Know your babies' limits and plan ahead when making a trip outside so you can keep them well this winter.

Bundle Up

Before infants head outdoors, make sure they are wearing fresh diapers and are insulated against the cold and wet. 

"A good rule of thumb is to dress newborns in as many layers as you're wearing," said Diane Arnaout, M.D., FAAP, a Cook Children's pediatrician in Willow Park. "That includes covering their heads, hands and feet. Those areas can lose a lot of heat and be harder to keep warm."

As a mom of young children, Dr. Arnaout has first-hand experience in facing area winters with a newborn. She recomends using socks to keep tiny hands and feet warm, knit hats for infant heads and sunglasses to keep the bright winter sun out of little eyes.

Pay Attention

It's important to regularly check on newborns while you're together outdoors. Babies tend to fuss when they're uncomfortable, so if they are crying or restless while you're out and about, it may be time to move outside. 

To see if infants are getting too cold, check their ears, nose, hands and feet regularly. If your own nose or ears are cold or your lips and becoming chapped, odds and it's too cold outside for babies.

Blue skin, shivering and a cool chest and stomach are signs that children may be dangerously cold. If you see these signs, take action immediately to get kids out the cold. Seek immediate medical attention if you're not able to warm the body.

About the source

Dr. Diane Arnaout joined the Cook Children's Willow Park practice in 2011. Dr. Arnaout was born and raised in the Dallas-Fort Worth area. She served as a leader on the medical education committees during her internship and residency in pediatrics at the University of Texas Health Science Center in the Texas Medical Center at Houston, Texas.

What follows are Dr. Ben's Top 10 areas of focus to promote good mental health for your soon-to-be adults.

1. Sleep - As a person goes through the teenage years, it's normal to have a harder time falling asleep early and harder to get up in the morning. Good sleep can be promoted by trying to keep weekday and weekend awakenings and sleep at around the same time (within an hour or two at least). Try to walk away from screens an hour or so before bedtime and rid the bedroom of screens as best you can. This is hard but doable. Strive to get eight hours or more sleep most nights. If you find yourself unable to consistently fall asleep quickly at bedtime or wake up consistently at night, talk to your parents or pediatrician. 

2. Unplug - To be a kid today is to have computerized screens as a central part of your education, entertainment and socialization. Being constantly connected, or just feeling like you have to be, is not mentally healthy. While it would be almost impossible to function today without them, it's important to realize that heavy screen use has been associated with poor mental health.

3. Exercise - If you are not involved in a sport, it's easy to have physical activity become less and less of a priority. However, studies have shown that adolescents who get regular exercise generally sleep better, perform better academically and are happier than their non-exercising peers. Finding some way to move your body with vigor, getting a bit out of breath and sweaty, can really improve your happiness level. 

4. Outside - Human beings have spent millennia evolving, which, until the last couple hundred years, necessarily involved spending a large degree of time outside. Now, some people's only time outside for days on end can be walking to and from a car into home, school or activity. Exercising outside, doing homework outside or simply going for a walk outdoors can boost happiness.

5. Play - Growing up necessarily means increasing responsibilities and pressures. It becomes easy to lose track of plain ol' FUN! Doing something joyful and "non-productive" can be rejuvenating. Baking cookies for somebody, going bowling or playing a board game be a great source of stress relief. Have fun. It's one of the things that makes life worth living. 

6. Mastery - The teenage years are actually the time in which certain areas of brain performance are at their absolute max. Developing what psychologists call a "growth mind-set" is a great tool for happiness. Instead of "I can't do it," think and say "I can't do it - YET." You are a human becoming and you can accomplish all wonder of things with persistence and grit.

7. Connection - During these years, it's normal to become more and more connected to your peers and rely less on your parents. Forging many relationships, different relationships (with classmates in different social spheres, people at church, camp or sports, etc.) can be a source of great mental strength. Forging these bonds away from screens is a good idea. Including others can make not only the other person happier, but can make you feel good too. Nobody feels good when someone is left out. 

8. Mindfulness - Although the term is in danger of becoming fuzzy from overuse, a good definition is "paying attention on purpose, non-judgmentally and with intention." Unfortunately, the screen in our lives promote the opposite of this. Many resources such as books, websites and apps (such as Headspace, Insight Timer, Aura, etc.) exist and cultivating mindfulness can play a tremendous role in increasing happiness.

