Ask the Pediatrician: How Can I Keep Baby Safe This Winter?
Meet Dina DiMaggio, MD, and Anthony F. Porto MD, MPH, official spokespeople for the American Academy of Pediatrics and the co-authors of The Pediatrician’s Guide to Feeding Babies and Toddlers. Each month, they’ll write about the latest AAP guidelines, studies and seasonal issues affecting babies and toddlers. Follow them on Instagram @pediatriciansguide.
Winter’s not over yet! Getting through the bitter cold is challenging for everyone, but cold weather safety is particularly important for babies and toddlers. Here are our tip tips.
We often get asked how to best dress baby when going outside. Several thin layers will keep babies and young children dry and warm, along with gloves or mittens, a hat and winter boots or booties. For example, you can first put on tights, leggings, or a long-sleeved bodysuit/thermal underwear under pants, a top like a sweater or thermal knit shirt, and top it off with a thin fleece jacket.
A good rule of thumb is to dress a child in one more layer of clothing than an adult would wear in the same environment. If you’re going out for a stroll and you are wearing pants and a shirt, a coat and a hat, then baby should be wearing his or her warm clothes, a coat, a hate and a blanket or bunting on top.
Even though it’s cold outside, remember to continue keeping blankets, pillows and bumpers out of an infant’s crib. Instead, dress your baby in footed pajamas, one-piece sleepers or wearable blankets like a sleep sack.
When taking young children sledding, it’s best to sled on areas only covered with snow and not ice. Stick to hills that are not too steep (less than a 30 degree incline) and that end with flat space for the sled to decelerate. Try to keep young children separate from older children, away from bigger crowds and away from areas that are close to trees or cars. Sleds that are steerable (not snow disks) are the safest option, and the safest way to sled is feet-first or sitting up. (Lying down head-first may lead to head injuries.) We also recommend putting helmets on kids to prevent any head injuries in case a fall occurs.
Make sure to only skate on approved surfaces; you can call your local police department for a list. We advise skating in the same direction as the crowd. We see many concussions and injuries this time of year, so we always recommend helmets, knee pads and elbow pads to protect against any bumps and bruises on little ones.
Outdoor Play Warnings
Hypothermia can occur when a child’s temperature falls below normal, which may happen when he or she is playing in cold weather and is not dressed warm enough or is playing in clothes that are wet. Signs of hypothermia are when a child becomes lethargic, clumsy, and is not acting like him/herself with slurred speech. If you suspect hypothermia, and if your child’s temperature drops below 95° Fahrenheit, which is an emergency, immediately call 911 and take your child inside.
Frostbite can occur when little ones become too cold and the skin becomes frozen. It may look pale and blistered. The most common areas of frostbite are on exposed skin, like fingers, toes, ears, and on the nose. Don’t rub the area, but do place the frostbitten parts in warm water or place warm washcloths on the areas. Also place warm clothing or blankets on your child and give him or her a warm drink. If you think your child has frostbite, alert your doctor immediately.
To avoid hypothermia and frostbite, of course dress your child warmly, but also limit play time outside and have them come indoors at regular intervals to help warm up.
In a car, babies and children (and adults!) should wear thin, snug layers rather than winter coats or snowsuits under the harness of their car seat or seat belt. In a car crash, the coat’s fluffy padding will get in the way of secure strap adjustment, leaving extra space under the harness as it flattens out from force. A child can then slip through the straps and be thrown from the seat.
If baby is cold with only thin layers in the car seat, you can add a blanket over the top of the harness straps once he or she is buckled in safely. Always make sure that your baby is strapped in correctly-; if the straps are loose enough that you can pinch them off of your child, then it needs to be tightened better to fit snugly against their chest.
About the authors:
Dina works as a board certified pediatrician at Pediatric Associates of NYC and at NYU Langone Medical Center. She has received numerous research awards, along with Patient’s Choice award, compassionate doctor recognition and was featured in the New York Times Magazine as a Super Doctors and New York Rising Star. She is dedicated to educating parents on baby and toddler nutrition and gives talks to parent groups throughout New York.
Anthony is a board certified pediatrician and board certified pediatric gastroenterologist. He is an Associate Professor of Pediatrics and Associate Clinical Chief of Pediatric Gastroenterology at Yale University. He has won numerous awards including the Norman J. Siegel Award at Yale University for leadership and providing outstanding clinical care as well as Physician of the Year during his time at Morgan Stanley Children’s Hospital. He has been named Castle Connolly Top Doctors since 2012. Anthony is interested in nutrition, especially in the care of children with difficulty gaining weight, feeding issues, and celiac disease. He loves teaching and educating parents and gives lectures to parents throughout New York and Connecticut.
Published Feb. 2018