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Winter Safety Tips

Whether winter brings severe storms, light dustings or just cold temps, the American Academy of Pediatrics has some valuable tips on how to keep your child safe and warm.

What to Wear

• Dress infants and children warmly for outdoor activities. Several thin layers will keep them dry and warm. Clothing for children should consist of thermal long johns, turtlenecks, one or two shirts, pants, sweater, coat, warm socks, boots, gloves or mittens, and a hat.
• The rule of thumb for older babies and young children is to dress them in one more layer of clothing than an adult would wear in the same conditions.
• Blankets, quilts, pillows, sheepskins and other loose bedding may contribute to Sudden Infant Death Syndrome (SIDS) and should be kept out of an infant’s sleeping environment. Sleep clothing like one-piece sleepers is preferred.
• If a blanket must be used to keep a sleeping infant warm, it should be tucked in around the crib mattress, reaching only as far as your baby’s chest, so the infant’s face is less likely to become covered by bedding.

Hypothermia

• Hypothermia develops when a child’s temperature falls below normal due to exposure to cold. It often happens when a youngster is playing outdoors in extremely cold weather without wearing proper clothing.
• As hypothermia sets in, the child may shiver and become lethargic and clumsy. His speech may become slurred and his body temperature will decline.
• If you suspect your child is hypothermic, call 911 at once. Until help arrives, take the child indoors, remove any wet clothing, and wrap him in blankets or warm clothes.

Frostbite

• Frostbite happens when the skin and outer tissues become frozen. This condition tends to happen on extremities like the fingers, toes, ears and nose. They may become pale, gray and blistered. At the same time, the child may complain that her skin burns or has become numb.
• Set reasonable time limits on outdoor play. Have children come inside periodically to warm up.
• If frostbite occurs, bring the child indoors and place the frostbitten parts of her body in warm (not hot) water. Warm washcloths may be applied to frostbitten nose, ears and lips.
• Do not rub the frozen areas.
• After a few minutes, dry and cover him with clothing or blankets. Give him something warm to drink.
• If the numbness continues for more than a few minutes, call your doctor.

Winter Health

• If your child suffers from winter nosebleeds, try using a cold air humidifier in the child’s room at night. Saline nose drops may help keep tissues moist. If bleeding is severe or recurrent, consult your pediatrician.
• Many pediatricians feel that bathing two or three times a week is enough for an infant’s first year. More frequent baths may dry out the skin, especially during the winter.
• Cold weather does not cause colds or flu. But the viruses that cause colds and flu tend to be more common in the winter, when children are in school and are in closer contact with each other. Frequent hand washing and teaching your child to sneeze or cough away from others may help reduce the risk of colds and flu.
• Children between the ages of 6 and 23 months should get the influenza vaccine to reduce their risk of catching the flu.

WINTER SPORTS AND ACTIVITIES

Ice Skating

• Allow children to skate only on approved surfaces. Check for signs posted by local police or recreation departments, or call your local police department to find out which areas have been approved.
• Advise your child to: skate in the same direction as the crowd; avoid darting across the ice; never skate alone; not chew gum or eat candy while skating.

Sledding

• Keep sledders away from motor vehicles.
• Children should be supervised.
• Keep young children separated from older children.
• Sledding feet first or sitting up, instead of lying down head-first, may prevent head injuries.
• Use steerable sleds, not snow disks or inner tubes.
• Sleds should be structurally sound and free of sharp edges and splinters, and the steering mechanism should be well lubricated.
• Sled slopes should be free of obstructions like fire hydrants or fences, be covered in snow not ice, not be too steep (slope of less than 30º), and end with a flat runoff.
• Avoid sledding in overcrowded areas.

