A winter storm that turned North Texas into a sheet of ice has led to a spike in emergency room visits related to sledding accidents, prompting pediatricians to urge parents to take immediate safety precautions.

Cook Children’s Health Care System has treated more than 60 children for sledding-related trauma since this weekend, with children as young as 2 years old. Injuries include bone fractures, head and facial trauma and internal organ lacerations.

Medical experts emphasize that the region's current conditions are far more dangerous than typical soft snow.

“This is not snow that we have here in Texas; this is ice,” said Taylor Louden, M.D., medical director of emergency services at Cook Children’s Medical Center – Fort Worth. “When kids hit their head on ice, it can cause catastrophic injuries.”

Dr. Louden warned that because most sleds are not equipped with a braking system, children have little to no control once they gain momentum on icy slopes.

“Sledding can be extremely dangerous,” said Dr. Louden.

As children head outdoors to enjoy their day off from school, Cook Children’s urges families to follow these safety guidelines to prevent injuries:

• Always wear a helmet.
• Never be pulled behind any sort of motorized vehicle.
• Do not sled on pool equipment or other non-sleds. These "non-sleds" offer no stability or steering.
• Avoid sledding on city streets or where objects that people can run into are located. 

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Severe winter weather is hitting North Texas over the weekend and early this week—with below-freezing temperatures, piercing wind chills, and the potential for snow and ice. 

Road and school closures are a possibility, which means you and your little ones might be stuck at home for a few days—but even if the roads stay clear, you’ll likely have to brave some pretty intense cold. No matter what the weather brings, our Cook Children’s experts have shared some of their go-to tips and tricks for staying safe, healthy, and entertained in the days to come.

Tips for Staying Healthy at Home  

Erin Bridgewater, M.D., pediatrician at Cook Children's Pediatrics Celina, offered some ways to ensure you and your family stay healthy through a potential freeze. 

1. Make sure your medicine cabinet is stocked. There’s no need to hoard, but it’s important to make sure you have some basic medications handy in case your child gets sick and the weather makes it hard to get to a doctor. Tylenol, Motrin, Pedialyte, and Benadryl are all great to have on hand.  “If your child requires prescription medications for asthma, seizures, or other chronic illness, make sure you are not running low when winter storms are coming,” said Dr. Bridgewater.
2. Practice carbon monoxide safety. In the case of a power outage, you might be desperate to find alternative ways to heat your home. Never use a gas stove for household heat, and only operate portable stoves and charcoal grills outside and at least 20 feet away from windows. “If you have a new generator you want to try out, make sure to read the manual and use it properly,” said Dr. Bridgewater. “Also make sure you have working carbon monoxide detectors on each level of your home. Improper use of generators in or around the home can lead to deadly carbon monoxide accumulation and poisoning.” If you lose heat and all else fails, consider stocking up on handwarmers and bundling up with winter wear and blankets until the power comes back on. 
3. Bundle Up.  It's safe to let your kiddos go out and play in the snow, as long as it's not too terribly cold. “Remember that cold weather does NOT cause head colds—viruses do. Just make sure your little ones are properly bundled. They may prefer several light, but warm layers over super bulky clothing.” 

Tips for Staying Safe Outside  

Sharon Evans, Trauma Injury Prevention Coordinator, filled us in on safety precautions for the car and playing outside.

1. Never dress your child in a coat in their car seat. No matter how much you tighten the harness, a coat will still allow for enough slack to cause potential dangers during a crash. “For infants, you can heat up the car while you put them in their infant seat inside. Place a blanket over the harness, and then take them out to the car once it’s warmed up,” Sharon explains. "If they’re older, just harness them in and put their jacket backwards over the harness so they can take it off as the car heats up.”
2. Always wear a helmet when playing on ice. Whether it’s sledding, ice skating, or anything in between, it’s easy to fall on ice. Wearing a helmet could protect your child from a serious head injury. “We usually don't have the proper equipment for sledding, for example, so protecting your child's head is really important."
3. Ensure your child is wearing safe clothing. “Some hoodies and coats have drawstrings around the neck, which could be choking hazards." Parents should ensure their kids have good rubber-soled boots to reduce their risk of slipping on ice. “It's fun to play and slide around in the ice and snow, but you don't want them falling and breaking a bone or hurting their head."

Tips for Keeping Your Family Entertained 

Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's, told us how to turn being stuck inside into fun and adventurous quality time. 

