Summer heat, snow or ice: It doesn’t matter the forecast, Cook Children’s Health Care System is ready for its patients and families.

 As severe winter weather blankets North Texas, Cook Children’s employees continue to shine. Their dedication to patient families and one another ensures that every child receives the care they need, regardless of the conditions outside.

 Dozens of staff members have stayed overnight at “Hero Hotel,” designated on-site spaces providing a safe and secure place to sleep. This allows essential personnel to remain available while avoiding travelling on dangerous roads.

 Additionally, Cook Children’s facilities crews have worked tirelessly to clear roads and sidewalks at the Fort Worth and Prosper medical centers. Food services and environmental services teams are working around the clock to ensure staff members have clean linens and warm meals.

 Cook Children’s Urgent Care Centers, Primary Care, Home Health and specialty clinics continue to monitor the weather closely. Click here to view closures and delayed openings at our Cook Children's locations. 

Keeping Warm and Having Fun

“If you are going to be outside, dress appropriately,” said Sharon Evans, injury prevention manager at Cook Children’s Health Care System.

Experts advise caregivers to dress little ones in several thin layers to keep warm and dry. Children are at more risk from the cold because their bodies lose heat more quickly. Insulated boots, mittens or gloves, and a hat are recommended.

Make sure children change out of any wet clothes as soon as they come indoors.

“While playing in the snow or “sledding” be aware of your surroundings, be careful to not run into trees or out into the street and mailboxes can be real dangers,” said Evans.

Know the Signs of Hypothermia 

According to the American Academy of Pediatrics, hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." This is a medical emergency, and treatment should be sought immediately. 

 Symptoms of hypothermia include: 

• Blue skin
• Shivering
• A cool chest and stomach are signs that children may be dangerously cold.
• If you see these symptoms, take action immediately to get kids out of the cold. Seek immediate medical attention if you are not able to warm the body.
• Victims of hypothermia can include babies sleeping in cold rooms. 

 Warning signs for infants include: 

• Bright red, cold skin
• Very low energy 

 Warning signs for adults include: 

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech, drowsiness 

Coats & Car Seats

While keeping kids warm is a priority during the winter, it should never come at the expense of car seat safety.

“Stay home and inside if possible. If you must be on the roads make sure everyone is buckled up correctly,” said Evans.

Bulky coats, such as puffy jackets, can create extra space between the child and harness straps or seat belt, which can increase the risk of injury in a car crash.  It is recommended to dress in thin layers and use a blanket or put the coat on backwards after the child is buckled in. 

If caregivers decide to start the car to allow it to warm up prior to entering the vehicle, it is important to make sure the car is in a ventilated area, such as an open garage, and that they lock the vehicle when they are not inside.  This will make sure that a child does not enter the vehicle unsupervised and become trapped in the vehicle.

Evans adds families should have snacks, water, and extra blankets in their car in case you get stranded. 

“If you are stranded and waiting for help on the side of the road, please make sure everyone stays buckled up,” said Evans, “often cars may slide/spin near you and hit your car.”

In addition, just as local officials advise people to stay off the roadways, if possible, ice can make dangerous driving conditions for ATV’s, Golf Carts and Go Karts.

 Safe Sleep

With winter weather, keeping infants warm is a priority for caregivers, and it is essential to do so safely.

“Caregivers often use extra blankets and hats for warmth, but these soft items can easily become a suffocation or entanglement hazard,” said Samantha St. John, program coordinator at Cook Children’s Center for Community Health.

A safer alternative is a sleep sack, also called a wearable blanket. A sleep sack provides warmth and comfort without risk because it fits securely around the baby's upper body and is sized so the fabric cannot cover their face, while still allowing plenty of room at the bottom for comfort and movement.

St. John suggests a general rule to follow dress a baby in one more layer of clothing than an adult would find comfortable in the same environment.  In winter months this could mean baby is in a long sleep fleece onesie with a wearable blanket/sleep sack. When dressing baby for bedtime or nap time during the extremely cold temperatures, it may be necessary to add socks, mittens, or hats to baby. Caregivers want to make sure that these items cannot come off during sleep and become a loose item in the crib.  It is also important to make sure baby is not going to overheat.  Signs of overheating can include sweating, a hot chest, or flushed skin.  

 Remember the ABCs of Zzzs:

• Alone: The sleep space should be clear of any soft items, such as blankets, stuffed animals, pillows, and bumper pads, leaving only a mattress with a tight-fitted sheet.
• Back: Babies should always be placed flat on their back for every nap and every night.
• Crib: A crib, bassinet, or portable play yard with a firm, flat mattress and a fitted sheet is the safest sleep surface. 

Related Stories:

• Arctic Cold Front: Readiness Tips for Parents
• What To Know During The Winter Weather This Week
• Know When to Use Telemedicine, Urgent Care, or the ER for Kids

De acuerdo a NWS se espera entre 3 a 6 pulgadas de nieve al norte de la I-20.

Lo mejor que uno puede hacer es tener un plan para mantener a todos en su familia seguros y calientitos.

Siga estos consejos de MedStar en preparación para el tiempo invernal:

• Asegúrese de tener números de teléfono importantes anotados, incluyendo sus proveedores de atención médica, farmacia y veterinario.
• Asegúrese de tener suficiente medicamento a la mano para varios días.
• Si depende de dispositivos médicos en su hogar, tenga un plan de respaldo en caso de que se quede sin electricidad durante un período prolongado, como un generador o paquete de baterías y el equipo de oxígeno.
• Tenga un plan de comunicación para su familia.
• Sepa cómo obtener información confiable durante la tormenta.
• Reúna suministros por si necesita quedarse en casa por varios días sin electricidad.

Abríguese 

• Asegúrese de que los recién nacidos estén vestidos apropiadamente. Vístalos en capas y cúbrales la cabeza, las manos y los pies.
• Para mantenerlos más calientitos, vista a sus pequeños con lana en lugar de algodón. Los artículos esenciales de invierno incluyen gorros, guantes, sudaderas o camisetas que pueden colocarse debajo de abrigos o chaquetas.
• La piel azul, los escalofríos, el pecho y el estómago frío son señales de que los niños pueden tener un frío peligroso (hipotermia). Si ve estos signos, tome medidas de inmediato para sacar a los niños del frío. Busque atención médica inmediata si no puede calentar el cuerpo. 

Esté atento a los síntomas de hipotermia.

Según los Centros para el Control y la Prevención de Enfermedades (CDC, por sus siglas en íngles), la hipotermia, o temperatura corporal anormalmente baja, "es una condición peligrosa que puede ocurrir cuando una persona se expone a temperaturas extremadamente frías".

Las señales de advertencia para los adultos incluyen:

• Tiritar
• Sentirse agotado o muy cansado
• Confusión
• Torpeza con las manos
• Pérdida de la memoria
• Habla enredada
• Somnolencia

Las señales de advertencia para los bebés incluyen:

• Piel fría y de color rojo brillante
• Muy poca energía

Entre las víctimas de la hipotermia se encuentran los bebés que duermen en habitaciones frías.