Snow Skiing and Snowboarding

• Children should be taught to ski or snowboard by a qualified instructor in a program designed for children.
• Never ski or snowboard alone. Young children should always be supervised by an adult. Older children’s need for supervision depends on their maturity and skill.
• The American Academy of Pediatrics recommends that children under age 7 not snowboard.
• Consider wearing a helmet.
• Equipment should fit the child. Skiers should wear safety bindings that are adjusted at least every year. Snowboarders should wear gloves with built-in wrist guards.
• Slopes should fit the ability and experience of the skier or snowboarder. Avoid overcrowded slopes.

Sun Protection

• The sun’s rays can still cause sunburn in the winter, especially when they reflect off snow. Make sure to cover your child’s exposed skin with sunscreen.

Snowmobiling

• The AAP recommends that children under age 16 not operate snowmobiles and that children under age 6 never ride on snowmobiles.
• Do not use a snowmobile to pull a sled or skiers.
• Wear goggles and a safety helmet approved for use on motorized vehicles like motorcycles.
• Travel at safe speeds.
• Never use alcohol or other drugs before or during snowmobiling.
• Never snowmobile alone.
• Stay on marked trails, away from roads, water, railroads and pedestrians.

TREES

• When purchasing an artificial tree, look for the label “Fire Resistant.”
• When purchasing a live tree, check for freshness because a fresh tree is less of a fire hazard.
• The tree should be green, needles are hard to pull from branches and when bent between your fingers, needles do not break. The trunk butt should be sticky with resin, and when tapped on the ground, the tree should not lose many needles.
• Cut a few inches off the trunk of your tree to expose the fresh wood. This allows for better water absorption and will help to keep your tree from drying out and becoming a fire hazard.
• When setting up a tree at home, place it away from fireplaces, radiators or portable heaters.
• Place the tree out of the way of traffic and don’t allow it to block doorways.
• Be sure to keep the stand filled with water, because heated rooms can dry live trees out rapidly.

LIGHTS

• Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights, and a person touching a branch could be electrocuted.
• Before using lights outdoors, check labels to be sure they have been certified for outdoor use.
• To hold lights in place, string them through hooks or insulated staples, not nails or tacks.
• Never pull or tug lights to remove them.
• Check all tree lights-even if you’ve just purchased them-before hanging them on your tree. Make sure all the bulbs work and that there are no frayed wires, broken sockets or loose connections.
• Plug all outdoor electric decorations into circuits with ground fault circuit interrupters to avoid potential shocks.
• Turn off all lights when you go to bed or leave the house. The lights could short out and start a fire.

DECORATIONS

• Use only non-combustible or flame-resistant materials to trim a tree. Choose tinsel or artificial icicles of plastic or nonleaded metals.
• Never use lighted candles on a tree or near other evergreens. Always use non-flammable holders, and place candles where they will not be knocked down.
• In homes with small children, take special care to avoid decorations that are sharp or breakable, keep trimmings with small removable parts out of the reach of children to avoid the child swallowing or inhaling small pieces. Avoid trimmings that resemble candy or food that may tempt a child to eat them.
• Wear gloves to avoid eye and skin irritation while decorating with spun glass “angel hair.”
• Follow container directions carefully to avoid lung irritation while decorating with artificial snow sprays.
• Remove all wrapping papers, bags, paper, ribbons and bows from tree and fireplace areas after gifts are opened. These items can pose suffocation and choking hazards to a small child, or can cause a fire if near flame.

TOY SAFETY

• Select toys to suit the age, abilities, skills and interest level of the intended child. Toys too advanced may pose safety hazards for younger children.
• Before buying a toy or allowing your child to play with a toy that he has received as a gift, read the instructions carefully.
• To prevent both burns and electrical shocks, don’t give young children (under age ten) a toy that must be plugged into an electrical outlet. Instead, buy toys that are battery-operated.
• Children under age three can choke on small parts contained in toys or games. Government regulations specify that toys for children under age three cannot have parts less than 1 1/4 inches in diameter and 2 1/4 inches long.
• Children under age 8 can choke or suffocate on uninflated or broken balloons. Remove strings and ribbons from toys before giving them to young children.
• Watch for pull toys with strings that are more than 12 inches in length. They could be a strangulation hazard for babies.

