406-522-KIDS (5437)    1819 S. 22nd Avenue, Suite 100, Bozeman, MT 59718
     Finally the snow is falling! It is beautiful and fun and kids, both young and old, want to be out playing in
it. That means it is time to think about how to stay warm and prevent cold injury like hypothermia and
frost bite. Children are more sensitive to cold injury. They are smaller, have less body fat and a high
metabolism. Small children and infants will not be able to communicate that they are cold and so
parents need to have some guidelines for safe outdoor play in our cold winter.

Hypothermia and Frostbite:

     The two major groupings of cold injury are hypothermia and frostbite. In hypothermia, the body’s core
temperature drops. This causes slowing of all of the body’s function. As a person becomes
hypothermic, they start to shiver, but then shivering stops as the body temperature drops further. A
concerning sign is when a child becomes lethargic as the brain slows with lower body temperature. If
your child is showing signs of hypothermia, get them into a warm environment and feed warm fluids.
     Frost bite is a freezing of the water in the skin due to cold. Mild frost bite is sometimes called frost nip.
In severe frostbite, there is freezing of muscle as well as skin. Typically the skin looks pale when there is
a cold injury. It can feel waxy or hard. As the injury is more severe, it will feel like frozen meat. In mild
cases, the area should be warmed up with warm water and should feel supple and look pink within 20
minutes. If the injury is more severe, seek medical attention immediately.
     How cold is too cold? There is an old Norse expression – “There is no bad weather, only inadequate
clothing.” So the best answer is to dress warmly and in layers. A warm under layer and then a wind
proof outer layer will help the core stay warm. Cover the head with a hat as opposed to a hood – as
much as 30% of body warmth is lost through the head, so a close fitting hat reduces heat loss. In
addition, hats that cover the ears protects the ears from frost bite. Frost bite, frost nip and chilblains
are most likely to happen on the tips of the fingers and toes, on the cheeks, and on the nose and ears.
These tender areas need to be covered with gloves, warm boots and balaclavas or scarves.
     Any temperature under freezing can be a risk for cold injury, but the lower the temperature, the higher
the risk. Be careful as the temperature drops below 10 degrees Farenheit, and be sure to keep children
dry. Being cold and wet is a higher risk for hypothermia.
With attention to warm clothing, get out and enjoy the snow!
-Dr. Idzerda

Acorn Pediatrics