After Christmas comes holiday vacation time, a time for outdoor fun activities for children.

The American Academy of Pediatrics (AAP) recommends the following tips for keeping children safe while outdoors in the winter.

What to Wear

Dress infants and children warmly for outdoor activities. Several thin layers will keep them dry and warm. Don’t forget warm 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.

When participating in activities such as ice skating, sledding, snow skiing and snowboarding, consider having your child wear a helmet.

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.

Hypothermia

Hypothermia develops when a child’s temperature falls below normal due to exposure to colder temperatures. It often happens when a youngster is playing outdoors in extremely cold weather without wearing proper clothing or when clothes get wet. It can occur more quickly in children than in adults.

As hypothermia sets in, the child may shiver and become lethargic and clumsy. Speech may become slurred and body temperature will decline in more severe cases. 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 his/her skin burns or has become numb.

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 the child with clothing or blankets. Give him/her something warm to drink.

If the numbness continues for more than a few minutes, call your doctor.

Frostbite facts from Rhode Island Hospital’s Burn Center.

Supervision

Children should be supervised while participating in all winter outdoor activities. Older children’s need for adult supervision depends on their maturity and skill. If older children are not with an adult, they should always at least be accompanied by a friend. Never let your child sled, skate, ski or snowboard alone.

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.
• 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 trees 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 crowded areas.

 Snow Skiing and Snowboarding

• Children should be taught to ski or snowboard by a qualified instructor in a program designed for children.
• 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. Eye protection or goggles should also be used.
• Slopes should fit the ability and experience of the skier or snowboarder.
• Avoid crowded slopes. Avoid skiing in areas with trees and other obstacles.

 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.
• Stay on marked trails, away from roads, water, railroads and pedestrians.

In a recent nightly news report, Brian Williams spoke about the serious danger in using the colorful, candy like, laundry detergent pods if you have young children in your home. He cited a recent new study in the journal Pediatrics that stated these detergent pods can pose a serious poisoning risk to young children.

He went on to say that just about once an hour a child is reported to have ingested one of these colorful pods that are small enough to fit into a young child’s mouth.

Dr. Cindy Haines of HealthDay TV, also reported on this serious threat in MedlinePlus. She shared that study researchers analyzed records from the National Poison Data System and found that more than 17,000 children under the age of six were exposed to laundry detergent pods from 2012 through 2013. Nearly 80 percent were exposed through ingestion, most of them one and two years of age.

Half of the children, who put the pods in their mouths, were treated at home, about a third were treated at a health care facility and released, and around 4 percent were hospitalized. While most of the young patients experienced minor injuries, more than 7 percent suffered a moderate to major medical outcome. One child died.

The researchers say since the pods have a colorful, candy-like appearance that they may attract children, especially during developmental periods when children commonly place items in their mouths. They are asking pediatricians and other health care providers to educate parents and other caregivers about the dangers of these products, as well as the importance of safe storage and careful use.They strongly recommend that households with young children use traditional laundry detergent. The study authors also say a national safety standard is needed to improve product packaging and labeling.

Brian Williams concluded his report by sharing that, as a result of this study and the attention it is getting, the manufacturers of the laundry pods are working on an education campaign to promote the safe storage of laundry pods and their use in homes with young children.

 The Centers for Disease Control (CDC) recommends that everyone 6 months of age and older get a seasonal flu vaccine.

The CDC states that children should be vaccinated every flu season for the best protection against flu. For children who will need two doses of flu vaccine, the first dose should be given as early in the season as possible. For other children, it is good practice to get them vaccinated soon after flu vaccine becomes available, ideally by October. However, getting vaccinated even later can be protective, as long as flu viruses are circulating.

While seasonal influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against influenza virus infection, it is best that people get vaccinated so they are protected before influenza begins spreading in their community.

The CDC warns that Influenza (“the flu”) is more dangerous than the common cold for children. Each year, many children get sick with seasonal influenza; some of those illnesses result in death.

• Children commonly need medical care because of influenza, especially before they turn 5 years old.
• Severe influenza complications are most common in children younger than 2 years old.
• Children with chronic health problems like asthma, diabetes and disorders of the brain or nervous system are at especially high risk of developing serious flu complications.
• Each year an average of 20,000 children under the age of 5 are hospitalized because of influenza complications.
• Flu seasons vary in severity, however some children die from flu each year. During the 2013-2014 influenza season, more than 100 flu-related pediatric deaths were reported..

The vaccination is especially important for certain people who are high risk or who are in close contact with high risk persons. This includes those at high risk for developing complications from the flu and adults who are close contacts of those children.

Starting in 2014-2015, CDC recommends use of the nasal spray vaccine (LAIV) for healthy* children 2 through 8 years of age, when it is immediately available and if the child has no contraindications or precautions to that vaccine. Recent studies suggest that the nasal spray flu vaccine may work better than the flu shot in younger children. However, if the nasal spray vaccine is not immediately available and the flu shot is, children 2 years through 8 years old should get the flu shot. Don’t delay vaccination to find the nasal spray flu vaccine. For more information about the new CDC recommendation, see Nasal Spray Flu Vaccine in Children 2 through 8 Years Old

 The September 2014 edition of the Centers for Disease Control (CDC) Vital Signs focuses on the amount of sodium in children’s diets.

Reducing Sodium in Children’s Diets

Nearly 9 in 10 US children eat more sodium than recommended, and about 1 in 6 children has raised blood pressure, which is a major risk factor for heart disease and stroke. Lowering sodium in children’s diets today can help prevent heart disease tomorrow. Small changes make a big impact on your child’s daily sodium intake. Learn more in the current CDC Vital Signs.

Sources of Sodium

Americans get most of their daily sodium—more than 75%—from processed and restaurant foods.² What is processed food?

Sodium is already in processed and restaurant foods when you purchase them, which makes it difficult to reduce daily sodium intake on your own. Although it is wise to limit your use of added table salt while cooking and at the table, only a small amount of the sodium we consume each day comes from the salt shaker.

Dietary Guidelines for Sodium and Potassium

The Dietary Guidelines for Americans, 2010[PDF-2.9M] recommend that everyone age 2 and up should consume less than 2,300 milligrams (mg) of sodium each day. Some groups of people should further limit sodium intake to 1,500 mg per day, including:

• Adults age 51 or older.
• All African Americans.
• Anyone who has high blood pressure, diabetes, or chronic kidney disease.

Those groups add up to about half of the U.S. population and the majority of adults.

The Dietary Guidelines for Americans also recommend meeting the potassium recommendation (4,700 mg per day). Higher potassium intake can help lower blood pressure. Foods that are high in potassium and low in sodium include bananas, potatoes, yogurt, and dry beans, among others. The U.S. Department of Agriculture’s Sodium and Potassium fact sheet[PDF-153K] has more information about the role of potassium in a healthy diet and a list of foods rich in potassium.

Nearly everyone benefits from lower sodium intake. Learn more about sodium in your diet in Where’s the Sodium?, a February 2012 report from CDC Vital Signs.