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The Doctor Is In

Snow Days

Stay Safe on the Slopes

     Growing up in Colorado, winter meant snow days, sledding and ski lessons for my family. The San Francisco Bay Area winter is delightfully different with fog and rain, weather more suited to curling up by the fire with a good book. However, many Bay Area families venture to Tahoe and other winter fun destinations in order to get their fill of the white stuff. How do we prevent injury and keep our kids safe while they play in the snow? Here are some tips.
     In general, infants and children should be dressed in several thin layers to keep them warm along with boots, gloves or mittens and a hat. For older babies and young children, you can dress them in one more layer of clothing than an adult would wear in the same conditions. Set time limits on playing in the snow, and have children come inside to warm up frequently to prevent hypothermia and frostbite.  

Snow Skiing and Snowboarding
     Parents or adults should supervise young children during all skiing and snowboarding activities. Never allow your child to ski or snowboard alone. Try to avoid crowded slopes and skiing in areas with many trees or obstacles. Be sure to pick slopes that fit the ability of the skier or snowboarder.
     It’s a good idea to enroll children in classes taught by qualified ski or snowboard instructors in a program designed for children.
     For the most part, the equipment used should be fitted properly to the child. Skiers should have safety bindings that are adjusted yearly. Snowboarders should wear gloves with built-in wrist guards. And goggles are important for several reasons: First, they protect the eyes from harmful UV rays that the atmosphere filters less at high altitudes. Second, the sun’s reflection on the snow is brighter and more intense, which can damage the eye, so goggles help in that regard. And third, goggles protect the eyes from wind, ice particles or twigs and branches.
      What about helmets? According to the American Academy of Orthopedic Surgeons, there were 353,346 injuries in 2009 relating to winter sports activities in the United States. In children under age 15, about 22 percent of those were head injuries. In the last decade, there were about 40 deaths per year resulting from skiing/snowboarding accidents. Of those deaths, only 20 percent were reported to be wearing helmets at the time of the injury. In all recent studies, skiers who were wearing a helmet had better outcomes and less neurological impairment after an injury. A recent study also showed that snowboarders are 30 percent more likely to have a significant head injury than skiers. The National Ski Patrol recommends wearing a helmet while skiing or snowboarding. The most important factor in preventing injury is safe and conscientious skiing, and helmets are a second line of defense. The message here is clear: Your child (and you, for that matter!) should wear a helmet when engaged in snow or ice sports.

Sledding, Ice Skating and Snowmobiling
     Supervise children while sledding and do not sled near streets. Encourage your children to sled feet first or sitting up. More head injuries occur when children sled lying down headfirst. Steerable sleds are safer than snow disks or inner tubes. It is preferable to sled on slopes that are free of obstructions like trees or fences that could cause injury.  
      Children should only ice skate on surfaces that are designated as skating areas. The safest place to skate is at a rink. Never assume that ice on a lake or pond is safe — always double check with officials such as local police or recreation department personnel. Never allow your child to skate alone. Encourage your child to skate in the same direction as fellow skaters. Have your child wear skates that fit comfortably and provide good ankle support.
     As for snowmobiling, the American Academy of Pediatrics guidelines state that children under age 6 should never ride on snowmobiles and that children under age 16 should not be allowed to operate snowmobiles. Riders should wear goggles and a safety helmet specially approved for motorized vehicles. The driver should drive at a moderate, safe speed, which will allow enough time to react to a dangerous situation. Stay on marked trails and never snowmobile alone. Never allow your child to ride on a snowmobile with anyone who has been consuming alcohol or other drugs.
     These tips will help to keep your family safe this winter. And, remember, the American Academy of Pediatrics recommends the seasonal influenza immunization for all children and adolescents 6 months of age and older during the flu season.

Molly Spiller, M.D., F.A.A.P, is a graduate of the University of Colorado School of Medicine and practices pediatrics with The Permanente Medical Group at Kaiser Permanente in Oakland.

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