Winter Health and Safety Tips for Kids

Winter is the busiest time of year in the Children’s Hospital Colorado emergency room. Between fun activities that come with some possible safety hazards and seasonal viruses, such as the flu and respiratory syncytial virus (RSV), there are plenty of things caregivers should prepare for.

Michael DiStefano, MD, Chief Medical Officer at Children’s Colorado, Colorado Springs, outlines the biggest winter health risks — and how to avoid them.

General tips for staying healthy and safe during the winter

Whether your family is celebrating holidays together, heading on an active winter adventure, throwing snowballs in the yard or simply taking a walk in the cold, there are a few simple guidelines to follow.

• Don’t forget sunscreen. Even on overcast days, especially up in the mountains, the sun’s rays can be harmful.   
• Keep kids safe by removing puffy winter coats before putting them in their car seats.  
• An adult should always be present to supervise winter activities.   
• Hydration is just as important during the winter as any other season. Have kids drink water before, during and after activities.

How to avoid hypothermia and frostbite

When the weather is particularly cold, caregivers should take extra precautions to make sure kids don’t get frostbite or hypothermia. Dr. DiStefano says that in temperatures below zero degrees Fahrenheit, kids should stay inside and skip outdoor activities, as the risk of developing these conditions is heightened. If your child is outside in the cold for a long period of time, Dr. DiStefano recommends that they wear appropriate layers, including a base layer (long underwear), an insulated middle layer and a waterproof outer layer. In addition, caregivers should perform regular skin checks on exposed skin to prevent frostbite. This might include checking the nose or ears, for example. If the skin on these areas is growing paler, bring kids inside to warm up.

Mental health during winter

During the winter months, some people experience lower moods as a result of less sunshine, fewer outdoor activities and colder temperatures. This is most common among adults, but some older children and teens can experience this as well. Dr. DiStefano says that to help kids avoid seasonal depression, making sure they stay active and spend time outdoors when safe and possible is key. It’s also important to let light into your home whenever possible and support help children support their mental health with good nutrition.

Winter health tips for common illnesses

During the winter months, doctor’s offices, urgent cares and emergency rooms typically see an uptick in respiratory illnesses, such as respiratory syncytial virus (RSV), the flu and COVID-19. Dr. DiStefano shares his tips for caring for kids who come down with these illnesses.  

Influenza

Influenza, or the flu, comes with several symptoms that can cause dehydration, including fever, vomiting and diarrhea. During the fall and winter, Dr. DiStefano frequently sees kids requiring IV fluids to help rehydrate them.

“When kids throw up, parents give them a bottle of Powerade or Pedialyte,” Dr. DiStefano says. “Kids are thirsty, so they chug it, and that doesn’t go that well if the intestines aren’t functioning.”

Instead of drinking a bunch of fluids all at once, Dr. DiStefano recommends offering kids a teaspoon or so every three to five minutes, which is easier on the digestive system. “Then the stomach can absorb it, and the intestines aren’t needed,” he says. He also recommends acetaminophen and ibuprofen to ease fevers and aches.

If that approach doesn’t work, call your child’s pediatrician first. Parents can also contact a nurse through Children’s Colorado’s ParentSmart Healthline by calling 855-543-4636, 24/7.

Respiratory syncytial virus (RSV)

Respiratory syncytial virus (RSV) is a common virus that produces cold-like symptoms in older children and adults. For kids 2 and younger and those who are immunocompromised, it can cause severe, and potentially life-threatening, complications. Thankfully, the U.S. Food and Drug Administration recently approved two shots that protect against RSV — a monoclonal antibody shot for infants and high-risk toddlers and a vaccine for people in their third trimesters of pregnancy— which are likely to help prevent severe infections in the future.

“RSV essentially causes mucus production and plugging in the lungs,” Dr. DiStefano says. “The smaller the air tubes, the bigger the problem.” In very rare cases, the condition can require the use of a ventilator.

The best way to avoid serious illness with RSV is to lower fevers quickly. “Sometimes when kids get high fevers, the respiratory system gets taxed,” Dr. DiStefano says. “Getting the fever down can help.”

He suggests trying a warm washcloth to allow for evaporation, a fan, and cool foods, such as popsicles and acetaminophen. Be sure to give your child the correct dose for their age and weight. Nasal suctioning, as well as a nasal saline solution, can also be helpful.

What won’t help: over-the-counter cough and cold remedies, as well as products that claim to “break up mucus.” Dr. DiStefano says that they typically aren’t approved for use in children under 2 and aren’t particularly effective.

If your child has trouble breathing, call 911 right away.

COVID-19

Most children who get COVID-19 will not develop severe symptoms or lasting complications from the illness. In fact, many children may only experience mild cold-like symptoms or no symptoms at all. In rare cases, some children may need a trip to the emergency room or doctor, but the good news is, with the widespread availability of the safe and effective COVID-19 vaccine, we can now prevent severe illness for most age groups.

