The effect of head trauma in aging football players has been a subject of national controversy, with studies showing that many professional players have serious symptoms from their years in the NFL. Now pediatricians are weighing in on ways to protect young players from concussions and other head traumas they can suffer from football.

A key concern of the American Academy of Pediatrics (AAP) is head-first plays, according to Forbes. Their new report released earlier this month suggests that children who play football may be at risk even from minor head injuries that can accumulate over time.

The AAP’s report takes on what they call a “culture of tolerance” for spearing, tackling that is characterized by a head-first dive into an opposing player. The doctors’ group recommends that coaches and trainers must create and enforce rules to end the practice, which they say could lead in the long term to an increase in chronic traumatic encephalopathy, a degenerative brain condition that has been found in many former football players.

The AAP also suggests creating additional non-tackle leagues to offer children a safer alternative. They also note that while there is scant scientific evidence for training that strengthens the neck as an aid to ward off concussions, their report supports the practice while research on it continues.