Winter isn't a time to just stay indoors and wait for spring. There's a whole wonderland of sports out there for the entire family - sledding, snowmobiling, and snowboarding, to mention a few. Plus, someone has to shovel the snow, right?

Once outdoors, however, you may need to take extra steps to keep your family safe in the cold. In ice and snow, accidents can occur easily, and before you know it, you may be on your way to the emergency room.

There are ways to keep safe - and stay fit - during the cold months. By following a few tips, you can have a great time, no matter how much white stuff piles up outside.

Why Is It Important to Be Safe in the Cold?
Certain injuries are more common in the winter because of special cold-weather activities. Activities like ice-skating, sledding, snowboarding, and skiing lead to the most accidents and injuries in the winter, and often it's children who get hurt.

Now that snowboarding is drawing more kids out in the cold weather, emergency rooms are seeing more abdominal, head, and neck injuries in those who run into trees or large rocks while snowboarding.

It's not just winter sports that send people to the hospital or a doctor's office. Certain illnesses are more common when the seasons change. Respiratory illnesses, especially viruses like the flu, are particularly prevalent during this time of year. That's because everyone spends more time indoors in chilly weather, exposing themselves to more germs in the air.

On the Home Front
One way to stay healthy while cooped up inside is to make sure your family washes their hands. It's especially important to wash after sharing toys, coughing, and blowing a runny nose to help prevent the spread of viruses.

Otherwise, it's difficult to avoid getting sick. People who sleep and eat well may be less likely to get sick because their bodies are more resistant to viruses and other germs, including bacteria.

Decided you've had enough of the indoors and you're going to get the family outside to shovel the snow? Fine, but take care. Snow shoveling is strenuous work. It's OK for older, school-age kids to help out, but young children should not be shoveling because they can strain their muscles from lifting heavy shovels full of snow.

Younger or older, kids sometimes have a tough time knowing when to come inside from the cold. To nip frostbite in the bud, check on your kids regularly to make sure that mittens are dry and warm and noses aren't too red.

Braving the Cold
If you're going outside in the cold, stay safe - and warm. Make sure your kids have a snack before going out. The calories will give their bodies energy in the cold weather.

And protect your kids' faces with sunscreen. Even though the idea of a sunburn in January can seem odd, snow can reflect up to 85% of the sun's ultraviolet rays.

Kids should dress warmly using layers of clothes - but not before using the bathroom! If the top layer gets wet from snow or freezing rain, they can peel off some clothes down to a dry layer.

Avoid cotton clothing because it won't keep the kids very warm. Stick with wool or other fabrics. Dress them in long underwear, a turtleneck, and a sweater and coat. Add more layers depending on the temperature. Waterproof pants and jackets are great top layers because they don't let the wetness seep into the other clothing. The cold-weather ensemble wouldn't be complete without warm socks and boots to keep feet dry and a hat to top it off.

There's no set amount of time children should be allowed to stay out in the cold. However, when being cold becomes unpleasant, it's time to go inside. Sometimes, though, kids may just need some dry gloves. It helps to have an extra pair of gloves or mittens tucked into their pockets if they plan to be outdoors for a while.

If your kids decide to go sledding on their own for the day, make sure you know about the hill where they will be playing. Is it steep or covered with trees? If so, it's not a good location for sledding. Also, watch out for hills where there are rocks or those that are near busy roads.

Sledding injuries can be very serious, resulting in head trauma, neck trauma, and broken bones. In serious injuries, there often is internal bleeding and abdominal trauma, which is why it's a good idea to supervise when your kids are sledding.

Ice-skating and ice hockey are great cold-weather activities, but they require safety smarts. Make sure your children avoid sports injuries by wearing supportive and properly fitted skates. In addition, rinks are always safer than ponds for skating. If you only have access to a pond, check the thickness of the ice yourself to prevent falls through the ice and supervise your children while they skate.

Snowmobiling is more popular than ever, and the machines also go faster than ever. When snowmobiling, follow these safety steps:

• Travel in groups and make sure someone knows where the snowmobilers are going.
• Know your machine and its capabilities.
• Respect snowmobilers and yield to those who have the right of way.
• If it's necessary to snowmobile on frozen bodies of water, do so with extra caution.
• When crossing a roadway, make sure the way is clear in both directions.
• Operate at a reasonable and prudent speed for trail conditions.
• Remember that alcohol and snowmobiles don't mix.

What to Do in an Emergency
Children are at greater risk for frostnip and frostbite than adults, and the best way to prevent it is to make sure kids are dressed warmly and that they don't spend too much time in extreme weather.

Frostnip is an early warning sign of the onset of frostbite. It leaves the skin white and numb. After bringing your child inside, remove all wet clothing because it draws heat from the body. Immerse the chilled body parts in warm (not hot) water - 104 to 108 degrees Fahrenheit (40 to 42 degrees Celsius) - until they are able to feel sensation again.

Frostbite occurs mostly on fingers, toes, ears, noses, and cheeks. The area becomes very cold and turns white or yellowish gray. If you notice frostbite, take your child immediately to the nearest hospital emergency room.

Going on a road trip over the holidays? Make sure you have a first-aid kit, extra blankets, and gloves in the car.

Reviewed by: Neil Izenberg, MD
Date reviewed: November 2003

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