Si hay un apagón, tenga mucho cuidado con el monóxido de carbono.

Durante la tormenta invernal de Texas en febrero de 2021, Cook Children's trató a 13 pacientes por intoxicación por monóxido de carbono en una noche.

Consejos para proteger su familia durante este tiempo:

• No utilice una parrilla o un tanque de propano para calentar su casa, ni nada similar.
• No prenda su vehículo dentro de un garaje adjunto a su casa con la puerta cerrada.
• No caliente su casa con un horno o estufa a gas.
• No queme carbón dentro de su casa.
• Busque atención médica si sospecha que ha sufrido una intoxicación por monóxido de carbono.
• Asegúrese de que los detectores de monóxido de carbono de su casa funcionen correctamente y estén instalados en áreas que lo despierten si suena la alarma.
• Busque recursos locales, como refugios para calentarse.

Los signos de intoxicación por monóxido de carbono pueden incluir:

• Dolor de cabeza
• Náuseas
• Mareos
• Vómitos
• Malestar estomacal
• Dolor de pecho
• Confusión
• Síntomas similares a los de la gripe

Los asientos de seguridad en el invierno

El uso adecuado de la silla de seguridad del auto es una de las formas más importantes en que los padres pueden mantener seguros a sus hijos pequeños, especialmente cuando conducen en condiciones climáticas adversas.

• No abroche a sus hijos en la silla de seguridad del coche con su abrigo. En caso de un accidente, el relleno de un abrigo o de capas gruesas se aplanará, dejando espacio debajo del arnés de la silla de seguridad. Esto aumenta el riesgo de que un niño se resbale a través de las correas y salga a través del asiento del coche. En su lugar, vista a su hijo con capas finas. Una vez abrochado el cinturón, deslice el abrigo hacia atrás con las mangas sobre los brazos del niño. De esta manera, el abrigo actúa como una cobija y no afecta el ajuste del arnés.
• Programe tiempo adicional para llegar a su destino. Y no olvide tomar en cuenta el tráfico.
• Prepare una bolsa de emergencia para su auto. Es una buena idea tener cobijas, ropa de invierno, gorros y guantes disponibles en caso de que se quede atrapado. También tenga alimentos no perecederos guardados.
• Evite los puentes elevados, si es posible. Planifique rutas alternativas para llegar a su destino y evite las zonas de mucho tráfico.
• Deje suficiente espacio con el vehículo que va delante para frenar gradualmente. Cuando las condiciones meteorológicas sean adversas, se toma para frenar el doble de tiempo que
• normalmente se necesita para detenerse por completo.

The best thing you can do is to have a plan in place to keep your family safe and warm through this first taste of winter.

Take these tips from MedStar on what a winter weather plan should include:

• Make sure that you have important phone numbers, including your health care providers, pharmacy, and veterinarian.
• Assure you have enough medication for several days on hand.
• If you rely on medical devices in your home, have a backup plan in case you lose power for an extended period of time, such as a backup generator or battery pack and backup oxygen bottles.
• Have a communication plan for your family.
• Know how to get reliable information during the storm.
• Gather supplies in case you need to stay home for several days without power.

Dress Warmly

• Make sure newborns are dressed appropriately. Dress them in layers and cover their heads, hands and feet.
• For the most warmth, dress your little ones in wool instead of cotton. Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets.
• 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 of the cold. Seek immediate medical attention if you're not able to warm the body.

Keep an eye out for signs of hypothermia.

According to the Centers for Disease Control and Prevention (CDC), hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." 

Warning signs for adults include:

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech drowsiness

Warning signs for infants include:

• Bright red, cold skin
• Very low energy

Victims of hypothermia can include babies sleeping in cold rooms.

If you lose power, be very cautious of carbon monoxide.

During the Texas winter storm in February 2021, Cook Children’s treated 13 patients for carbon monoxide poisoning in one night. 

Here are some tips for keeping your family safe during this time:

• Don’t use anything such as a BBQ grill or propane tank to heat your home.
• Don’t run a vehicle inside of a garage attached to your home.
• Don’t heat your home with a gas oven or stovetop.
• Don’t burn charcoal inside your home.
• Do seek medical attention if you suspect carbon monoxide poisoning.
• Do ensure the carbon monoxide detectors in your home are properly functioning and installed in areas that will wake you if it alarms.
• Do check for local resources, such as warming shelters, to keep your family safe.

Signs of carbon monoxide poisoning can include:

• Headache
• Nausea
• Dizziness
• Vomiting
• Upset Stomach
• Chest Pain
• Confusion
• Flu-like symptoms

If you have to travel, have a plan in place to keep yourself and your child safe.

Proper car seat use is one of the most critical ways parents can keep their young children safe when driving during inclement weather conditions. Here are a few safety tips to consider:

• Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.
• Give yourself extra time to get where you are going. And don't forget to account for traffic. 
• Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.
• Avoid overpasses if possible. Plan alternate routes to your destination and avoid high traffic areas when possible.
• Give yourself enough space from the car in front of you to gradually brake. When weather conditions are poor, give yourself double the time it normally takes to come to a complete stop.

Making sure your baby stays warm on a cold winter’s night is a natural instinct for any parent. While tucking them in with a soft, cushy blanket may seem like the obvious choice to keep them cozy, it can pose a risk of sudden unexplained infant death (SUID) for infants less than 1-year-old.

In nearly 30% of SUID cases, the cause is attributed to accidental suffocation or strangulation in bed, according to the Centers for Disease Control.

In 2023, Cook Children’s recorded 15 sudden infant unexplained deaths. All of them were caused by unsafe sleep conditions, which could mean a child was suffocated by a pillow, stuffed animal, another person in the bed, a too-soft sleeping surface or a loose blanket.

“In the colder months we often see parents adding lots of layers of clothing and extra blankets to keep a baby warm in bed,” said Samantha St. John, Community Health Program Coordinator at the Center for Community Health, led by Cook Children’s. “But our recommendations for safe sleep in the winter are the same as in the summer.”

In every season, babies should sleep alone, on their backs, and in a crib or pack n’ play with a firm surface and tight fitted sheet.

Alone means nothing in the bed but baby — no person, stuffed animal, pillow or blanket. All of these pose a risk of covering the baby’s nose and mouth. Because of their limited muscle strength and control, babies are not able to move the item off of their face or move their head away, leading to suffocation.

So what is a parent concerned about their baby’s comfort to do?

St. John recommends a wearable blanket, also known as a sleep sack. Babies fit inside the sack, which has armholes, zips up to their neck and billows out down toward their feet.

“It’s an extra layer that is just like having a blanket but, when fitted and zipped properly, there is no risk of the blanket moving up around their face and causing suffocation,” St. John said.

Wearable blankets that allow a baby’s arms to be swaddled inside the sack can be used up to 8 weeks or when the baby starts to roll on their own, whichever comes first. Babies use their arms to roll over and need them free once they show signs of reaching this developmental milestone. Sleep sacks should be fitted according to the manufacturer’s recommendations based on the baby’s height, weight and age.