FOOD SAFETY

• Bacteria are often present in raw foods. Fully cook meats and poultry, and thoroughly wash raw vegetables and fruits.
• Be sure to keep hot liquids and foods away from the edges of counters and tables, where they can be easily knocked over by a young child’s exploring hands.
• Wash your hands frequently, and make sure your children do the same.
• Never put a spoon used to taste food back into food without washing it.
• Always keep raw foods and cooked foods separate, and use separate utensils when preparing them.
• Always thaw meat in the refrigerator, never on the countertop.
• Foods that require refrigeration should never be left at room temperature for more than two hours.
• Monitor your children’s intake of holiday sweets. It’s okay to let them indulge for a special occasion, but be sure to balance it out with healthier food choices the rest of the time.

HAPPY VISITING

• Clean up immediately after a holiday party. A toddler could rise early and choke on leftover food or come in contact with alcohol or tobacco.
• Remember that the homes you visit may not be childproofed. Keep an eye out for danger spots.
• Keep a laminated list with all of the important phone numbers you or a baby-sitter are likely to need in case of an emergency. Include the police and fire department, your pediatrician and the poison control center.
• Ask your neighbor if he has a gun before sending your kids over to play. If the answer is yes, you need to make absolutely sure that all guns are stored unloaded and locked – ideally in a gun safe – with ammunition locked separately. Include the question along with other things you might normally discuss before sending your child to someone’s house.
• Traveling, visiting family members, getting presents, shopping, etc., can all increase your child’s stress levels. Sticking to your child’s usual routines, including sleep schedules and timing of naps, can help you and your child enjoy the holidays and reduce stress.

FIREPLACES

• Before lighting any fire, remove all greens, boughs, papers, and other decorated from fireplace area. Check to see that flue is open.
• Use care with “fire salts,” which produce colored flames when thrown on wood fires. They contain heavy metals that can cause intense gastrointestinal irritation and vomiting if eaten. Keep them away from children.
• Do not burn wrapping papers in the fireplace. A flash fire may result as wrappings ignite suddenly and burn intensely.
• Have a safe and happy holiday!

FIREWORKS SAFETY

Source: aap.org

• Fireworks can result in severe burns, scars and disfigurement that can last a lifetime.
• Fireworks that are often thought to be safe, i.e. sparklers, can reach temperatures above 1000 degrees F, and can burn users and bystanders.
• The AAP recommends prohibiting public sale of all fireworks, including those by mail or Internet, and encourages parents to attend professional fireworks displays instead of using fireworks at home.

BOATING SAFETY

Source: aap.org

• Children should wear life jackets at all times when on boats or near bodies of water.
• Make sure the life jacket is the right size for your child. The jacket should not be loose. It should always be worn as instructed with all straps belted.
• Blow-up water wings, toys, rafts and air mattresses should never be used as life jackets or life preservers.
• Adults should wear life jackets for their own protection, and to set a good example.

OPEN WATER SWIMMING

• Even good swimmers need buddies. Make sure your child knows never to swim alone.
• A lifeguard or another adult (preferably one who knows about water rescue) needs to be watching children at all times.
• Make sure your child knows never to dive into water except when permitted by an adult who knows the depth of the water and who has checked for underwater objects.
• Never let your child swim in canals or any fast-moving water.
• Ocean swimming should be allowed only when a lifeguard is on duty.
• Younger children should be closely supervised while in the water – use “touch supervision,” keeping no more than an arm’s length away.

