choose a mask, enlarge the eyeholes as masks can obstruct a child’s vision.
• Some costumes can be associated with unpleasant allergic reactions. Here are some more tips on that from a Mount Sinai dermatologist.

Tessa Scripps, MD

 Street Safety:

• Add reflective tape to costumes or use glow sticks or flashlights to help children see and be seen by drivers.
• Pay attention, be alert. Cross the street at corners and use traffic signals and crosswalks. Always walk on sidewalks or designated paths. If there are no sidewalks, walk facing traffic as far to the left as possible.
• If your child gets lost or is separated from the group, make sure they know their home phone number and address. If your child is too young or has special needs, consider writing your telephone number in a bracelet, sticker on the costume, or even with a marker on their arm.
• Sometimes it is helpful to choose a designated “meet up point” where your child can go if they get lost or separated from the group or from their adult.
• Explain to your child that they should never enter an unknown person’s home or vehicle while “trick or treating”.
• In case of an emergency, teach your child how to call 9-1-1.

Treats:

• Wait until children are home to sort and check treats. Throw away candy that has an unusual appearance or discoloration or is spoiled or unwrapped. Homemade items or baked goods should be discarded unless you know who made them.
• Remove all choking hazards like gum, nuts, or hard candies from younger children’s goodie bags.
• Eat candy in moderation and ensure your child brushes their teeth before bedtime.
• Instead of eating all of the collected candy, you can encourage your child to donate to “candy drives” run by local schools, churches, doctor, and dentist offices.
• Another option to reduce candy is through a game called “Switch Witch” or “Candy Fairy” where a special toy is left in exchange for a bag of candy placed outside your child’s door at the end of Halloween night.

 For Kids With Food Allergies:

• Be proactive and prepared when you have a child with food allergies, as most Halloween candies contain a variety of highly allergenic foods like nuts, soy, and dairy.
• You may want to sort candies and treats at the end of the night and replace the removed candies with treats you have purchased beforehand that you know are safe for your child to eat to avoid feelings of disappointment and exclusion.
• Reinforce which candies are safe for your child to eat before you go trick-or-treating and keep some allergen-free candy in your pocket, in case your child wants to have a treat while you are still out.
• Carry an EpiPen with you while trick-or-treating in case an accident happens.
• Become familiar with allergen-free candy brands, including “No-Whey” chocolate lollipops and sunflower buttercups, “Enjoy Life,” “Free2B,” “Yum Earth,” and “Annie’s Organic” fruit bunnies.
• Be on the lookout for houses that place a teal pumpkin sign on their doorstep—this sign indicates that they have a separate allergy-free container stocked with allergy-free treats or toys. You too can put a teal pumpkinsign on your home to identify your house as having allergen-free treats or goodies.

One of the most common cancers in the United States, breast cancer will affect about 1 in 8 women in their lifetimes, according to the Centers for Disease Control and Prevention.

Yet there are many misconceptions about breast cancer—and improving your knowledge of the disease is one way you can fight it.

Here are seven common misconceptions, and the facts from some of Mount Sinai’s leading breast cancer specialists.

Misconception: More than 50 percent of breast cancer patients have a family history of breast cancer.

The Facts: Many women think you can only get breast cancer if there is a genetic factor and, as a result, are not getting screened. In fact, 80 to 90 percent of all breast cancer patients have no family history. There are women who have genetic predispositions to breast cancer and genetic mutations that cause breast cancer. However, only 5 to 10 percent of all breast cancer patients actually have one of these genes, and a majority have no genetic predisposition or family history. In reality, your biggest risk factors are gender and age. If you are a woman who is 40 or older, even if you don’t have a close relative with breast or ovarian cancer, you should still follow the CDC’s recommended guidelines to begin getting screened annually.

Misconception: Screening recommendations are the same for everyone, regardless of a family history of breast cancer.

The Facts: The guidance for the general population is to start mammography screening at age 40 and continue on an annual basis thereafter. Those who may be at a higher risk, such as those with a family history or other personal factors, may need to be screened earlier. If you have a first-degree relative, such as a mother or sister, who was diagnosed at a certain age, you should start screening 10 years before that relative’s age at diagnosis. So, for example, if you were diagnosed at 45, your daughter should start screening at age 35. If you have a genetic predisposition, such as the breast cancer (BRCA) gene, you may need to begin screening as early as age 25.

Misconception: Only women get breast cancer.          

