family
By Dr. Christina Johns
Published Dec 14, 2021
“My stubborn 4-year-old refuses to put his jacket on…even in 40 degrees weather! I’m really sick of the power struggle every morning just to get out the door, but I obviously don’t want him to catch a cold (or worse). How bad is it to let him leave the house without a jacket this winter?”
The cold weather has arrived in my neck of the woods and I’m officially on high alert for any and all symptoms, undoubtedly compounded by news of the Omicron variant of Sars-CoV-2. Related to winter, something I’ve heard from parents for years is that they think their child “caught a cold” because he or she went outside without a coat on. Or a hat. Or they insist on wearing shorts. Kids will often vehemently assert their independence by refusing to or insisting on doing something—my two do it regularly! But back to the topic at hand: Often, kids don’t want to wear big, bulky winter coats because they feel that they’re too restrictive and they claim they are “not cold” even when temperatures are low.
This, of course, can drive parents crazy (raising my hand)! We also remember what our mothers told us: that a child is at risk for getting sick, specifically a cold or pneumonia, if they go out in the cold without a jacket. This is, in fact, a myth. There is no specific, definitive scientific data to support the claim that sending a child outside in cold weather without a coat (or, with wet hair, for that matter) will increase their chances of “catching a cold.”
There’s a good reason for this, and that is that these types of illnesses are caused by germs (usually viruses), not exposure to cold. While it is true that cold viruses (there are over 200 of them!) can travel more easily in cooler temperatures, being exposed to cold does not directly correlate with whether or not a child becomes infected. There is some lab evidence that indicates a lower body temperature may actually decrease proper immune response slightly, but it is unclear whether this particular data has any significant real world effect in this scenario. If a child happens to be exposed to germs while their body temperature is lowered, the body could be less likely to activate a fully effective immune response to fight off infection. But again, the direct correlation between a child not bundling up and a cold infection is simply not there.
Here are some other cold weather questions and concerns that I hear during this time of year.
How cold is too cold for my kids to play outside?
If we’ve learned anything from the last two years, it’s that playing outdoors is much safer than indoor gathering when it comes to most viral infections. However, there is a threshold for unsafe temperatures when outdoor play should simply be taken off the table. Look at temperature and wind-chill to determine if the conditions are too cold for a child. If the wind-chill is at or above 32 degrees Fahrenheit, it is deemed safe for children to enjoy outdoor play for an unlimited amount of time. The younger the child, the more layers they need. If the wind-chill drops the temperature below 32 degrees Fahrenheit, I’d recommend limiting time spent outdoors until temps warm up. Any temperature under 13 degrees Fahrenheit, with or without the wind-chill factored in, could be considered dangerous due to the potential of hypothermia. These are general guidelines of course, but good to keep in mind.
What about the risk of pneumonia when my child spends lots of time outdoors and isn’t bundled properly?
Pneumonia is spread after contact with droplets containing germs from an infected person’s throat, nose or mouth and breathing them in. Community acquired pneumonia is fairly common and can affect anyone at any time. However, it should be noted that it occurs most often during the cold months, not because of the temperature or exposure to cold itself, but because many of these germs thrive in cold weather and also because we all spend more time indoors in close contact with others so they can travel more easily. Another benefit of masks: Wearing one outside can mitigate this risk for your kids, and it may also help keep their faces a bit warmer as well! This is also a good time to mention the importance of coughing into the elbow instead of covering the mouth with the hand to help avoid spreading germs: teach kids this strategy early.
My child gets extremely red cheeks after playing outside in the cold. Is this cause for concern?
Some kids will get really red cheeks that can look infected from being outside in the cold for prolonged periods. This is called “cold panniculitis” and while it may look dramatic, it is harmless and will go away on its own. One way to avoid it is by applying an ointment like Vaseline on the cheeks prior to going outside.
The bottom line
I suggest worrying less about your older child refusing to layer up and instead focus your energy on other tactics to mitigate viral spread like hand-washing, enforcing mouth covering when sneezing or coughing, and keeping their immune systems strong through proper nutrition, hydration and sleep. What is most important is that kids should be comfortable when playing outdoors. When playing outside in cold weather, take frequent “warming breaks” to protect their skin from the elements, make sure they stay hydrated (dehydration can still happen in the winter), and it certainly won’t hurt to have their coat, hat, and mittens available if they change their mind (in my experience, they often do!).
Dr. Christina Johns is a pediatrician + Senior Medical Advisor at PM Pediatrics, the largest pediatric urgent care group in the U.S.
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Dr. Christina Johns
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Dr. Christina Johnsis a pediatrician + Senior Medical Advisor atPM Pediatric Care, the largest pediatric urgent care group in the U.S. She received her undergraduate degree at...
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As a pediatrician and Senior Medical Advisor at PM Pediatrics, the largest pediatric urgent care group in the U.S., I bring a wealth of firsthand expertise and a deep understanding of pediatric health. My knowledge extends beyond the common misconceptions, providing evidence-based insights into various aspects of children's well-being. Now, let's delve into the concepts addressed in the article you shared.
The article revolves around winter-related concerns for children's health, specifically addressing the notion that children might catch a cold or pneumonia if they go outside without wearing a jacket. Here are the key concepts discussed:
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Children and Winter Clothing: The author acknowledges the common struggle parents face when trying to get their kids to wear winter jackets. Kids often resist bulky winter coats, claiming they are "not cold" even in low temperatures. The article dispels the myth that not wearing a coat directly leads to catching a cold or pneumonia. The emphasis is on understanding that these illnesses are caused by germs, usually viruses, rather than exposure to cold weather.
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Cold Weather and Viral Infections: The article touches upon the relationship between cold weather and viral infections. While cold viruses can travel more easily in cooler temperatures, exposure to cold does not directly correlate with a child becoming infected. The author cites the lack of specific, definitive scientific data supporting the idea that sending a child outside without proper winter clothing increases the risk of catching a cold.
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Outdoor Play in Cold Weather: The article provides guidelines on determining when it's too cold for children to play outside. It suggests looking at both the temperature and wind-chill, emphasizing that outdoor play is generally safe as long as the wind-chill is at or above 32 degrees Fahrenheit. The younger the child, the more layers they may need. Extreme cold, below 13 degrees Fahrenheit, could be considered dangerous due to the potential of hypothermia.
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Pneumonia Risk and Cold Weather: The risk of pneumonia is discussed, emphasizing that pneumonia is spread through contact with droplets containing germs. While cold weather is associated with an increase in pneumonia cases, it is not the temperature itself but factors like germ survival in cold weather and increased indoor close contact that contribute to the seasonal rise in cases.
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Skin Conditions in Cold Weather: The article addresses a specific skin condition called "cold panniculitis," where children may develop red cheeks from prolonged exposure to cold. It reassures parents that this condition is harmless and will resolve on its own. Preventive measures, such as applying an ointment like Vaseline, are suggested.
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General Recommendations: The author advises parents to worry less about children refusing to layer up and instead focus on other strategies to mitigate viral spread, such as hand-washing, proper hygiene practices, and maintaining strong immune systems through nutrition, hydration, and sleep.
In conclusion, the article provides evidence-based information to help parents navigate common concerns related to children's health during the winter months, dispelling myths and offering practical recommendations.