A good rule of thumb for adding layers for warmth is to match what the parent is wearing, plus add one layer.

“There is a risk of overheating when too many layers are added and the baby becomes too warm,” St. John said. “Babies usually run a little bit warmer than what we do. So the recommendations for how many layers to put them in is no more than one additional layer than what the parent is wearing. We’re matching the parent’s layer and then adding one more.”

For example, if the caregiver is in flannel pants and a flannel long-sleeve shirt for bedtime, then it would be appropriate to put the baby in a fleece long-sleeve onesie and then put a cotton sleep sack over that long-sleeve onesie.

Anything that can come off during sleep, like a hat, poses a risk, too. Avoid using a twin sheet to cover a crib mattress. If the too-big and ill-fitting twin sheet comes loose during sleep, the baby can become tangled.

When you are bundling a baby up for a trip out of the house, be careful of puffy coats while they are riding in a car seat. Puffy coats make it difficult to tighten the harness as snug as it should be. In an accident, the loose harness can slide off the shoulders, creating a risk of ejection from the car seat.

St. John says to use a thin layer coat, like a zip-up sweatshirt jacket, instead.

“Another good option is to strap your older infant into their car seat and then put their jacket on backward,” St. John said. “So their arms will be through the armholes with the jacket laying on top of them. It gives them that warmth, but does not interfere with the harness so that it is still tight on their shoulders.”

By choosing the right layers and avoiding loose items in your baby’s crib, you’ll rest well knowing your little one is sleeping safe and sound in the long winter months ahead.

More about safe sleep from Cook Children’s Checkup Newsroom:

• Safe Sleep Starts With Babies in Their Own Separate Sleep Area (checkupnewsroom.com)
• Safe Baby Sleep: Keep Decorating 'Extras,' Blankets Out of Infant Cribs (checkupnewsroom.com)
• Pediatrician's Advice: Straight Talk About Sleepless Nights (checkupnewsroom.com)

Wind chills are expected to be below zero degrees on Thursday, according to the National Weather Service. Be sure to dress warmly, cover up any exposed skin and limit your time outdoors. Hypothermia begins when our body temperature drops two to four degrees. 

By Thursday night, low temperatures will fall into the single digits across most of the Dallas-Fort Worth region. By Friday morning, temps will be in the teens or possibly in the single digits with high wind gusts.

People exposed to extreme cold are susceptible to frostbite in a matter of minutes. Areas most prone to frostbite are uncovered skin and the extremities, such as hands and feet.

Take these tips from MedStar on what a winter weather plan should include:

• Make sure that you have important phone numbers, including for your health care providers, pharmacy, and veterinarian.
• Assure you have enough medication for several days on hand.
• If you rely on medical devices in your home, have a backup plan in case you lose power for an extended period of time, such as a backup generator or battery pack and backup oxygen bottles.
• Have a communication plan for your family.
• Know how to get reliable information during the storm.
• Gather supplies in case you need to stay home for several days without power.

Carbon Monoxide

If the power does go out, be very cautious of carbon monoxide.

During the Texas winter storm in February 2021, Cook Children’s treated 13 patients for carbon monoxide poisoning in one night. Sam Selby, D.O., worked the overnight shift in the emergency department on Feb. 15, 2021 and saw families use propane or diesel-burning engines that are meant for outside use with adequate ventilation.

Dr. Selby described how families used generators inside or too close to their homes or garages to keep warm. Generators emit fumes and can cause carbon monoxide poisoning.

“Carbon monoxide poisoning prevents your blood from being able to bind to or carry oxygen. You suffocate while you are still breathing,” Dr. Selby explained. 

Here are some additional ways to keep your family safe during this time:

• Don’t use anything such as a BBQ grill or propane tank to heat your home.
• Don’t run a vehicle inside of a garage attached to your home.
• Don’t heat your home with a gas oven or stovetop.
• Don’t burn charcoal inside of your home. 
• Do seek medical attention if you suspect carbon monoxide poisoning.
• Do ensure the carbon monoxide detectors in your home are properly functioning and installed in areas that will wake you if it alarms.
• Do check for local resources, such as warming shelters, to keep your family safe. 

Coats & Car Seats

Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.

Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.

Dressing Warmly

When Outside

• Make sure newborns are dressed appropriately. "A good rule of thumb is to dress newborns in as many layers as you're wearing," said Diane Arnaout, M.D., Cook Children’s Medical Advisor for Digital Health. "That includes covering their heads, hands and feet. Those areas can lose a lot of heat and be harder to keep warm."
• For the most warmth, dress your little ones in wool instead of cotton. Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets.
• 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 of the cold. Seek immediate medical attention if you're not able to warm the body.

Recognizing Hypothermia

According to the Centers for Disease Control and Prevention (CDC), hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." To learn more about the warning signs of hypothermia, click on this site from the Centers for Disease Control and Prevention (CDC).

Warning signs for adults include:

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech drowsiness

Infants:

• Bright red, cold skin
• Very low energy

Victims of hypothermia can include babies sleeping in cold rooms.

Want to know more about winter weather safety? 

Check out these articles from Checkup Newsroom contributors:

• Cold Weather and Kids. How to Keep Your Family Safe at Home, Outside and in the Car. 
• Bracing for Freezing Weather: Plan Ahead to Protect Your Family on the Road
•  Common Winter Mistakes Parents Make
• Cook Children’s Sees Spike in Carbon Monoxide Poisoning Patients During Freezing Temperatures

After last February’s big freeze and mass power outages, it’s understandable to be a little uneasy about the forecast. But thankfully, this cold plunge isn’t expected to last as long as last year’s storm.

Still, it’s a good idea to have a plan in place.

Take these tips from MedStar on what a winter weather plan should include:

• Make sure that you have important phone numbers, including for your health care providers, pharmacy, and veterinarian.
• Assure you have enough medication for several days on hand.
• If you rely on medical devices in your home, have a backup plan in case you lose power for an extended period of time, such as a backup generator or battery pack and backup oxygen bottles.
• Have a communication plan for your family.
• Know how to get reliable information during the storm.
• Gather supplies in case you need to stay home for several days without power.

If the power does go out, be very cautious of carbon monoxide.

During last February’s winter storm, Cook Children’s treated 13 patients for carbon monoxide poisoning in one night. Sam Selby, D.O., worked the overnight shift in the emergency department on Feb. 15, 2021 and saw families use propane or diesel-burning engines that are meant for outside use with adequate ventilation.

In this Checkup Newsroom article, he described families using generators inside or too close to their homes or garages to keep warm. Generators emit fumes and can cause carbon monoxide poisoning.

“Carbon monoxide poisoning prevents your blood from being able to bind to or carry oxygen. You suffocate while you are still breathing,” Dr. Selby explained. 