9. Kindness - As you get older, it's easier to note the imperfections of others - classmates, siblings, teachers and especially parents. However, making a point to be kind to all of those around you not only makes others happier, it can remarkably improve your own happiness. EVERYBODY responds well to kindness. 

10. Gratitude - Although it may seem silly, finding things to be grateful for can have a big impact on happiness. Keeping a gratitude journal, saying "thank you" often, or writing notes of gratitude can be very positive. Striving to do this even more in times of stress is especially important. The things themselves that we can be grateful for can be large and small; it is the process of finding them, savoring them and remembering them that's important.

But are they ready for the hottest part of the year?

Locally, the National Weather Service has issued a heat advisory that remains in effect until 8 p.m. Saturday. Daily temperatures will range between 94 to 102 degrees, with a heat index between 105 to 109 degrees.

So while you don't want your children to waste their summer vacation away playing video games inside, warm summer temperatures can lead to more than just a sunburn. Being outdoors in the heat for too long can pose a heat-safety risk.

Corwin Warmink, M.D., medical director of the Emergency Department at Cook Children's, says eight kids have been treated in the ED this summer with a chief complain of heat related illness.

"As the outside temperature rises, your family's risk of heat stroke rises right along with it," Dr. Warmink said. "On 100-degree days, it's best to stay inside when it gets that hot. If temperatures exceed 90 degrees, stay in the shade and keep an extra eye on the kids."

Children today are spending increasing amounts of time in air conditioned environments, lured indoors by the constant upkeep of social media accounts and online gaming. One study of nearly 9,000 U.S. children, ages 3 to 5 years old, found that only half were taken outside by their parents on a daily basis to walk or play.

"The more you're out in the heat, the more your body gets used to it, or 'acclimatizes,'" Dr. Warmink said. "Children who are always inside are more prone to heat exhaustion and heatstroke than those who are frequently outdoors and active."

Play it cool

But don't mistake what Dr. Warmink is saying. Too much time out in the heat can cause heat-related illnessess such as heat exhaustion and heatstroke.

Lack of acclimatization has led to an uptick in heat illness among children in recent years, according to Dr. Warmink. Most incidents occur during the first two weeks of school athletics training when kids begin cross country, football, cheerleading or band practice.

"More is being demanded of young athletes during the late summer months," Dr. Warmink said. "Kids who spend all summer indoors and then go out for training in August are setting themselves up for heat illness."

Staying safe

Symptoms of heat exhaustion include flu-like symptoms such as paleness, sweating, nausea and vomiting. Signs of heatstroke include hot, red and dry skin, as well as confusion, vomiting, rapid heart rate, decreased sweating, shortness of breath, decreased urination, increased body temperature (104 to 106 degress Farenheight), or convulsions.

MedStar reminds us that heatstroke and heat exhaustion are common this time of year, but they can be easily prevented:

• Hydrate: Drink plenty of water during the day, especially if you are engaged in any strenuous activity. Sports drinks are a good choice if you're exercising or working in hot conditions, but water is a good way to hydrate as well.
• Ventilate: Stay in a place where there is plenty of air circulating to keep your body cool. If you are indoors and don't have access to air conditioning, open windows and use a fan.
• Cover Up: Wear light-colored and loose-fitting clothing to avoid absorbing the sun's light and trapping heat. Wear a hat to shield yourself from the sun, but once you feel yourself getting warm, remove any items covering your head which can trap heat close to your body.
• Limit Activity: Heatstroke can occur in less than an hour when you are participating in strenuous activity during a hot day. If you feel yourself getting hot or light-headed, stop your activity and rest in a cool place out of the sun. Be sure to drink water or a sports drink before, during, and after any strenuous activity.
• Check on Loved One’s: MedStar reminds families to make sure that your child's grandparents are OK. The elderly are especially vulnerable to heat related emergencies. Many elderly residents are not aware of how hot it may get in their residence. Call on older friends and family members regularly to assure they are doing OK.

About the source

Corwin Warmink, M.D., is the medical director of Emergency Services at Cook Children's. Cook Children's Emergency services are available 24 hours a day, seven days a week. Cook Children's Emergency Department (ED) treats more than 105,000 patients every year. Our ED is the only EMS-designated pediatric trauma center in Tarrant County.