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The question: It's -20 C outside and my child wants to go out and play. Should I let him? What is frostbite and when do I have to worry about it?

The answer: Canadian winters can be long and cold, and I must admit that sometimes hibernation sounds very appealing!

I applaud your son's enthusiasm and desire to embrace the winter weather. Winter is, after all, a great season for many outdoor activities. With a few precautions, there is no reason why children and families can't get outside regularly throughout the winter months.

Frostbite is the medical term used to describe frozen skin. Frostbite occurs when skin is subjected to extreme cold or is left exposed for prolonged periods of time. Not surprisingly, it is the cheeks, ears, nose, hands and feet that are most commonly affected.

With mild frostbite, the skin looks red and swollen and may have a burning sensation. Slowly warming the skin at room temperature is usually all that is required. Alternatively, warming the area by covering it with a warm hand is also effective. Resist the urge to rub or massage the area, as this may cause more damage.

Severely frozen skin has a shiny, white appearance, often with decreased sensation. Such cases require medical evaluation and treatment.

In my clinic, we give the following advice to parents:

  • 1. Check the temperature and wind-chill factor before going outdoors. Stay inside if the temperature with the wind chill is -25 C or colder. Consider a cutoff of -20 C for preschool children or children prone to getting cold.
  • 2. Appropriate clothing is essential. You don’t want your child to be either too hot or too cold. Layers work well. A hat that covers the ears, warm mittens and waterproof boots are essential parts of the winter wardrobe.
  • 3. Take frequent breaks to come indoors and warm up. These breaks are a great way to prevent hypothermia and frostbite. They also give kids a chance to change into dry socks and gloves if necessary. Include a small snack with a warm drink and a bathroom break and your child will be ready for more fun in the snow.
  • 4. Head injuries are common and can be serious, especially with skating and sledding. Ski helmets or hockey helmets are always advised. When tobogganing, choose slopes away from roadways and bodies of water, and avoid hills with trees, fences or other obstacles.

There is no end to the number of family activities that can be enjoyed in the winter. Winter sports like snowshoeing and cross-country skiing can be enjoyed by children starting at a very young age. Be creative! Games like hide-and-seek, tag and soccer take on a whole new dimension when played in the snow.

Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He's a staunch advocate for children's health in Atlantic Canada through his involvement with the Canadian Paediatric Society.

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