Here are some additional ways to keep your family safe during this time:

• Don’t use anything such as a BBQ grill or propane tank to heat your home.
• Don’t run a vehicle inside of a garage attached to your home.
• Don’t heat your home with a gas oven or stovetop.
• Don’t burn charcoal inside of your home. 
• Do seek medical attention if you suspect carbon monoxide poisoning.
• Do ensure the carbon monoxide detectors in your home are properly functioning and installed in areas that will wake you if it alarms.
• Do check for local resources, such as warming shelters, to keep your family safe. 

The best bet during winter weather is to stay off the roads. 

If you have to travel, have a plan in place to keep yourself and your child safe.

Proper car seat use is one of the most critical ways parents can keep their young children safe when driving during inclement weather conditions.

“The injuries we see from car wrecks are because parents are making the same mistakes over and over with car seats,” explains Sharon Evans, trauma injury prevention coordinator at Cook Children’s.

She reminds parents to keep children calm and quiet when traveling, whether that means playing their favorite music, letting them bring a safe toy, or talking with them before leaving home.

“Children can read your emotions,” she said. “If you’re uptight, they will be able to sense it.”

More to consider before getting behind the wheel:

1. Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.
2. Give yourself extra time to get where you are going. And don't forget to account for traffic. 
3. Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.
4. Avoid overpasses if possible. Plan out alternate routes to your destination and avoid high traffic areas when possible.
5. Give yourself enough space from the car in front of you to gradually brake. When weather conditions are poor, give yourself double the time it normally takes to come to a complete stop.

Want to know more about winter weather safety? 

Check out these articles from Checkup Newsroom contributors:

• Cold Weather and Kids. How to Keep Your Family Safe at Home, Outside and in the Car. 
• Bracing for Freezing Weather: Plan Ahead to Protect Your Family on the Road
•  Common Winter Mistakes Parents Make
• Cook Children’s Sees Spike in Carbon Monoxide Poisoning Patients During Freezing Temperatures

By Michelle Bailey, M.D.

I’m writing this from home, dressed in three layers and with all unnecessary electrical items turned off. I’m anxious about when the power may go in and out, and if the water will continue dripping from the faucets. During extreme weather, with doctor’s offices closed, it may be worrisome to think about what you would do if your child is sick.

Right now with the power on, I am available, as are many other Cook Children’s Pediatric and Urgent Care clinics, to do telemedicine Zoom or phone visits. But if a medication is necessary, you’d still be responsible for going into a pharmacy to pick it up. Under some extreme circumstances, there are a few things you can find in your medicine cabinet to use in a pinch. Of course, follow any doctor recommended advice and call 911 if your child is having a medical emergency that needs immediate assistance.

The following is simply what can be done - if absolutely necessary - in extreme circumstances: 

• Heating formula or breastmilk bottles: While it’s nice to have a bottle warmer, if the power is out, it is not necessary. Your baby can and will drink milk even if it is cold. So go ahead and offer pumped breastmilk from the fridge, or mix formula powder with room temperature nursery water or even bottled water from the fridge. Room temperature breastmilk or formula should be consumed within 1-2 hours.

• Vomiting: The main goal is to keep your child hydrated. If you have powdered electrolyte solution on hand, such as Pedialyte powder packs, use this. Otherwise, offer frequent sips of water. Motion sickness medication and antihistamines, such as Dramamine and Benadryl, can also offer some relief to nausea and vomiting.

• Fever: If your child’s temperature is above 100.4F, use a weight-based dose of fever reducing medication. If you are out of medication, use natural ways to reduce temperature such as removing a layer of clothing, place cool wet rags to the forehead, armpits and back, and offer sips of cold water, popsicles or even yogurt. There is no “brain boiling” temperature, but you will want to keep your child comfortable by lowering their fever. Remember, fever is an actual thermometer measured temperature of above 100.4F, not just how warm your child feels.

• Wheezing, coughing, fast or difficulty breathing: If your child is in respiratory distress, call for an ambulance. If they are having a worsening cough or wheezing and you have a nebulizer and albuterol medication at home, start using it as directed on the prescription. It is always helpful for your child with asthma or wheezing to have a backup albuterol inhaler and spacer, in the event power goes out and you cannot use the nebulizer machine. If it has been awhile since you put together the nebulizer and tubing, here is a refresher video, click on the “using a nebulizer” tab: https://cookchildrens.org/pediatrics/McKinney/Pages/video-library.aspx. And in the most extreme of circumstances, if your child is wheezing or having trouble breathing and you are out of nebulizer medication, and/or or power is out, and you don’t have the albuterol inhaler, and you can’t drive to the emergency room, and 911 says they are 30 minutes away…. you get it, worst of worst scenarios, then offer your child some coffee or other highly caffeinated beverage. Caffeine is a weak bronchodilator, which can reduce respiratory muscle fatigue and can improve lung function for up to two hours. This is not to say coffee or soda is a replacement for your child’s prescribed inhaler, but it can make a difference when minutes matter during an impossibly unprecedented situation.

Again, call your child's pediatrician FIRST and speak to the doctor or nurse before trying any of the above. Please stay safe and stay warm!

The National Weather Service previously warned of widespread freezing rain and sleet across North and Central Texas, which left roadways wet and slick.

Going into the weekend and early next week, temperature highs will range in the teens up into the 30s, and some areas are expected to see 2-7 inches of snow. If you don’t have a reason to leave home, please stay inside, stay safe and stay warm. If you have to go out, have a plan in place and rid yourself of any distractions so you can focus on the road.

Proper car seat use is one of the most critical ways parents can keep their young children safe when driving during inclement weather conditions.

“The injuries we see from car wrecks are because parents are making the same mistakes over and over with car seats,” explains Sharon Evans, trauma injury prevention coordinator at Cook Children’s.

The American Academy of Pediatrics recommends parents keep their children rear-facing as long as they fit within the height and weight requirements printed on their car seats. Evans says another prevalent issue is the lack of transitioning children into booster seats.

“Children should be in a booster seat until they’re 4-foot-9. We often see parents letting them go into a seat belt too early,” Evans explained.

She reminds parents to keep children calm and quiet when traveling, whether that means playing their favorite music, letting them bring a safe toy, or talking with them before leaving home. “Children can read your emotions,” she said. “If you’re uptight, they will be able to sense it.”

Here are more tips for parents to consider before getting behind the wheel:

1. Leave enough time for your commute. Give yourself extra time to get your children to school and yourself to work, accounting for other drivers on the road.
2. Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.
3. Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.
4. Avoid overpasses if possible. Plan out alternate routes to your destination and avoid high traffic areas when possible.
5. Give yourself enough space from the car in front of you to gradually brake. When weather conditions are poor, give yourself double the time it normally takes to come to a complete stop.

At Home

• Don’t put blankets or other loose bedding in your infant’s sleeping environment. Instead, babies should wear one-piece sleepers or sleep sacks to keep warm while avoiding the risk of suffocation. For more information on SIDS, suffocation and co-sleeping dangers, click here.
• Make sure your home has working carbon monoxide detectors on every level, especially near bedrooms. They should be located at least 15 feet away from fuel-burning appliances. You can find more information about carbon monoxide dangers in this Checkup Newsroom story from 2015.
• Have a fire escape plan ready in case of a house fire. Make sure the whole family knows what to do if the unimaginable happens.