Still, it is important that children if your child has cold-like symptoms — fever, cough, congestion or sore throat — they take an at-home test or get tested in the doctor’s office to determine whether they should stay home to prevent spreading the virus to others. Read the latest guidelines from the Centers for Disease Control and Prevention.

How to prevent winter activity injuries

Lots can happen in the snow. Sledding, skiing and snowboarding can lead to concussions and other head injuries, fractures and sprains. Even heading outside without the right clothing can result in exposure injuries. Fortunately, many of these accidents can be prevented with the right knowledge and preparation.

“When we get a big dump of snow, the number of sledding injuries and fractures go up,” Dr. DiStefano says. “I had one day where two separate kids decided to sled off the roof. Both broke bones.”

Sledding and snow tubing

Sledding injuries are some of the most common wintertime injuries in emergency rooms. These injuries are often caused by collisions with fences, trees, equipment and debris. However, just as many happen when people crash into each other. That’s why finding a safe place to sled or tube is important.

• Find a hill with a clear path that is free of obstacles. Make sure the hill does not end on a street, road, parking lot, fence or any bodies of water. Choose a low-traffic hill (no roofs, please).  
• Never slide downhill headfirst. Sit up, facing forward to steer. The risks of head and back injuries are greater when kids lie down on the sled.  
• Make sure that no one is at the bottom of the hill before allowing another sled to go down the slope.  
• Use sturdy sleds that won’t be punctured by debris during the ride down. Avoid rubber or plastic sheets.  
• Use a sled with runners and a steering mechanism. Toboggans and snow disks are not as safe.

Snowmobiling

• Any child under 6 should not ride on a snowmobile, regardless of whether an adult is present.  
• Children under 16 should not operate the snowmobile.  
• Wear certified helmets designed specifically for high-speed motor sports — not bike helmets.   
• Make sure you are familiar with the area in which your family is snowmobiling so you know what hazards to avoid, including things like fences and barriers that might be covered by snow.  
• Practice avalanche safety. Check the avalanche forecast before heading out, educate yourself in how to prepare for and react to an avalanche, and bring the proper tools with you. This includes shovels, beacons, probes and more.

Ice skating

Choose skating rinks over pond skating when possible. If you do choose pond skating, do the following:  

• Call local authorities to ask which areas have been approved and to ask permission to skate on a pond or lake.  
• Ice skating on a pond or lake always carries some risk, but you can take some precautions. For example, Colorado Parks and Wildlife suggests checking online or calling local officials for guidance on a particular area’s safety.  
• Sharpen skates properly before skating on pond or lake ice.

Skiing and snowboarding

Before skiing or snowboarding:

• Make sure you have the right equipment, including warm layers, a well-fitting helmet and bindings that are adjusted by a professional.  
• Get to know the mountain before you go and choose terrain that is appropriate for everyone in your group.
• Plan a meeting place in case your group becomes separated.
• Plan to take breaks throughout the day to reapply sunscreen, eat, hydrate and rest.

While you are on the slopes:

• Take some warm-up runs on gentle terrain before moving to steeper slopes.
• Always look uphill before you start moving.
• Don’t stop in areas where you can’t be seen from above.
• Be aware of areas where people funnel into a narrow area or are slowing down.
• Stay off closed runs and out-of-bounds areas.

More skiing and snowboarding tips:

• If your child has never skied or snowboarded, enroll them in lessons.
• Stick to trails and runs appropriate for your child’s skill level.
• Pay attention to signs on the trail. Obey trail closures and do not go off trail.
• If you’re heading to the backcountry, dress kids very warmly and check the weather to make sure you will be able to get back safely. Frostbite is a real danger and can happen fast.
• Check the avalanche forecast for your destination. If the danger is high, stay home or choose a safer area.
• If you plan to ski or snowboard in the backcountry, practice avalanche safety. Check the avalanche forecast before heading out, educate yourself in how to prepare for and react to an avalanche, and bring the proper tools with you. This includes shovels, beacons, probes and more.

Choosing the right helmet for each winter activity

Helmets are critical to safety during winter activities to prevent head injuries. Everyone should wear an appropriate, properly fitted helmet that is secured under the chin. Different activities require different types of helmets so choose wisely, and make sure they are certified to meet federal safety standards. If you have questions about helmets or would like to purchase one, reach out to our experts at the Safety Store.

Knowing where to go for care

Even when you’re well prepared, accidents can still happen. When they do, it’s a good idea to know whether to take advantage of urgent care instead of the ER. For example, if your child is experiencing a head injury with confusion, lethargy or vomiting, or if they have injured an extremity like an arm or leg with severe swelling or deformity, you can seek help at urgent care. Children’s Colorado’s urgent care clinics treat many of the same conditions and injuries as the ER, and the wait times are a lot shorter.