ALL-TERRAIN VEHICLES

Source: aap.org

• Off-road vehicles are particularly dangerous for children younger than 16 years who may have immature judgment and motor skills. Children who are not licensed to drive a car should not be allowed to operate off-road vehicles.
• Injuries frequently occur to passengers; therefore riding double should not be permitted.
• All riders should wear helmets, eye protection and protective reflective clothing. Appropriate helmets are those designed for motorcycle (not bicycle) use, and should include safety visors/face shields for eye protection.
• Parents should never permit the street use of off-road vehicles, and nighttime riding should not be allowed.
• Flags, reflectors and lights should be used to make vehicles more visible.
• Drivers of recreational vehicles should not drive after drinking alcohol. Parents should set an example for their children in this regard.
• Young drivers should be discouraged from on-road riding of any 2-wheeled motorized cycle, even when they are able to be licensed to do so, because they are inherently more dangerous than passenger cars.

Why are physicians concerned about sunburns and suntans?  For starters, too much sun exposure can cause actinic keratosis, melanomas, skin cancer and premature skin aging.  They are all a nuisance and some are potential killers.

These problems, as well as several others, are part of living in a sun worshiping culture.  To avoid these, we need to start from birth.  The first two decades of life are crucial in preventing later problems from over exposure to the sun.  Malignant melanomas are one type of cancer death we can prevent.

A single blistering sunburn in a child or teenager will double that person’s later risk of developing a melanoma.  How many of us haven’t had a bad sunburn?  Many of us take vacations in the sun and enjoy the opportunity of coming home and showing off gorgeous tans.  Unfortunately, all this damage is cumulative.  Each time the skin is over exposed to the sun, it speeds the premature aging process and increases the risk of subsequent cancers.

What about all those tanning parlors that claim their tanning rays are safe?  These tanning parlors became popular in the late 1970s and began the myth that ultraviolet A was safe.  This myth has been disproven in numerous medical studies.  Ultraviolet tanning rays contribute to skin aging and skin cancer, regardless of what anyone says.

Are sunscreens safe for children?  Yes, they are unless your child is allergic to them.  To test for allergies, dab some on a small patch on his or her forearm and observe for 24 hours.  If the test patch does not become red or itchy, it should be safe to use the sunscreen.  I recommend limiting a child’s sun exposure during the first year of life.  However, if your children are going to be in the sun, I recommend sunscreens for everyone.

For blondes and redheads, I recommend a #15 or higher sunscreen and for brunettes, #8 to #15.  For infants under one year of age, I recommend at least a #20 sunscreen.  Just for reference, a light-weight white t-shirt is supposed to be equivalent to #30 to #50 sunscreen.

Do your lips need sunscreen?  Yes, particularly the lower lip, which has the most direct sun exposure.  I recommend either a medicated lip balm with built-in sunscreen or one of the zinc oxide preparations.  Most kids really enjoy the new colored zinc oxide sunscreens.

In summary, I recommend limiting sun exposure during direct over-head sunlight (i.e. from 1:00 to 3:00 p.m.), stay away from tanning parlors and sun lamps, and remember that even on cloudy days you can get sunburned.  All forms of tanning are damaging to your skin, so I would recommend moderating your sun exposure to preserve healthy and young-looking skin.

Lead is a soft, pale gray metal found naturally in the earth. It is used in paint for bridges, boats, and factories, in making batteries, and in many other products such as pottery glazes and printing inks. When lead gets into the body, it enters the bloodstream and the soft tissues and organs such as the liver, kidneys, and even the brain.  In time, it settles in the bones and teeth. As the amount of lead builds up, lead poisoning occurs. Lead usually does not cause symptoms until the poisoning becomes very dangerous. Although lead poisoning can affect every part of the body, damage to the brain and nervous system is of most concern. Young children are more likely to be hurt by lead than older children or adults, because their brains are still developing. A child with severe lead poisoning may complain of stomach aches or headaches, act tired or be overactive, not play as much as she used to, sleep more or less than usual, eat less, or vomit, but most children with lead poisoning show no symptoms at all. In the worst cases, the brains of children with lead poisoning can swell, causing lack of coordination, vomiting, loss of consciousness, seizures, and—if they don’t get the right treatment in time—some children can die.