In the Car

• Don’t put your child in a car seat with a heavy coat on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backwards with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.
• If using a blanket over a newborn in a car seat, tuck it several inches below the child’s chin to ensure it won’t become a source of suffocation.
• Be mindful of road conditions which may increase the risk of a collision. 
• Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats and gloves available in case you become stuck in winter weather. You’ll also want to have non-perishable snacks packed away.

When Outside

• Make sure newborns are dressed appropriately. "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."
• For the most warmth, dress your little ones in wool instead of cotton. Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets. “Infants have the same temperature intolerance as adults, but they lose more heat through their heads,” said Frank McGehee, M.D., a Cook Children’s pediatrician at Fort Worth (Magnolia). “A hat is one of the most important pieces of winter clothing for infants.”
• 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 of the cold. Seek immediate medical attention if you're not able to warm the body.

Recognizing Hypothermia

According to the Centers for Disease Control and Prevention (CDC), hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures. Stay safe this winter by learning more about hypothermia, including who is most at risk, signs and symptoms, and what to do if someone develops hypothermia." To learn more about the warning signs of hypothermia, click on this site from the Centers for Disease Control and Prevention (CDC).

Warning signs for adults include:

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech drowsiness

Infants:

• Bright red, cold skin
• Very low energy

Victims of hypothermia can include babies sleeping cold rooms.

1. They don't leave enough time for their commute. Even if the roads get mildly slippery and you were born and raised in North Dakota, keep in mind that us native Texans pretty much absolutely freak out about winter weather. We'll either be taking it too slow or driving like a maniac. Give yourself some extra time to get the kids to school.
2. They leave their kids puffy coats on in the car. Car seats are not meant to be buckled around big puffy jackets. Take them off and use them as a blanket before you take off. Read more about this here. Give your child an extra second to put it back on in the school drop off line. (Yet another reason to see No. 1 above).
3. They forget to take care of their kid's skin. Get outside and play in the cold weather, but remember that sun and snow can still cause significant sunburns. Apply sunscreen like you're at the beach. Cold wind can also lead to dry, red cheeks in children of all ages. Apply some vaseline to the cheeks after being outside and at the first sign of irritation.
4. They ran out of their child's albuterol. Weather change can be a significant risk factor for children with asthma. A sharp drop in temperature often bring the wheezers into the office in droves. Make sure you have inhalers or albuterol for your nebulizer on hand (and not expired).
5. They worry about things that don't really matter. "Cover their head so they won't catch a cold." "Don't let them outside with a wet head." Here is more information about these and many other Winter Wives' Tales.

Now that you know some of my big tips for keeping your child safe when the weather turns cold, stay safe and enjoy the winter while you can!

Kids are gross.

Germs and kids are doubly gross.

As parents, we know this is true, especially during this time of year. The illness visits are piling up in my office and throughout the Cook Children's system. The days off school are starting. Missed workdays are causing stress.

We all hate this part of winter.

In my office, we're seeing lots of barky coughs from croup. We've also seen a ton of kids with sore throats from strep and viruses. Lots of fever from ear infections and flu season is just around the corner.

So what do you do? How do you survive the winter and keep your child healthy?

There's no magic vitamin. There's no magical food. There's no magical anything.

But here's something you can do: teach them not to be (as) gross.

1. Kids, stop licking and chewing stuff: Not the table, not your clothes, not your friends. There is nothing you can lick except your food, and really, you should chew it.
2. Kids, wash your hands. Several times a day. Wash them after you eat. Wash them after you go to the bathroom. Wash them just because you need to wash your hands. Get those germs off.
3. Kids, cough into the crook of your elbow. Don't cough on your classmates or your teacher (this isn't going to get you out of a test). Don't cough into your hands because then you will be spreading germs around the next time you touch someone or hand something to a classmate or sibling. 
4. Kids quit sucking your snot back up into your nose. You're driving us all crazy and making us all nauseous. It's disgusting. Really. And it's also bad for you. Get that crud out of your nose and out of your body.
5. Kids, stay home from school if you're sick. If you have a fever, it's not allergies, and no, you can't take Motrin on your way into school to make it through the day. (Ok, kids. This one was more for your parents.)

I'm sure there's more. What other lessons should we teach our kids so they won't be as gross this winter?

Stay well,

Doc Smitty

"One of the triggers of asthma symptoms are respiratory viruses and we are seeing a large number of those driving people to access Emergency Care," said Corwin Warmink, M.D., medical director of Emergency Services at Cook Children's.

Karen Schultz, M.D., medical director of Pulmonary Services, advises parents of children who have asthma to make sure they have an asthma action plan. An asthma action plan should be provided by the outpatient physician who cares for the child's asthma or, if admitted to the medical center, will be provided by the discharging nurse at Cook Children's.

The written plan helps patients develop with their doctor the methods to help control their asthma. The plan looks at the daily treatment of the patient, including medication to take and how to control asthma long term and how to handle worsening asthma, or attacks.

"General signs of initial worsening of asthma include some difficulty breathing, coughing and wheezing, problems working or playing, or waking up at night coughing," Dr. Schultz said. "At this point families should start using their rescue medications as instructed by their physician. Families should call their physician if their child has required three extra treatments in a 24 hour periods or they need them more frequently than every four hours."

Worsening signs of asthma include breathing that is hard and fast, trouble talking or walking, inability to work or play, constant coughing, or a color change in the lips and/or nail beds. At this point, rescue medications should be given and the family should seek immediate care.

To learn more about asthma, Dr. Schultz answered a few of our questions:

1.What is asthma?

Asthma is an inflammatory process that happens in the lungs that causes swelling and increased mucus down in your lungs so it makes it harder to breathe.

2.When do asthma flare ups occur?

An asthma flare up occurs when someone is exposed to a trigger of their asthma. The muscles around their airwaves actually squeeze down and make it even more difficult for people to breathe. They can also get more mucus and more swelling in their lungs, which also makes it harder.

3.What are the triggers?

People have different triggers for their asthma. The most common ones tend to be weather changes, viral infections and exposure to certain allergens. Cold, dry air can cause bad flare-ups and viral infections are the most common trigger this time of year. Parents should stress to their children the importance of handwashing, especially this time of year.

Allergens could include cats, pollen, grass and mold. Another big trigger is exposure to smoke. Exposure to second-hand smoke is a big issue with kids with asthma. Not only can it be a trigger for an asthma flare, but it can keep your child’s asthma from ever getting under control in the first place. Any parent who has a child with asthma, should not smoke. Even smoking outside exposes your child to some smoke particles and can still keep their asthma out of control.

4.Who gets asthma?

Asthma happens to people with a genetic predisposition who then have the right trigger to start their asthma flaring at the right time.