The Facts: For most men, the risk of getting breast cancer is extremely low, approximately 1 percent. However, for men with the BRCA1 gene, the risk is about 1 to 2 percent, and for those with the BRCA2 mutation, the risk is 7 to 10 percent, about the same as the general female population. These men should be followed at a high-risk surveillance center.

Misconception: Consuming too much sugar directly increases your risk for breast cancer, and non-natural sugar is riskier than natural.

The Facts: There are no human studies that can absolutely defend or corroborate that theory. Your body maintains a more or less constant sugar level, and even if you consume a lot of sugar, it does not directly affect cancer cells. However, adopting healthy eating habits can reduce your risk for developing cancer and other chronic health conditions, especially if you have diabetes and are prone to have high blood sugars. You need to have a certain amount of fiber. You need to have foods that are natural whole foods, and minimize the amount of processed foods.

The U.S. government dietary guidelines recommend five to seven servings a day of fresh fruits and vegetables. We recommend increasing that to 7 to 10 servings a day. One serving is an amount that fits in the palm of your hand. Stay away from saturated fats, eat healthy oils, such as extra virgin olive oil, and lean meats that don’t have a lot of fat. You should eat a mostly plant-based diet. That doesn’t mean vegetarian or vegan. It means the majority of the foods you consume should be plants. Legumes, a type of vegetable that includes peas, beans, and lentils should be an essential part of it. Two servings a day of legumes are associated with decreased chronic disease, including cancer. You can still enjoy some sweets in moderation.

Concerning whether there are better types of sugar: Fruit, even though it is high in fructose, also contains fiber, which blunts the absorption of the fructose, so you don’t really get those peaks of high blood sugar. Honey and agave nectar don’t raise blood sugar as much as other sugars, because they are thicker, and they have some health benefits. Though artificial sweeteners are referred to as “sugar-free,” they contain ingredients that drive appetite and cause people to consume more calories throughout the day, and should be limited or avoided.

Misconception: Limiting alcohol consumption to several drinks per week can reduce your risk for developing breast cancer.

The Facts: Studies show there is no amount of alcohol that a human being can safely consume without any future risk for chronic disease. When people increase their alcohol intake, they also tend to eat less fruits and vegetables, which is linked to a number of cancers. This is because, unlike food, your body cannot burn off alcohol for energy. Instead, it converts alcohol to fatty acids in certain parts of the body that become fat depots and can lead to insulin resistance. This is how unhealthy diets can lead to cancer.

Misconception: If you tested negative for the BRCA gene 10 years ago, you do not need to get tested again because the test today is not much more advanced.

The Facts: If you haven’t been tested since 2013, you should get re-tested, because the testing today is based on much more comprehensive data. Aside from BRCA genes, we now test for a whole other panel of genes that predispose for developing breast cancer, including PALB2, CHEK2, and the ATM gene. The risk these carry is affected by family history. If there’s a lot of family history of breast or ovarian cancer, and you also have that gene, then you are in the highest range of the risk model of that gene.

Misconception: It is not necessary for everyone to get tested for the BRCA gene because only some ethnicities are affected.

The Facts: Genetic testing is vastly underutilized. The American Society of Breast Surgeons recently changed its guidelines and recommended testing every woman diagnosed with breast cancer regardless of family history or background. However, there are certain ethnic groups that are at higher risk for having a BRCA gene. For example, in the general population, about 1 in 500 to 1 in 1,000 will have a BRCA gene—far less than one percent. Among the Ashkenazi Jewish population (Jewish people of European descent), the rate is 1 in 40, or 2 percent of the Ashkenazi Jewish population. Many clinicians feel that population-based testing should be done in these selected groups where the yield is higher. But no ethnic group is without risk. For example, there’s an Icelandic version of BRCA. There’s a Hispanic version of BRCA. We see BRCA in Black women. There is a version of BRCA across all ethnic backgrounds, and it’s just a question of picking populations where the yield is the highest. We implemented a program so every woman can get genetic testing regardless of ability to pay. The maximum out-of-pocket expense is $99, which will be waived if you can prove financial need.

This Q&A is based on questions and answers from the annual Dubin Breast Center Fact vs. Fiction Luncheon and Symposium held in June. The panel discussion was moderated by Elisa Port, MD, FACS, and featured a panel of experts, including David Anderson, MD, FACS; Anna Barbieri, MD; Jeffrey Mechanick, MD; Cardinale Smith, MD, PhD; and Joseph Sparano, MD, FACP. Watch the video here.