Even small amounts of lead in the body are harmful. Sometimes, children who are exposed to lead, especially when they are very young, may have a hard time controlling their behavior, and when they get to school they may have trouble keeping up with their classmates.

How do children get lead poisoning?

Children sometimes swallow paint chips, soil, water, or food that has lead in it, but usually they swallow dust that contains lead. If they live in a building that is being rebuilt, or where lead paint is being scraped, sanded, or burned, they may breathe in tiny lead paint particles or fumes. If a pregnant woman is exposed to lead dust or fumes, the lead in her body may pass through the placenta into her unborn baby’s body.

The way young children behave adds to the problem. Little children crawl on the floor, get dust and dirt on their hands, and put their hands in their mouths. They suck on toys, pacifiers, and thumbs, and chew their fingernails. Sometimes they eat things that aren’t food—paint chips, or soil from the backyard or playground.

Paint. Most of the lead children are exposed to comes from peeling lead-based paint. Most paint made before 1960 and many paints made before 1979 were made with lead. This paint was used outside and inside of houses. Since 1979 the amount of lead in paints has decreased significantly.  Paints with unsafe levels of lead are no longer available except for boats and industrial and military use. Unfortunately, these paints still occasionally end up being used in homes.

Severe poisoning can occur quickly if children eat chips of peeling lead paint, the kind you sometimes see in window wells or along baseboards. Lead-based paints break down as they age into smaller and smaller pieces that eventually become particles of dust. This dust alone is most often the cause of lead poisoning.

Soil. Leaded gasoline fumes from automobile exhaust used to be another major source of lead in the environment. These days, leaded gas has been almost completely phased out of use in the US (only very old cars and some farm equipment still use it), but the lead particles that have settled out of the air onto the ground are still there. Unlike some other kinds of pollution, lead never breaks down into something less dangerous. It’s poisonous for all time. Concentrations are especially high alongside busy roadways.

Water. In the last century, the pipes that brought water into the house were often made of lead.  Lead pipes are still found occasionally in places where water pipes haven’t been replaced since the early 1900s, More recently, solder containing lead was used to seal water pipes and cans of food.  Licensed plumbers are no longer allowed to use leaded solder in household pipes, but people who do their own repairs or fix up their own houses may be using lead solder without realizing that it’s dangerous.

Food. Food cans in the US are no longer made with lead solder, but cans made in some other countries may still contain lead. Commercially made pottery and ceramic dishes that have not been glazed correctly may also be a source of lead, and storing food or beverages in china patterned with lead glazes or in lead crystal can also be a danger. Antique pewter dishes or mugs often contain lead.

Dye. Dyes on newspapers, comic books, and magazines that have been printed with red, yellow, or orange ink may be a source of lead. Don’t burn these papers in fireplaces or allow children to chew on them. Lettering on plastic wrappers should be kept away from contact with food since the dye may contain lead.

Objects made of lead. Fishing sinkers, bullets, old printing type, some toy soldiers, battery casings, and curtain weights may contain lead.

Work. Factories that process lead (lead smelters and battery manufacturers, for example) may pollute the air and soil, and adults who work in industries that use or process lead may carry lead dust home on their clothes and shoes. Workers can be exposed to lead in aircraft factories, brass foundries, brass and copper manufacturing, radiator repair, construction, bridge repair, painting contracting, mining, and working at firing ranges.

Crafts and hobbies. Artists working with stained glass and jewelry may use lead solder, and some of the glazes used in making ceramics contain lead.

Medicines and cosmetics. Many traditional medicines such as greta and azarcon, which some Mexican families use for children’s stomach upsets, and some cosmetics used in the Middle East, Asia, and Africa (surma, kohl) are made with lead.

How can you prevent lead poisoning?

The best way to prevent lead poisoning is to learn about lead hazards and keep your child away from them.