Depending on the age, asthma can be diagnosed in different ways. In very young children and toddlers, it’s diagnosed based on their symptoms and what their physician on examination. So kids that have recurrent wheezing are diagnosed with asthma.

In older kids, 5 years and up, lung function testing can be done to help determine asthma severity.

5.What are the symptoms?

Common starting symptoms of an asthma flare often are just cough. Sometimes families can start seeing the kiddos breathe harder and faster and sometimes they can actually hear them wheeze. But often the wheezing can only be heard by a physician.

If they start noticing their child is breathing very rapidly, if they are sucking their air in above their sternum or in between their ribs, then those are signs that they are really struggling to breathe and a doctor needs to take a look at them.

6.How is asthma treated?

Asthma is treated with inhaled medications generally. The most common medication we use is albuterol which helps relax the muscles that tighten down around the airwaves. However, this will not prevent asthma attacks. To prevent asthma attacks, patients are often placed on inhaled steroids to help control the swelling and mucus in their lungs so they can breathe easier.

Asthma is monitored mainly by symptoms. Your physician may ask how often you are using your rescue inhaler or your albuterol to help determine whether your asthma is under good control or not.

The best way to control your child’s asthma is for him or her to take the medication that your physician prescribes on a regular basis. Many people will think that their children’s asthma is under good control and they will stop their medications and that’s when they start having more flares of their asthma.

Everyone with asthma should have an action plan. It will list out your child’s medications and what to do when they start having symptoms. It will tell you what to do when they have mild symptoms or more severe symptoms and should direct you to the appropriate health care resource should they start having more difficulty.

When children use inhalers for their asthma, they are more effective if they use a spacer, which is generally a clear plastic tube with a mouthpiece that helps the medicine deposit into your lungs rather than stuck on your tongue if you just puff the inhaler in your mouth.

7.When should I see a pediatrician?

If your child is having an asthma attack that’s difficult to get under control, you can try doing extra albuterol treatments or extra puffs of your albuterol. If your child needs more than three extra treatments in a day, then you need to contact your physician.

Related articles

• Asthma Information from Cook Children's
• Asthma Center
• Asthma and your child
• Can my child die from asthma? Yes.
• Why asthma shouldn't be an excuse for keeping your child off the field
• Innovative program keeps kids with asthma in class - and out of hte ER

Dressing your children appropriately when the mercury plunges is particularly important. Failing to do so can result in serious harm.

To ensure your children stay safe during this bitter blast, it’s important to identify the fine line between too much clothing and too little.

“You don’t want your children to be so bundled up that they sweat and lose moisture,” said Frank McGehee, M.D., a Cook Children’s pediatrician in Fort Worth (Magnolia). “However, you also don’t want your child exposed to hypothermia by playing outside in the cold without the proper or wet clothes. The key is to dress your children in layers that can be easily put on and taken off, depending on the ages and responsibility levels of the kids.”

Essential items include hats and gloves that your kids will actually wear, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets on very cold days.

Keep in mind the following clothing tips for your children so you can properly stock their closet for winter’s arrival:

• For the most warmth, dress your little ones in wool instead of cotton.
• Make sure your children wear long underwear on particularly chilly days.
• Purchase waterproof pants and jackets to keep your children’s underlying layers of clothing dry during snowy weather.
• Don’t let your children go outside without warm gloves, socks, boots and a hat.

“Infants have the same temperature intolerance as adults, but they lose more heat through their heads,” Dr. McGehee said. “A hat is one of the most important pieces of winter clothing for infants.”

Newborns aren't able to manage their body temperature like adults can. So, as the thermostat dips, the way you handle outings with little ones needs to change.

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 recommends 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 are 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 of the cold. Seek immediate medical attention if you're not able to warm the body.

Fast forward five years and I have learned that my kids can decide for themselves what to wear to keep warm. I let them step outside in the morning and advise them that they might want pants or a jacket, but I let them decide.

Tuesday, they both went to school in shorts, but took a fleece. It was 40 degrees outside. Wednesday was the same.

They might wear pants when the temperature hits 20 degrees… maybe.

Beyond infancy, kids can self-regulate what they wear for warmth. As parents, it’s our job to provide the right clothes and then let them decide.

I encourage my parents to get their kids outside even in cold weather. If it’s above freezing, a jacket is often all they are going to need if they are active. Below freezing, a hat and gloves can be added/offered, but don't be surprised if they come off once your child is active.

Finally, even your toddler can go out and play in the cold for 30 to 60 minutes. Don't be afraid of the cold. There are wonders to discover out there and kids need to be outside. It’s good for their bodies, minds and souls. 

Related Stories

• Can I Take My Newborn Out In The Cold?
• Winter Old Wives Tales: Separating Fact From Fiction

About the author

Vanessa Charette, M.D., has been a pediatrician at Cook Children's for 10 years and is located in Fort Worth. Dr. Charette embraces the many components that contribute to health nutrition, physical activity, emotional, psychological stresses and the environment. As your pediatrician she will spend time with you discussing nutrition, child development and take the time to address any concerns you have about your child's health.

• Make sure your hair is dry.
• Wear shoes outside.
• Put on your hat.

But does any of this really matter?

Between well-meaning friends and family members and the wealth of websites devoted to health, parents are bombarded with tips and tricks to their kids healthy year round, but especially during the winter. This can make separating fact from fiction difficult.

“Not all old wives’ tales are fictitious – some are grounded in truth. However, if you have questions or hear health advice that doesn’t make sense to you, always ask your children’s pediatrician before acting on the information or simply believing a statement is true,” said Justin Smith, M.D, a pediatrician and medical advisor for Digital Health at Cook Children’s.

And now, let’s let Dr. Smith give us the facts on these five winter health myths.

Myth 1: If children go outside with wet hair or without shoes during winter months, they’ll get sick.

Many people believe that cold temperatures are responsible for the spike in illness that typically occurs during late fall and the winter months. According to Dr. Smith, people get sick in the winter because they spend more time in close proximity to one another – not because they’ve been exposed to cold weather.

The truth is it’s not really going to matter that much if your kids go outside without socks and shoes – except maybe if you don’t want dirty feet or if it’s extremely cold, your child runs the risk of frostbite.

“It’s true that we do see more colds, flu and flu-like viruses during the winter,” Dr. Smith said. “Both the life cycle of common viruses and the fact that people are more likely to be clustered inside their homes and schools when it’s cold outside, which causes viruses to circulate, contribute to this increase.”

Myth 2: People lose most of their body heat throughout their heads, so children should wear hats while playing outside in cold weather.

This tale originated in response to several studies conducted by the United States Army in the 1950s. Further research has since debunked this claim, but it’s true that your face, chest and head get colder faster when you’re exposed to winter weather.

“Your face is particularly sensitive to the cold,” Dr. Smith said. “If your children’s faces are cold while playing outside, they should wear warmer clothes. But colds come from germs – not cold temperatures – so children aren’t going to get sick if they don’t wear a hat.”

Myth 3: Feed a cold and starve a fever.

