As families begin to celebrate this festive season, parents often worry about communicable illnesses like colds and flu but may overlook other weather-related health issues, such as frostbite and hypothermia. To help parents recognize key signs and symptoms and, ideally, prevent these problems, we spoke with Dr. Beth Greenwood, vice president of medical affairs for Consensus Health and board-certified family medicine physician practicing in Cherry Hill, New Jersey.
What are some common cold weather concerns for children?
Our practice sees a lot of conditions related to exposure to extreme cold temperatures, such as frostbite, which is freezing of the skin and underlying tissue, mainly affecting extremities — fingers, toes, ears, nose — that tend to get less blood flow.
Prolonged exposure can also cause hypothermia, where we see decreased core body temperature below 95 degrees.
Kids are also more susceptible to dehydration in colder weather, as well as sunburn. Staying hydrated and using sunscreen are a must all year round.
How can parents identify frostbite and hypothermia?
With mild cases of frostbite, parents want to look for numbness, tingling or burning sensations, mostly in the extremities. In more moderate to severe cases, you can see discoloration, with paleness or greying of the skin and even some blisters.
For mild cases of hypothermia, initial symptoms would be shivering and cold skin to the touch. As the temperature continues to drop, you see a slowing of the entire system: slurred speech, some confusion and drowsiness, and declines in heartrate and breathing. Those are obviously more concerning symptoms.
You typically need temperatures well below freezing and for children to be outside for a significant time to see severe symptoms.
How should parents respond to signs of frostbite or hypothermia?
First, remove any wet or extremely cold clothing and reclothe the child in warm clothing and blankets.
Use warm water where you are noticing frostbite to gently rewarm the skin. With the numbness, the child can’t feel if the water is too hot and you can have a paradoxical burning of the skin. So, gentle warming is the way to go, letting the temperature increase over time.
With hypothermia, wrap the child in warm blankets but avoid very hot coverings, like heated blankets. It’s also helpful to warm the core from the inside out with warm beverages, like hot tea or cocoa.
Mild symptoms should improve fairly rapidly, on the order of 10 to 20 minutes. If in an hour they aren’t getting any relief or symptoms appear to worsen, seek additional care.
If you see any of the symptoms of moderate to severe frostbite (greying, blackening or darkening of the skin or blisters) or hypothermia (cognitive decline or vital sign disturbances), that’s a medical emergency requiring attention in an emergency department.
Any final advice to help parents protect their children while enjoying wintertime fun?
First, keep in mind that children are not as efficient as adults at regulating their body temperature, so they might need an additional layer, especially a moisture-wicking base layer to keep skin drier. Then, layer them in warm clothing and add coats, gloves, boots and hats, keeping skin well covered. Hand or foot warmers can be helpful in the extreme cold as well.
Also, we know how kids are: When they’re running about, they could be outside for hours. We need to remind them to come in, rest and warm up for a few minutes, have a warm drink and then go back out.
Too many layers can lead to dehydration if they’re overdressed and sweating. Make sure they’re drinking plenty of water and look to find that balance, depending on the temperature.
And now, a final “speed round” of important winter questions:
- Gloves or mittens? As someone with poor circulation, I’m mittens all the way!
- Marshmallows or whipped cream on hot cocoa? Whipped cream
- Skiing or snowboarding? I’m a snowboarder.
- Fleece or flannel? I like fleece.
- Elsa or Anna? This is a tough one! I think I have to go with Elsa.
