width= Winter Wisdom

By: Dr. Michelle MD
 

As the cold weather sets in and the days get shorter we often assume that staying indoors with the heat turned up high is the best way to keep our babies and children healthy. This is clearly a misunderstanding. To do our best for our children we should get them outside every day that the weather is tolerable, try to keep the rooms as cool as possible, open windows, and humidify the air indoors if the heat must stay on.

Here are a few facts about winter health:

Sunshine -We must get our kids and ourselves outside before the day ends in early darkness.

1)    Everybody needs a little sunshine on his or her face every day. Sunshine helps us to produce vitamin D. Whenever possible we should all get outside in the morning or midday sun, since in the winter the suns rays hit us less directly than in the summer and they are strongest in the earlier hours of the day. Sunlight shining on the skin allows the production of Vitamin D, important for healthy bones. Even though, in cold weather, very little skin is exposed to sunlight, 15 minutes of sunshine on the face is enough to keep up production.

2)    Sunshine is also important to keep our spirits up. Adults, the elderly and even small kids can become moody and restless if many days go by without seeing sunlight. Technically this is called SADD or Seasonal Affective Depressive Disorder. It seems that everyone needs a little sunshine. There are times when the weather is cloudy and snowing or raining for many days in a row. We must take advantage of every little bit of sun when we get it in the winter.

3)    A recent study showed that young children who get outside regularly between the hours of 1pm and 4 PM are better sleepers than the ones who do not. The sunlight regulates the brain hormone melatonin, which is responsible for the sleep-wake cycle.

4)    Although we have been taught to be careful and use sunscreen lotion when we go out in the sun, it should be used less consistently in the winter (except for people with very sensitive skin) since we need to get the full benefits from our limited exposure. Skiing is of course, an exception. The altitude and the snow reflection can cause severe winter sunburns so skiers must use sunscreen.

Cold air -If we have a choice, it is better to breathe cold air than heated indoor air.

1)    The air in winter has very little moisture. The humidity is often below 30%. When that air is heated indoors the moisture level drops even more. This causes irritation and dryness of the nasal membranes, which makes it easier for cold viruses to invade. It is better to sleep in a poorly heated room with warmer bedclothes than to sleep in a warmed room. Setting the thermostat to turn the heat up an hour before everyone wakes up will prevent the morning chill when they are dressing. If humidifiers-either cool mist, ultrasonic, or hot steam units, are used, they must be cleaned daily according to instructions for the unit. Usually this requires using a vinegar solution to remove mold from the machine. If this is not done there could be real problems from breathing the moldy mist.

2)    Outdoors, the cold air may feel sharp and irritating if it is below freezing. The best solution is to breathe through a scarf wrapped directly over the nose and mouth. This humidifies and warms the air a little and makes it easier to stay outside.

Preventing frostbite -using common sense
Extremely cold fingers and toes and noses are sometimes subject to a very painful spasm of the blood vessels in the skin, causing first numbness then a severe burning sensation, known as frostbite. This can cause serious damage in severe cold exposure. The best preventive measure against frost bite is knowing how cold it is and, on very cold days, add layers to the clothing of the child, and putting on warm dry mittens over a small pair of knit gloves, and heavy socks with good weatherproof shoes or boots.(If you send the child to school in boots have him change to shoes in school. We see a lot of “boot dermatitis” in kids who sit around all day in a warm school in boots.) If it is really bitterly cold, be aware of how long the children are standing outside waiting for a bus. Standing on a corner, the children are not being physically active, so they will get colder. Strenuous activity such as running and playing warms up their bodies and makes staying outside safer. If there is a “ frostbite alert” in the weather forecast do not let them stand outside for more than a few minutes. If anyone comes indoors with severe pain in the fingers and toes put the painful hands or feet under warm (not hot,) water immediately. This restores the circulation fast. Do not let fear of frostbite keep you or your child indoors on most winter days. Just be aware when the weather is very severe and use common sense.

Small babies should be taken out in winter. -Don’t turn your infant into a “hot house plant”!
Small babies should be taken out in all kinds of weather. Even though little noses tend to run in cold air this does not mean they have a cold. By taking a baby out in cold and changeable weather you are getting them used to all kinds of conditions. If they are always kept in either the house or the car they tend to be more likely to get sick when you do take them out. As always, common sense is needed when deciding how warm the outerwear must be. It makes sense to use the wind shield on the stroller if the wind is strong. If the weather is tolerable to the caretaker there is no reason to stay indoors with the baby.

Please note that sheepskin like liners for the stroller seat are fine but never put the baby face down on one to sleep! The fashion of using heavy plush acrylic baby blankets for the stroller or carriage is fraught with danger. These blankets really could suffocate an infant. I prefer a thermal knit blanket, which is much more breathable, over a warm snow suit. Don’t forget to lighten up the outer clothing on warmer days. Sick children should be allowed to go outside if they feel up to it.
Fresh air is fine for a sick child, even in the winter . If a child is ill but has the energy to play and wants to go outside in reasonably cold weather there is no reason to keep him indoors. The fresh air will make him feel better. He can even play with other children because illness can’t spread outdoors in daylight since the ultraviolet rays of the sun kill viruses.

Sick children who have a lot of secretions or have fever (over100.6F) should not be sent to school
Viruses spread very easily in indoor air. In the atmosphere of a closed classroom there is a virtual certainty that other children will get sick if a drippy, coughing child comes to school. After the first few days of a cold there are fewer viruses to spread around, so it is reasonable to send him back to the classroom. Children with Strep can be sent back after 24 hours on antibiotics if they are feeling better. Ear infections are never contagious. Coughs can be caused by a variety of problems, some are contagious. Ask your doctor about the fairness of sending your coughing child to school. Winter does not have to be a time of imprisonment in our homes and schools. Some of us, (including myself), love the cool fresh air. With proper layering of clothing everyone can enjoy winter. It’s all a matter of having a positive attitude and common sense.

 
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