According to Dr. Smith, there’s no scientific evidence to support the idea that children should fast when running a fever. Children who are sick should eat when they feel up to it and drink plenty of fluids to prevent dehydration.

“Even if children don’t feel hungry, we ask parents to encourage their kids to drink as many liquids as they can,” Dr. Smith said. “I’ve also heard an old wives’ tale that says you shouldn’t drink milk if you’re running a fever, but milk works as well as other fluids when it comes to keeping kids hydrated. Other good choices include water, Pedialyte and Gatorade.”

Myth 4: All fevers should be treated with medicine because high fevers are dangerous.

As parents, it’s only natural to rush to the medicine cabinet at the first sign of a high temperature, but fevers aren’t always a cause for concern. In fact, they help your child’s body fight infection. According to the American Academy of Pediatrics, children’s demeanors are often better indicators of illness severity than the numbers on the thermometer. If children aren’t fussy or complaining of feeling badly, there’s no need to treat a fever unless their doctor says otherwise.

Myth 5: You can’t prevent your child from catching a cold.

While there’s no cure for the common cold, you can take steps that will reduce your child’s risk. In this case, grandma is right. These are the same steps she told you. Wash your hands after you sneeze. Wash your hands after you blow your nose. Wash your hands after you eat. See a theme? Children should sneeze into the crook of their elbow and not their hands. They should blow their nose to get rid of the mucus. For children too young to blow their noses, parents should use a blue bulb syringe and drain the child’s nose with salines. If a cold lasts longer than a week, bring your child in to see his or her pediatrician. It could possibly be a sign of acute sinusitis and may need to be treated differently than the common cold.

Some estimate that children will have 8-12 upper respiratory infections (coughs and colds) per year. Because many of those will be clustered in the winter and viral respiratory infections can last 1-2 weeks, it’s possible your child might seem to be sick “all winter long.”

Anytime a child seems to be sick off and on for months at a time, people will search for answers. Anytime people search for answers, they will start to make connections where connections don’t really exist…

So, now it’s time for: Winter Weather Health Myths

Myth No. 1 - Feed a cold and starve a fever.

I don’t care if you decide to feed a cold. If a child is hungry and not vomiting, let them eat but starving a fever doesn’t make sense. Besides, the major thing is that you need to monitor a child’s drinking when they are sick more than their eating. Dehydration is frequently what causes a child with a cold or flu to get sicker and require medical attention. You should encourage (“force”) your child to drink small, frequent sips of whatever fluid they will drink. Pedialyte or Gatorade are good options but milk is fine too (yes, even with fever).

Myth No. 2 – It’s been too cold for my child to exercise.

Maybe, for like two weeks in late January, it’s too cold for your child to exercise OUTSIDE. Otherwise, buy you and your child a sweatshirt and go for a walk. During those two weeks, you can walk circles around the house together or just do some lunges or something. Even 10 minutes a day is better than zero.

Myth No. 3 – Going outside to the cold (wet head or not) will make your child sick.

Cold weather and getting cold doesn’t actually make you sick. Getting sick is the result of being exposed to an infection that makes you sick not by getting cold. We think that viruses tend to increase in activity during winter due to the fact that people are more likely to be crowded inside.

Myth No. 4 – Taking Vitamin C (or a multivitamin or Zinc or essential oils) will protect your child from colds and flu.

The supplement industry has become big business for both adults and children as people look for anything to prevent illness. Unfortunately, study after study show that they simply don’t work. Essential oils are one of the latest to promote the ability to “boost” the immune system but studies are still lacking to show benefit in children. For now, our best bets are simple things like washing hands, covering coughs and getting the flu vaccine (I know it’s not perfect but at least it’s something).

Myth No. 5 – If you don’t like the weather in Texas, wait 5 minutes.

While not technically a myth, because weather can change fast in Texas. Good evidence is the last week. But, we’re not alone. Most of the United States believes that the phrase “If you don’t like the weather in ____, wait 5 minutes” applies to their state. A Google search ranking for this phrase puts Texas at number 8 on the states where this phrase was searched for (behind Massachusetts, New York, Georgia, Pennsylvania, Maine, South Carolina and North Carolina).

Don’t buy into the winter weather myths. Here are some tips for preventing winter weather health issues:

• Help your child eat healthy and get good sleep.
• Get your child up and active in some way every day.
• Teach your child to wash their hand and cover their coughs.
• Get your child a flu shot (it’s still not too late).

Then you walk inside, feel your arm itching and see the familiar red bumps on your arms. Mosquitoes! In December?

Why are we still seeing mosquitoes three weeks from Christmas?

For the answer, we asked Michael Merchant, Ph.D., a professor and Extension Urban Entomologist at Texas A&M University.

Merchant noticed mosquitoes over the weekend while out in the garden. But he wasn’t too surprised. After all, understanding pest management and insects is something he’s been an expert at for nearly 30 years.

“When the temperature drops below about 55 degrees, mosquitoes stop flying,” Merchant said. “We’ve already seen a major decline in mosquitoes, but we are still seeing a few of the hardier folks persisting.”

Mosquitoes don’t all die off during cold weather, they often just hide in protected spots to avoid freezing.

Mosquitoes are cold-blooded and like temperatures best in the 80s or warmer. Once the temperature drops below 55, they go away – or at least stop moving around as much. Some mosquitoes find holes or places inside to hide in until warmer weather. Others lay their eggs before the freezing weather and then die. The eggs then hatch in warmer winter.

But the risk isn’t over entirely. Merchant said it’s not unusual to see a few West Nile Cases in the Dallas/Fort Worth area into December, and this year’s warm weather has kept the insects around longer than usual.

The last bites of the year may even occur indoors. “A few mosquitoes always make their way indoors, often coming in from your doorways,” Merchant said. “Mosquitoes often hide in protected home entryways to get away from the cold.” From there it’s a short flight inside when the doors open and close.

Merchant suggests sweeping and vacuuming the upper part of your doors and around the doorway, as well as applying insecticides.

“For most of us, the threat of mosquitoes is almost over,” Merchant said. “Hopefully, by next week we will have a blast of cold weather and we won’t see them for a while.

For more information

To learn more on mosquito control around the home, Michael Merchant's website:

• Mosquito Safari Website. Go on a mosquito safari with this interactive AgriLife website. Mosquito Safari takes you on a walk through both urban and semi-rural landscapes to learn more about mosquito risks, biology and control options.
• Mosquito videos. Learn more about practical ways to make your home and landscape safer from mosquitoes, and see mosquito larvae breeding in a backyard setting.

In the state of Texas, it's illegal for anyone under 18 years of age to use an indoor UV tanning facility, even with a parent's permission. But recent studies show that the use of tanning beds can become an obsession and parents need to make sure their child is not finding a way to work around the law.

Why?

The dangers of cancer:

• Ultra-violet (UV) light in tanning bed is known to cause cancer.
• Every year, more than 170,000 cases of skin cancer related to indoor tanning are diagnosed.
• One indoor tanning session increases your risk of getting melanoma skin cancer by 20 percent.
• Melanoma is the second most common type of invasive cancer in teens and young adults and is the leading cause of cancer death in women ages 25 to 30.
• One indoor session increase your riks of getting squamous cell carinoma by 67 percent.

