For better or for worse, Santa brings lots of puppies to children for Christmas. Puppies are true bundles of love, and when things are done properly, your child will derive immense benefit from his new best friend. However, there are many pitfalls that parents should note and consider fully before making this commitment — because puppies are not presents, but rather new family members.

1. The child does not like the puppy, and the puppy ends up unloved and unwanted in a kill shelter

Pshaw! There is no such thing as a child who doesn’t like puppies! The only way the puppy will end up in a shelter is if you aren’t willing to take responsibility. Your child cannot be expected to fully care for his pet, so when you give him a puppy you must accept that, in fact, you are adopting the puppy. For this reason, uncles and aunts and grandparents and friends never should give puppies to children. Only parents should have the right.

The best way to ensure that a puppy has no future in a shelter is to properly train the dog, starting at an early age. Conveniently, Annie Phenix recently wrote an article on how to do exactly that. I recommend you read the article before you decide to get a puppy.

2. The puppy breaks a leg on Christmas morning

In my experience, Christmas day is the No. 1 day for limb fractures in puppies. Seriously. Puppies are wiggly, and children aren’t good at holding onto things. It therefore is common for puppies to wiggle out of their new owners’ arms, fall to the ground, and suffer broken bones. Few things put a greater damper on Christmas than spending it in an emergency clinic and being told that the new family pet needs surgery that will cost thousands of dollars.

Parents need to be cognizant of this very real threat. Puppies should be held by children only under careful adult supervision. The child should sit while holding the puppy until everyone is confident that the child is competent to hold and carry the puppy safely.

3. The puppy gets hit by a car

Like the risk of leg fractures, this sounds a bit implausible but is actually a very common problem. Small children often do not have what it takes to hold a leash properly. Combine that with a young dog who isn’t leash trained, and you have a recipe for disaster.

I regularly see dogs and puppies who have been struck by vehicles after the children walking them lose their grip on the leash. The tragedy only grows worse when, as is often the case, the dog is struck by the car right in front of the child. Such accidents have the potential to cause severe emotional trauma to the child involved. In some instances, parents are faced with the choice between paying for extreme vet bills (dogs who are hit by cars often require multiple expensive surgeries) and putting money in their child’s college fund.

Again, the solution involves careful adult supervision and common sense.

4. The puppy consumes something toxic

Did I mention that children aren’t good at holding onto things? Besides leashes (and puppies themselves), children often drop foods and, in some instances, medications that can be toxic to pets. Furthermore, dogs learn quickly that food can be stolen from the hands of inattentive children.

In my experience, the most common toxic exposures that occur when dogs mix with children involve raisins (or grapes), xylitol, and chocolate. Many children eat raisins on a daily basis. Unfortunately, these dried fruits have significant potential to cause kidney failure in dogs. Parents often seek sugarless alternatives for sweetened gums and candies. Unfortunately, these items often contain xylitol, which is super dangerous for puppies and dogs. Chocolate is highly palatable to dogs, but fortunately it has slightly less potential to cause serious problems than raisins and especially xylitol.

The solution, as always, involves careful supervision. Medications should be dispensed and consumed in an area inaccessible to the puppy. Chocolate should be consumed only under adult supervision. And, I’m sorry to say it, parents should make a choice: You can either have grapes, raisins, and xylitol in your house, or you can have a dog or puppy. But nobody ever should combine these toxins and a puppy in the same home.

Although many other potential risks exist, in my experience the above three are the most common dangers that children pose to puppies.

Now, let us talk about the dangers that puppies can pose to children.

1. The child is injured as the result of bites, knockdowns, or aggression

Puppy teeth are sharp, but serious bites generally can be prevented by proper training. So can aggression and knockdowns. Don’t forget to add in a good deal of parental supervision.

2. The child contracts worms from the puppy and suffers serious illness as a result

Did you know that there are certain worms that can spread from dogs to humans? Children are at increased risk. And, due to a quirk in the most common worm’s lifecycle, puppies are very likely to be born with worms. When children are exposed to the worms, they can suffer injury to their internal organs, eyes, and brains.

Fear not. The CDC has stated that it is safe, and in fact beneficial, for puppies to live with children. But the puppies need to be he healthy, and they need to be dewormed. Current recommendations state that puppies should be dewormed every two weeks, starting at two weeks of age and continuing at least until the puppy starts a regular broad spectrum heartworm preventative. Regular stool testing also should occur. Feces should be removed from the environment immediately by an adult, and the puppy should be kept clean.

A good veterinarian can offer specific recommendations regarding the prevention of worms in puppies.

Although many other potential risks exist, in my experience the above two are the most common and worrisome. And I’m happy to report that they aren’t that common.

This article has focused on what can go wrong when puppies and children mix. It is important to remember, however, that the most common outcome of such mixings, by far, is a healthier and happier life for both the puppy and the child.

Read more about training a puppy:

• Three Important Things to Teach Your New Puppy – Dogster
• It’s OK to Get a Puppy for Christmas If You Agree to Do These 30 Things
• Are You Training a Puppy? Read “The Boy Who Was Raised as a Dog”

Read more from Dr. Eric Barchas:

• Ask a Vet: When Should My New Puppy Have Her First Vet Exam?
• Is it Safe to Make My Dog Vomit at Home When He Ingests Toxins?
• Is It Safe to Anesthetize an Older Bulldog for a Dental Abscess?

Got a question for Dr. Barchas? Ask our vet in the comments below and you might be featured in an upcoming column. (Note that if you have an emergency situation, please see your own vet immediately!)