Here are some specific actions you can take:

• Find out whether your house contains lead paint (usually found in houses built before 1960, but may be found in homes built as late as 1979), especially if the paint is peeling or breaking down. You can find out when your house was built by looking at the tax records in the municipal office of your city or town. Your local health department can tell you where to get paint, water, and soil samples tested for lead and how you can get your home inspected.

• If your house has lead-based paint in it, don’t vacuum or sweep windowsills or uncarpeted floors; that just spreads the lead dust. Instead, wash or wet-mop all hard surfaces once or twice a week with a high-phosphate cleaner. You can find one called TSP in paint and hardware stores, cruse an automatic dishwasher detergent that contains 5% to 8% phosphate. Follow the directions on the package to make the cleaning solution.  Usually, about 1/4 cup of high phosphate cleaner in a gallon of warm water is the right mixture. If you find loose paint chips on windowsills or wells, use a cloth soaked with the high phosphate cleaning solution to pick them up. Dispose of the chips in a safe place where the children can’t get at it; down the toilet, for example. The used cleaning solution can go down the toilet, too. Wash the rags and mops used for lead cleanup separately from other laundry, or use disposable rags.

• Be careful about any remodeling, renovation, or work on the house. Sanding, scraping, or burning lead-based paint will contaminate the air in your house as well as the neighborhood.

• If you find peeling lead paint, take immediate steps to keep your children away from it. Check places your child visits as well, such as day care or a relative’s house. You can cover small areas temporarily with sticky-backed contact paper, and block off access to larger areas with furniture or partitions.

• Don’t try to remove lead paint yourself. That’s a job for a professional. Call your local or state health department for advice. Have peeling lead paint removed or covered by someone specially trained to do so in a non-hazardous and effective way. Children and pregnant women must stay out of the house until the work is finished and the house has been thoroughly cleaned of lead dust.

• Wash your child’s toys frequently with mild soap and water, and rinse and dry them well (dampness attracts dust). Pacifiers should be rinsed and dried even more frequently than toys. Help your children wash their hands with soap and water after playing outside and before eating (snacks included), or do it for them. Wash their faces also. Be certain to dry well.

• Supervise your children’s play to stop them from swallowing lead-contaminated dirt or paint chips. Don’t let children play in soil next to the house, where peeling paint chips may have fallen. Encourage play in grassy areas away from the house.

• Find out whether your job or hobby involves work with items that contain lead. If you work with lead, leave your work clothes or shoes at work; don’t bring them into the house.

• Always use cold water for drinking or cooking, especially for mixing infant formula. If you haven’t run the water for several hours, flush the pipes by letting the cold water run until it’s as cold as it gets. You can also have your water tested for lead.

• Nutrition affects how much of the lead a child swallows gets taken into the body. Empty stomachs absorb more lead, so don’t let children go too long between meals. Calcium and iron decrease the body’s absorption of lead. Give your child lots of foods containing calcium (milk, cheese, ice cream, yogurt, dark green leafy vegetables like turnip greens and collards, broccoli, salmon or sardines canned with bones, molasses, and rhubarb) and iron (red meats, pork, liver, chicken, turkey, canned tuna fish, dried beans-black, kidney, pinto, or baked, peanut butter, iron-fortified cereals, and egg yolks). Eating a lot of fat makes it easier for lead to be absorbed by the body. Avoid fried foods and other high fat foods. Young children should drink whole or 2% milk, however, not skim or nonfat.

• Because lead is so prevalent in the environment and even small amounts are hazardous to children, have your child’s blood tested for lead when he or she is 9 to 12 months of age, and again at about age 2-sooner and more often if you live in a house or a community with hazards from lead-based paint or contaminated water or soil.

• If your child’s test shows a high lead level, don’t be frightened. If a retest confirms the first result, your doctor will help you find out where the lead is coming from, put you in touch with governmental agencies that can help you deal with the problem, and-in the small number of cases where the amount of lead is a serious danger, help you get treatment to remove the lead from your child’s body.