"While all tanning is bad, tanning bed usage exposes people to ultraviolet A rays," said Sandra Peak, M.D., a Cook Children's pediatrician in Lewisville. "UVB rays cause sunburn, but UVA rays penetrate much deeper into the skin."

Other icky health risks may also be found at your local tanning salon, including bacteria that can lead to staph infection. Regular trips to the tanning bed can also change skin texture and cause sunspots, which probably aren't what your teen is after.

So what if your child begs you to go? It's time to talk.

"Parents should sit down and discuss the risks of indoor tanning with their children," Dr. Peak said. "Melanoma has become the cancer of young people."

Instead encourage your children to use a self tanner to get that summer glow, and urge them to always apply a broad-spectrum sunscreen with a minimum sun protection factor of 15 before heading outdoors, even during winter months. Dr. Peak recommends staying away from spray tans, since the chemicals can damage delicate mucus membranes.

About the author

Sandra Peak, M.D., joined Cook Childrens Physician Network in Lewisville in 2004. Dr. Peak enjoys gardening, yoga, and boating and in her spare time can be found at the lake with her husband Jay, stepson Sage and the world’s most amazing Lab, Sugar Mae.

Then, go inside and get warm. Make hot chocolate with marshmallows. Work together to make a batch of homemade soup. Play cards, board games, or do craft projects. Build a fort or set up a tent so they can play or read books.

When parents need a break, go watch a show or read for a bit. Kids can watch cartoons or play on their mobile devices for a while.

Make some healthy snacks- make popcorn from scratch, celery sticks with peanut butter, cut up fruit and dip in chocolate or other fruit dip; cheese and crackers."

Vanessa Charette, M.D., a pediatrician in Fort Worth: My 7 year old had a blast making colored “crystals” in the kitchen all morning this week. I set him up with a tray of plastic tubes (but cups will do fine), food coloring, water and a dropper and let him mix colors and add water and the “crystals”. He ended up with six different colored bags of crystals.For supplies: All you need are craft water absorbing polyacrylamide gel crystals from a craft store and the food coloring.

We also went sledding! And I let the boys build a giant pillow blanket fort."

Joel Steelman, M.D., endocrinologist: "Entertainment could include bundling up and getting outside. Gotta be safe though with the ice and slipping risk. My daughter and I were out a little over an hour this week, ice sledding on the street. We saw lots of kids using various items – pizza pans, laundry baskets, ect. as impromptu sleds. Just need to make sure that the little ones are warmly dressed and limit outside time. That’s a good active, outside entertainment. For indoors & media that's free - board games, art projectsand puzzles.

And how to you take care of yourself as a parent: "Healthy and sanity as a parent may also include doing a family meal prep together. For me, though, cooking when I’m not rushed is enjoyable. So, I did breakfast for dinner the other night with a little help from my daughter. S’mores if you have an indoor fireplace would be a fun (although not healthy) activity as well."

Kim Mangham, M.D., pediatrician, Keller: Dr. Mangham wants to make sure all the kids are bundled up, before they enjoy the snow. But enjoy the snow! She recommends fun indoor activities such as board games and the family watching a movie together. We recommend her baked oatmeal:

Sandra Peak, M.D., pediatrician, Lewisville: In the Peak household, they have just three words: Chocolate. Chip. Cookies!

Ensure school-age children know when to wash - before eating and after playing on a playground at recess, using the restroom, and coming into contact wiht friends and classmates. Teach kids that it's important not to chew their fingernails or touch their faces.

"Hand-to-mouth transmission is a major way children are infected by viruses," said Vanessa Charette, M.D., a Cook Children's pediatrician in Fort Worth. "Keeping hands out of the mouth is a difficult behavior for certain children to master, but it's important that they do."

Little hands can pick up a lot of germs. At any given time, you have close to 150 different bacteria living on your hands, and 80 percent of illnesses are spread by direct human contact. For kids, stomach bugs, strep throat and other bacterial illnesses can spread quickly, particularly in environments such as schools and day cares.

"I also tell young children to keep their hands below their neck. They don't rub their eyes, such their fingers or pick their nose," said Kim Mangham, M.D. a Cook Children's pediatrician in Keller. "Kids can have all the germs in the world living on their hands, but they don't put their hands in their mouth, nose or eyes, they won't get sick."

Having trouble convincing your children to get with the hand hygiene program? Let them know that fighting the spread of germs can be pretty cool. A recent study published in the American Journal of Infection Control concluded that fist bumping transmits far few bacteria than handshaking.

When I came home from the hospital with my new bundle of joy last fall, the first two weeks were filled with the tasks of survival – learning to feed my son, making sure he was growing appropriately, entertaining family and friends who wanted to meet him, catching a snooze here and there, and establishing a routine. After those two weeks ended and I had barely left my house, my next plan of action was: Operation Mama Sanity! I needed to get out!

Everyday in my office I have parents who ask me when they can take their newborn babies out and about, and get into the swing of life with their new child. My answer is always the same: now! But … with a few rules.

From day one it is absolutely fine to get out into the fresh air and go for a walk in the park, or in your neighborhood, if the weather permits.Try not to go out on extremely hot or extremely cold days, and as a rule of thumb, dress your little one in as many layers as you are wearing. Make sure the baby is not exposed to direct sunlight. Most strollers these days come with a nice shade for this purpose, or you can use an umbrella.

If you’d like to go out where there are a lot of people, like a busy restaurant, grocery store, or mall, I always tell parents to try to keep their infant’s seat completely covered by a light blanket.This serves a few purposes. First, a baby’s immune system before age 6-8 weeks is still immature. If someone at the next table sneezes or coughs, its best to have this protective canopy over them so viruses and bacteria are less able to come in contact with her. Also, it keeps the baby hidden as a deterrent to well-intentioned patrons from touching your sweet little one. As nice as that is, it’s best if people don’t touch your baby during those careful first weeks. 

If it’s holiday season and you and your new baby are expected at the family get-together, don’t fret. Just politely ask that everyone wash their hands before they hold her. If you’re too shy to ask them yourself – do what I tell my patients to do – blame me! Say, “My pediatrician says everyone has to wash their hands before holding her!”  This way no one can get their feathers ruffled. Carrying a small bottle of hand sanitizer and offering it to everyone is also a great and easy way to get germy hands cleaned. If someone appears to be sick and you don’t want that person to hold your baby at all, don’t. It’s Ok. You can blame that on your pediatrician too.

Don’t be afraid to go out with your new baby – she and YOU need it! Getting fresh air, exercise and social interaction in those first few months is vital to parents, and happy parents make happy babies. 

Hope my two cents help you muster the courage to venture out! And remember, many pediatricians have slightly differing opinions about these things, so it’s best to speak with yours if you have questions.

About the author:

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.