1. Stock up on hands-on, creative supplies. “I like to have crafting stuff available, things that kids can color or paint that you might not get out on a regular day to play,” Ashley said.
2. Focus on stimulating, long-form activities. Ashley emphasizes the importance of engaging in activities that pass the time, like painting a mural on an old delivery box or building and reconstructing Legos. “I always try to encourage creativity and have things that kids enjoy doing,” she said. “Anything that you can build and then change to try something new is really helpful.” 
3. Make it a movie day. This option won’t work if your power goes out (but we’re hopeful that won’t happen)! Snuggle up and watch your kids’ favorite movies—keeping in mind screen time limitations, which we’ll get to on number 5. She also suggests keeping fun snacks and yummy beverages on hand. “Having some popcorn or hot chocolate with marshmallows is really fun for kids."
4. Set expectations for outside playtime. Only let your kids go outside for 20-25 minutes at a time, taking breaks to come back in and warm up for a while in between. “When kids see snow and ice, they just want to run out and play, and that's typically how they get hurt,” Ashley explains. “I try to prepare my kids by telling them exactly what clothes they need to put on and setting an expectation for how many times we’re going to go outside throughout the day.” 
5. Limit screen time as much as possible. Be careful letting your kids watch TV all day, as they will inevitably become irritable from too much time in front of the screen. “Getting outside is great as long as you have the right clothes, but also getting up and moving around and maybe having a dance party inside is helpful,” she said. “I would encourage families to limit screen time to the afternoon or evening, because if you start the day with it, your kids won’t want to do anything else.”

No matter what the winter weather brings, we hope you stay warm, healthy, and safe and can enjoy some quality time with your family. Inclement weather may cause many of our primary care offices and specialty clinics to close or delay openings. Click here to view closure updates and delayed openings at our Cook Children's locations.

The answer is complicated.

Yes, it's very important for toddlers ages 1-3 to interact with other kids their age and challenge their balance, strength and coordination. Sports are a great way to promote these skills and literature shows that athletes who play sports at a younger age are more likely to be active adults than their peers who don't participate in sports.

However, organized sports  may not be the best solution for children 3 and under, and aren't the only way to teach our children these skills. The list below describes activities for toddlers and some benefits of these activities for their development.

Swimming: Helps strengthen the arms and legs, as well as improve coordination since the child has to use both arms and both legs at the same time. Learning swimming at an early age helps promote good water safety habits later in life. You can practice swimming in a "parent and me" swimming class. 

Dance: Improves balance, coordination, strength and flexibility. You can practice in a class setting or by having a "dance party" or playing a game of "freeze dance" at home.

Biking: Between ages 2 and 3, kids should be able to begin riding a tricycle. For young kids, there are tricycles that offer a parent guide bar to help kids move and steer. You can practice biking in your neighborhood or on trails.

Soccer: Most teams start between ages 3-5; however, kicking a ball in the backyard with your toddler is a great way to help them learn to run, develop core strength and balance on one foot for a short period of time.

Basketball: Helps kids develop hand-eye coordination when dribbling and shooting and improve running and jumping skills, as well. You can play with an adjustable hoop in the driveway, or sing up for a community team (which will generally begin between ages 3-5).

T-Ball: Teaches running, balll skills and coordination skills. Using larger balls for young children will help them be successful with catching and throwing.

Yoga: Helps improve flexibility, which is very important since toddlers are growing quickly and develop tight musles quickly. Yoga can also improve strength (especially in the core muscles) and balance. Several toddler yoga videos can be found online, and classes are available throught out the DFW area.

Gymnastics: Another way to gain strength, balance and flexibility, gymnastics is a sport that children can begin learning as early as 18 months old. Many gyms have special toddler and preschool classes, as well as "parent and me" classes.

Yard games: The old staples of "tag" and "hide and seek" are great for teaching turn taking and problem solving, as well as practicing and running and climbing. Taking your child to a local playground also offers a wide variety of ways to practice climbing stairs, running, swinging, balance, etc. 

With all of these, safety is a primary concern. Toddlers are at high risk of injury when practicing new things. Contact your pediatrician if you feel like your child is having difficulty learning new skills and they may refer you for evaluation by a physical therapist to evaluate your child and help them learn these new skills.

About the author

Jodi Burgett PT, DPT, CPST, is the clinical coordinator of Neurodevelopmental Physical Therapy at Cook Children's. Physical therapy at Cook Children's focuses on large motor and functional skils to enhance development, restore function and prevent disability from pediatric conditions, illness or injury. Cook Children's has Rehabilition Services in locations in Fort Worth, Hurst and most recently in Mansfield.