Although the snow in some part of the country may be delightful, the cold winter weather that many experience can be frightful (to paraphrase a popular holiday tune). Additionally, a morning that can have a frigid start may end up warming throughout the day to moderate temperatures. It's on those days when making the decision on how to properly dress your child to protect him or her from the elements becomes a guessing game. Too little outerwear and the chill could make them uncomfortable; too much and they'll be soaking with sweat, bundled up in their little insulated cocoons.

Cold weather, winter winds, and the reflective properties of snow are all elements that can contribute to illness if your child isn't properly protected throughout the winter season. With a little basic knowledge of the effects of temperature on the body, and some basic hints regarding how to dress, you can make certain your kids are prepared to have fun outside when the snow flies.

Along with much colder temperatures, this time of year is known for precipitation in the form of rain and snow. As you remember from your own childhood, snow tends to get everywhere and, when it gets warm, it melts and causes hands and feet to get wet. In addition, warm bodies playing tend to perspire, causing yet another layer of moisture to form. The combination of wet skin and cold temperatures is one you want to avoid in order to keep your child toasty warm while romping in the snow. According to the American Academy of Pediatrics, some of the dangers children confront during cold weather are the following:

Hypothermia occurs when a child's temperature falls below normal due to exposure to cold. It often happens when a child is playing outdoors in extremely cold weather without wearing proper clothing. Warning signs for hypothermia include shivering, lethargy, clumsiness, slurred speech, and a decreased body temperature. If you suspect hypothermia, call 911 immediately. While waiting for help to arrive, move the child indoors, remove any wet clothing, dress the child in warm clothes and apply warm blankets.

Frostbite occurs when skin and outer tissues become frozen—most often the extremities including ears, fingers, nose, and toes. They may become pale, gray, and blistered and your child may complain that his or her skin burns or has become numb. In case of frostbite, move the child indoors and place the frostbitten parts of the body in warm (not hot) water. The AAP recommends a water temperature of approximately 104°F. Warm washcloths can be applied to frostbitten ears, lips, and nose. Do not rub frostbitten areas. After a few minutes, dry the areas and cover the child with warm clothing and blankets and give something warm to drink. If numbness continues for more than a few minutes, call your family physician.

Nosebleeds occur in the winter due to dry air. The AAP recommends using a cold air humidifier in a child's room at night to help keep the inner tissues of the nose moist. Saline nose drops can also help keep the tissue lining of the nasal passage moist. In cases of recurrent or severe bleeding, consult your pediatrician.

Dry skin—Many pediatricians believe that bathing two or three times each week is sufficient for an infant's first year. More frequent bathing can dry out the skin, especially throughout the winter months.

Colds—Cold weather does not cause colds or the flu. However the viruses that cause both tend to be more common in the winter when children are in school and in close contact with each other. Teach your child to practice frequent hand washing and to sneeze in the bend of his or her elbow to help reduce the spread of cold and flu viruses.

Keeping warm while outdoors in winter weather is all about layering. The AAP recommends dressing infants and children warmly for outdoor activities and notes a rule of thumb as dressing them in one more layer of clothing than an adult would wear in the same weather conditions. Several thin layers of clothing will help keep infants and children dry and warm. Recommended clothing items include thermal long johns, turtlenecks, one or two shirts, pants, sweater, coat, warm socks, boots, gloves or mittens, and a hat. Blankets, quilts, pillows, sheepskins, and other loose bedding should be kept out of an infant's sleeping environment. If a blanket is used, it should be tucked around the crib mattress and should reach only as far as the baby's chest so the baby's face is less likely to become covered by the bedding.

When it comes to choosing the right winter coat, the Children's Hospital of St. Louis says that winter coats for kids should have hoods to cover the head. Make certain there are no loose drawstrings around the neck that could become caught in playground equipment or by another child as they play. They add that coats should extend below the waist to cover the seat. Look for coats with rib-knit cuffs in the sleeves to help keep the wind out and choose fabrics that are breathable, wind-resistant, and water-repellent. Also tuck pant legs into the top of boots to help keep snow out.

The head is like a chimney when it comes to losing body heat. The University of Wisconsin Extension Office notes that approximately 50% of your body heat is lost from our heads so it recommends that a child should wear a hat while outdoors. The hat should cover the ears and should be made of a material that is warm and lightweight. The UW Extension Office also recommends that two-piece top-and-bottom sets are easier for a child to get on and off. When choosing clothing, pick materials that will wick moisture away from the skin and that are quick to dry. Avoid cotton as it absorbs perspiration and moisture and sticks to the skin.

The hands are ideal candidates for frostbite so they need to be protected accordingly. St. Louis Children's Hospital suggests choosing mittens over gloves since mittens allow the trapped warm air to circulate around the fingers to keep them warm. They add that lined mittens are a better choice than those that are knit.

The University of Wisconsin includes a few last bits of advice for keeping your kids warm and safe while playing in the cold outdoors:

• Dress children in bright colors if they are playing or walking outdoors in snowy conditions.
• Avoid clothing with drawstrings at the neck or waist, hoods or caps with ties, and any clothing with excessively large pockets. Any of these items are prone to getting caught on play equipment or while playing and could cause strangulation or injury.
• Set time limits for the amount of time your children can play outdoors. A good rule of thumb is to require a break indoors to warm up every 30 minutes before returning outdoors.
• When clothes get wet, replace them with dry clothes.
• If a child gets overheated, remove a layer of clothing or remove a hat.
• Remember that the sun reflects off winter snow. Use a sunscreen to protect children from sunburn.

There are few things more fun than enjoying a fresh snowfall—running outside to build a snowman or throw a round of snowballs with your friends. With a well-chosen winter wardrobe of layered clothing and regularly scheduled breaks to warm up, you can make sure your child's winter playtime outdoors is a comfortable and enjoyable experience every year!

As with any health issues, consult with your family physician, pediatrician, or health care provider regarding any winter health issues your family may encounter.

Sources:
St. Louis Children's Hospital—www.stlouischildrens.org
American Academy of Pediatrics—www.aap.org
University of Wisconsin Extension Office—www.uwex.edu

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