TORONTO - It's a question all new parents — or parents new to our climate — ask at some point or another as Canadian winters descend: How much bundling do you need to do to protect babies and little children from the cold?
With the kinds of low temperatures that have been recorded lately in many parts of the country, it's critical to know how many layers little kids need to wear when they go outside. It is also crucial to understand when it's best to keep babies and toddlers indoors.
"I would say that all parents wonder about that when they're sending their children off to school or child care," says Dr. Alyson Shaw, a pediatrician at the Children's Hospital of Eastern Ontario in Ottawa and a member of the Canadian Pediatric Society's public education advisory committee.
There are rules of thumb, but the interpretation of them will depend on the parent, on the child, and on the day.
In general, groups like the Canadian Pediatric Society recommend that parents put one more layer on a child than they themselves need to stay warm.
So on a day when Mum is wearing just a winter coat over her clothing, a baby ought to wear its outfit plus a sweater and a snow suit. If Dad needs an additional layer under his winter coat, then a toddler may need two — or it may be time to think about whether outdoor activity is wise.
The pediatric society suggests that when temperatures (including wind chill) hit the -25 C mark, children should not be allowed to play outdoors. At that point, skin freezes quickly.
Frostbite is a concern with babies and little children and they need to be covered up as much as possible against the cold, experts say.
"So that means wearing a warm snowsuit, dressing in several warm layers that can be put on or taken off easily," says Shaw.
"A hat that covers the ears, because the ears can be prone to frostbite. Mittens generally keep hands warmer than gloves because the baby or child can bunch their fingers together for extra warmth. And having warm waterproof boots is important as well."
Older children can tell you if they are cold, but how can you tell with a baby or a toddler who cannot yet speak? "A good measure is if your child's hands and feet are warm, then they're warm enough," Shaw says.
Boots should be roomy enough that if a child is wearing an extra pair of socks for warmth he or she can still wiggle their toes. That's important for good circulation, she says.
Scarves aren't recommended for little children; they pose a strangulation risk. Neck warmers are a better option. Likewise, snowsuits shouldn't have drawstrings and mittens shouldn't be attached by strings. Use Velcro, clips or snaps instead.
Too little clothing is dangerous, but too much has its problems as well.
Julia Commisso suggests she has to find the fine balance with her 10-month-old son Andrew, her first child.
"Dressing him is an issue, just because he's a very warm body," says Commisso, a graphic designer in Toronto.
"I find that he's such a warm body that I tend to overdress him.... When I start to disrobe him, he's just all sweaty and hot."
Overheating should be avoided, experts say, because kids who are sweating in their outdoor gear can then get a chill.
Babies in strollers should be in dressed in the appropriate number of layers and should then have a blanket over top, says Myrna Mann, a public health nurse with Saskatoon Health Region public health services.
But parents and caregivers need to be careful to ensure that all these layers aren't blocking babies' airways. When you are outside with infants and small children they should be checked often to make sure they are warm enough and nothing is covering their mouths or noses, she says.
Skin should be checked for the telltale signs of frostbite, says Shaw. Red and swollen patches of skin are the early signs; patches of white, numb skin are a signal the frostbite is more progressed.
Children with frostbite should be brought into a warm environment immediately and put into dry and warm clothing, or wrapped in a blanket, Shaw says.
Avoid rubbing or massaging the injured skin. It's better to allow it to warm slowly, she says.
Another issue parents and caregivers need to be careful about relates to the tricky combination of car seats and snowsuits.
Some organizations recommend babies and little children not be dressed in snowsuits when they are strapped into car seats, because the bulky outerwear impedes the ability to fit the child into the seat snugly.
"There's a risk if the snow suit is overly large that the car seat buckles won't be tight enough and the baby could actually come out of the car seat," Shaw says.
"It's better, if it's cold, to put the baby in the car seat and then cover them over with a blanket that's tucked in around them after they're securely buckled in. And not to put anything under their body or behind their body that would impeded the ability of the car seat buckles to work they way they're supposed to."
But the safety expert group Parachute doesn't take this approach. The group says it's OK to put children in snowsuits into car seats, as long as the child is buckled in tightly.
Parachute is a new group that amalgamates several safety groups including Safe Kids Canada, a national injury prevention program formerly run by Toronto's Hospital for Sick Children.
Pam Fuselli, Parachute's vice-president for government and stakeholder relations, says the key is to readjust straps every time a child is buckled in.
The amount of outerwear a child is wearing can change from one day to the next with temperature fluctuations, Fuselli says, and it's important to make sure straps and buckles are snug with each use.
"If you change your child's attire, readjust those straps so that the tightness is maintained," she says.
Straps shouldn't just rest on the snowsuit, but should be tightened to the child in it — and that can be a challenge for parents, Fuselli admits.
"They can't get them tight enough. Or they think they're tight enough, but the down or whatever is in the coat compresses, (and) you've got more room there. So the message is for parents: Make sure that it is tight, regardless of what the child has on."
